Search results for: Taiwanese version of the brief fatigue inventory

Authors: Dejene Ermias Mekango, Mussie Alemayehu, Gebremedhin Berhe Gebregergs, Araya Abrha Medhanye, Gelila Goba

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Background: Maternal near miss (MNM) can be used as a proxy indicator of maternal mortality ratio. There is a huge gap in life time risk between Sub-Saharan Africa and developed countries. In Ethiopia, a significant number of women die each year from complications during pregnancy, childbirth and the post-partum period. Besides, a few studies have been performed on MNM, and little is known regarding determinant factors. This study aims to identify determinants of MNM among women in Tigray region, Northern Ethiopia. Methods: a case-control study in hospital found in Tigray region, Ethiopia was conducted from January 30 - March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric care at six public hospitals. Clients having a life-threatening obstetric complication including haemorrhage, hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women without haemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls. Cases were selected based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (odds ratio) analyses were calculated with 95% CI. Results: The largest proportion of cases and controls was among the ages of20–29 years, accounting for37.9 %( 39) of cases and 31.7 %( 65) of controls. Roughly 90% of cases and controls were married. About two-thirds of controls and 45.6 %( 47) of cases had gestational age between 37-41 weeks. History of chronic medical conditions was reported in 55.3 %(57) of cases and 33.2%(68) of controls. Women with no formal education [AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced labor[AOR=3; 95%CI:1.44, 6.17], history of Cesarean section (C-section) [AOR=4.6; 95%CI: 1.98, 7.61] or chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM. Conclusions: The Government of Ethiopia should continue its effort to address the lack of road and health facility access as well as education, which will help reduce MNM. Work should also be continued to educate women and providers about common predictors of MNM like the history of C-section, chronic illness, and teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. The targeted follow-up to women with a history of chronic disease and C-section could also be a practical way to reduce MNM.

Keywords: maternal near miss, severe obstetric hemorrhage, hypertensive disorder, c-section, Tigray, Ethiopia

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Authors: Aderonke Olaitan Adesina

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Background: The paradigm shift to knowledge, as the key to organizational innovation and competitive advantage, has made the management of knowledge resources in organizations a mandate. A key component of the knowledge management (KM) cycle is knowledge creation, which is researched to be the result of the interaction between explicit and tacit knowledge. An effective knowledge creation process requires the use of the right model. The SECI (Socialisation, Externalisation, Combination, and Internalisation) model, proposed in 1995, is attested to be a preferred model of choice for knowledge creation activities. The model has, however, been criticized by researchers, who raise their concern, especially about its sequential nature. Therefore, this paper reviews extant literature on the practical application of each mode of the SECI model, from 1995 to date, with a view to ascertaining the relevance in modern-day KM practice. The study will establish the trends of use, with regards to the location and industry of use, and the interconnectedness of the modes. The main research question is, for organizational knowledge creation activities, is the SECI model indeed linear and sequential? In other words, does the model need to be reviewed in today’s KM practice? The review will generate a compendium of the usage of the SECI modes and propose a framework of use, based on the strength weaknesses opportunities and threats (SWOT) findings of the study. Method: This study will employ the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to investigate the usage and SWOT of the modes, in order to ascertain the success, or otherwise, of the sequential application of the modes in practice from 1995 to 2019. To achieve the purpose, four databases will be explored to search for open access, peer-reviewed articles from 1995 to 2019. The year 1995 is chosen as the baseline because it was the year the first paper on the SECI model was published. The study will appraise relevant peer-reviewed articles under the search terms: SECI (or its synonym, knowledge creation theory), socialization, externalization, combination, and internalization in the title, abstract, or keywords list. This review will include only empirical studies of knowledge management initiatives in which the SECI model and its modes were used. Findings: It is expected that the study will highlight the practical relevance of each mode of the SECI model, the linearity or not of the model, the SWOT in each mode. Concluding Statement: Organisations can, from the analysis, determine the modes of emphasis for their knowledge creation activities. It is expected that the study will support decision making in the choice of the SECI model as a strategy for the management of organizational knowledge resources, and in appropriating the SECI model, or its remodeled version, as a theoretical framework in future KM research.

Keywords: combination, externalisation, internalisation, knowledge management, SECI model, socialisation

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Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan

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Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.

Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)

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Authors: Fouzia Khanam, Tridib Chowdhury, Belal Hossain, Sajedur Rahman, Mahfuzar Rahman

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Introduction: Over the last decades, the world has achieved a noticeable success in preventing malaria. Nevertheless, malaria, a vector-borne infectious disease, remains a major public health burden globally as well as in Bangladesh. To achieve the goal of eliminating malaria, BRAC, a leading organization of Bangladesh in collaboration with government, is distributing free LLIN to the 13 endemic districts of the country. The study was conducted with the aim of assessing the gap between coverage, access, and utilization of LLIN among the people of the 13 malaria endemic districts of Bangladesh. Methods: This baseline study employed a community cross-sectional design triangulated with qualitative methods to measure households’ ownership, access and use of 13 endemic districts. A multistage cluster random sampling was employed for the quantitative part and for qualitative part a purposive sampling strategy was done. Thus present analysis included 2640 households encompassing a total of 14475 populations. Data were collected using a pre-tested structured questionnaire through one on one face-to-face interview with respondents. All analyses were performed using STATA (Version 13.0). For the qualitative part participant observation, in-depth interview, focus group discussion, key informant interview and informal interview was done to gather the contextual data. Findings: According to our study, 99.8% of households possessed at least one-bed net in both study areas. 77.4% households possessed at least two LLIN and 43.2% households had access to LLIN for all the members. So the gap between coverage and access is 34%. 91.8% people in the 13 districts and 95.1% in Chittagong Hill Tracts areas reported having had slept under a bed net the night before interviewed. And despite the relatively low access, in 77.8% of households, all the members were used the LLIN the previous night. This higher utilization compared to access might be due to the increased awareness among the community people regarding LLIN uses. However, among those people with sufficient access to LLIN, 6% of them still did not use the LLIN which reflects the behavioral failure that needs to be addressed. The major reasons for not using LLIN, identified by both qualitative and quantitative findings, were insufficient access, sleeping or living outside the home, migration, perceived low efficacy of LLIN, fear of physical side effects or feeling uncomfortable. Conclusion: Given that LLIN access and use was a bit short of the targets, it conveys important messages to the malaria control program. Targeting specific population segments and groups for achieving expected LLIN coverage is very crucial. And also, addressing behavior failure by well-designed behavioral change interventions is mandatory.

Keywords: long lasting insecticide net, malaria, malaria control programme, World Health Organisation

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Authors: Mary Jane B. Suarez

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Public speaking anxiety (PSA), also known as speech anxiety, is innumerably persistent in any traditional communication classes, especially for students who learn English as a second language. The speech anxiety intensifies when communication skills assessments have taken their toll in an online or a remote mode of learning due to the perils of the COVID-19 virus. Both teachers and students have experienced vast ambiguity on how to realize a still effective way to teach and learn speaking skills amidst the pandemic. Communication skills assessments like public speaking, oral presentations, and student reporting have defined their new meaning using Google Meet, Zoom, and other online platforms. Though using such technologies has paved for more creative ways for students to acquire and develop communication skills, the effectiveness of using such assessment tools stands in question. This mixed method study aimed to determine the factors that affected the public speaking skills of students in a communication class, to probe on the assessment gaps in assessing speaking skills of students attending online classes vis-à-vis the implementation of remote and blended modalities of learning, and to recommend ways on how to address the public speaking anxieties of students in performing a speaking task online and to bridge the assessment gaps based on the outcome of the study in order to achieve a smooth segue from online to on-ground instructions maneuvering towards a much better post-pandemic academic milieu. Using a convergent parallel design, both quantitative and qualitative data were reconciled by probing on the public speaking anxiety of students and the potential assessment gaps encountered in an online English communication class under remote and blended learning. There were four phases in applying the convergent parallel design. The first phase was the data collection, where both quantitative and qualitative data were collected using document reviews and focus group discussions. The second phase was data analysis, where quantitative data was treated using statistical testing, particularly frequency, percentage, and mean by using Microsoft Excel application and IBM Statistical Package for Social Sciences (SPSS) version 19, and qualitative data was examined using thematic analysis. The third phase was the merging of data analysis results to amalgamate varying comparisons between desired learning competencies versus the actual learning competencies of students. Finally, the fourth phase was the interpretation of merged data that led to the findings that there was a significantly high percentage of students' public speaking anxiety whenever students would deliver speaking tasks online. There were also assessment gaps identified by comparing the desired learning competencies of the formative and alternative assessments implemented and the actual speaking performances of students that showed evidence that public speaking anxiety of students was not properly identified and processed.

Keywords: blended learning, communication skills assessment, public speaking anxiety, speech anxiety

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Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

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Authors: Keivan Davami, Michael Munther, Lloyd Hackel

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The control of properties and material behavior by implementing thermal-mechanical processes is based on mechanical deformation and annealing according to a precise schedule that will produce a unique and stable combination of grain structure, dislocation substructure, texture, and dispersion of precipitated phases. The authors recently developed a thermal-mechanical technique to stabilize the microstructure of additively manufactured nickel-based superalloys even after exposure to high temperatures. However, the mechanism(s) that controls this stability is still under investigation. Laser peening (LP), also called laser shock peening (LSP), is a shock based (50 ns duration) post-processing technique used for extending performance levels and improving service life of critical components by developing deep levels of plastic deformation, thereby generating high density of dislocations and inducing compressive residual stresses in the surface and deep subsurface of components. These compressive residual stresses are usually accompanied with an increase in hardness and enhance the material’s resistance to surface-related failures such as creep, fatigue, contact damage, and stress corrosion cracking. While the LP process enhances the life span and durability of the material, the induced compressive residual stresses relax at high temperatures (>0.5Tm, where Tm is the absolute melting temperature), limiting the applicability of the technology. At temperatures above 0.5Tm, the compressive residual stresses relax, and yield strength begins to drop dramatically. The principal reason is the increasing rate of solid-state diffusion, which affects both the dislocations and the microstructural barriers. Dislocation configurations commonly recover by mechanisms such as climbing and recombining rapidly at high temperatures. Furthermore, precipitates coarsen, and grains grow; virtually all of the available microstructural barriers become ineffective.Our results indicate that by using “cyclic” treatments with sequential LP and annealing steps, the compressive stresses survive, and the microstructure is stable after exposure to temperatures exceeding 0.5Tm for a long period of time. When the laser peening process is combined with annealing, dislocations formed as a result of LPand precipitates formed during annealing have a complex interaction that provides further stability at high temperatures. From a scientific point of view, this research lays the groundwork for studying a variety of physical, materials science, and mechanical engineering concepts. This research could lead to metals operating at higher sustained temperatures enabling improved system efficiencies. The strengthening of metals by a variety of means (alloying, work hardening, and other processes) has been of interest for a wide range of applications. However, the mechanistic understanding of the often complex processes of interactionsbetween dislocations with solute atoms and with precipitates during plastic deformation have largely remained scattered in the literature. In this research, the elucidation of the actual mechanisms involved in the novel cyclic LP/annealing processes as a scientific pursuit is investigated through parallel studies of dislocation theory and the implementation of advanced experimental tools. The results of this research help with the validation of a novel laser processing technique for high temperature applications. This will greatly expand the applications of the laser peening technology originally devised only for temperatures lower than half of the melting temperature.

Keywords: laser shock peening, mechanical properties, indentation, high temperature stability

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Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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Authors: Zayd Khayi

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This paper deals with the construction and analysis of the Tamazight text corpus. The grammatical structure of the Tamazight remains poorly understood, and a lack of comparative grammar leads to linguistic issues. In order to fill this gap, even though it is small, by constructed the diachronic corpus of the Tamazight language, and elaborated the program tool. In addition, this work is devoted to constructing that tool to analyze the different aspects of the Tamazight, with its different dialects used in the north of Africa, specifically in Morocco. It also focused on three Moroccan dialects: Tamazight, Tarifiyt, and Tachlhit. The Latin version was good choice because of the many sources it has. The corpus is based on the grammatical parameters and features of that language. The text collection contains more than 500 texts that cover a long historical period. It is free, and it will be useful for further investigations. The texts were transformed into an XML-format standardization goal. The corpus counts more than 200,000 words. Based on the linguistic rules and statistical methods, the original user interface and software prototype were developed by combining the technologies of web design and Python. The corpus presents more details and features about how this corpus provides users with the ability to distinguish easily between feminine/masculine nouns and verbs. The interface used has three languages: TMZ, FR, and EN. Selected texts were not initially categorized. This work was done in a manual way. Within corpus linguistics, there is currently no commonly accepted approach to the classification of texts. Texts are distinguished into ten categories. To describe and represent the texts in the corpus, we elaborated the XML structure according to the TEI recommendations. Using the search function may provide us with the types of words we would search for, like feminine/masculine nouns and verbs. Nouns are divided into two parts. The gender in the corpus has two forms. The neutral form of the word corresponds to masculine, while feminine is indicated by a double t-t affix (the prefix t- and the suffix -t), ex: Tarbat (girl), Tamtut (woman), Taxamt (tent), and Tislit (bride). However, there are some words whose feminine form contains only the prefix t- and the suffix –a, ex: Tasa (liver), tawja (family), and tarwa (progenitors). Generally, Tamazight masculine words have prefixes that distinguish them from other words. For instance, 'a', 'u', 'i', ex: Asklu (tree), udi (cheese), ighef (head). Verbs in the corpus are for the first person singular and plural that have suffixes 'agh','ex', 'egh', ex: 'ghrex' (I study), 'fegh' (I go out), 'nadagh' (I call). The program tool permits the following characteristics of this corpus: list of all tokens; list of unique words; lexical diversity; realize different grammatical requests. To conclude, this corpus has only focused on a small group of parts of speech in Tamazight language verbs, nouns. Work is still on the adjectives, prounouns, adverbs and others.

Keywords: Tamazight (Berber) language, corpus linguistic, grammar rules, statistical methods

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Authors: Camille Aouinaït, Danilo Christen, Christoph Carlen

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Introduction: Small and Medium-sized Enterprises (SMEs) are facing different challenges such as pressures on environmental resources, the rise of downstream power, and trade liberalization. Remaining competitive by implementing innovations and engaging in collaborations could be a strategic solution. In Switzerland, the Federal Institute for Research in Agriculture (Agroscope), the Federal schools of technology (EPFL and ETHZ), Cantonal universities and Universities of Applied Sciences (UAS) can provide substantial inputs. UAS were developed with specific missions to match the labor markets and society needs. Research projects produce patents, publications and improved networks of scientific expertise. The study’s goal is to measure the contribution of UAS and research organization to innovation and the impact of collaborations with partners in the non-academic environment in Swiss traditional fruit production. Materials and methods: The European projects Traditional Food Network to improve the transfer of knowledge for innovation (TRAFOON) and Social Impact Assessment of Productive Interactions between science and society (SIAMPI) frame the present study. The former aims to fill the gap between the needs of traditional food producing SMEs and innovations implemented following European projects. The latter developed a method to assess the impacts of scientific research. On one side, interviews with market players have been performed to make an inventory of needs of Swiss SMEs producing apricots and berries. The participative method allowed matching the current needs and the existing innovations coming from past European projects. Swiss stakeholders (e.g. producers, retailers, an inter-branch organization of fruits and vegetables) directly rated the needs on a five-Likert scale. To transfer the knowledge to SMEs, training workshops have been organized for apricot and berries actors separately, on specific topics. On the other hand, a mapping of a social network is drawn to characterize the links between actors, with a focus on the Swiss canton of Valais and UAS Valais Wallis. Type and frequency of interactions among actors have identified thanks to interviews. Preliminary results: A list of 369 SMEs needs grouped in 22 categories was produced with 37 fulfilled questionnaires. Swiss stakeholders rated 31 needs very important. Training workshops on apricot are focusing on varietal innovations, storage, disease (bacterial blight), pest (Drosophila suzukii), sorting and rootstocks. Entrepreneurship was targeted through trademark discussions in berry production. The UAS Valais Wallis collaborated on a few projects with Agroscope along with industries, at European and national levels. Political and public bodies interfere with the central area of agricultural vulgarization that induces close relationships between the research and the practical side. Conclusions: The needs identified by Swiss stakeholders are becoming part of training workshops to incentivize innovations. The UAS Valais Wallis takes part in collaboration projects with the research environment and market players that bring innovations helping SMEs in their contextual environment. Then, a Strategic Research and Innovation Agenda will be created in order to pursue research and answer the issues facing by SMEs.

Keywords: agriculture, innovation, knowledge transfer, university and research collaboration

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Authors: Aarif Hussain, Afnan Tariq

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In recent years, microfinance has emerged as a critical tool for promoting financial inclusion and empowering marginalized communities, particularly women. In India, where poverty and lack of access to financial services continue to be significant challenges for many, microfinance has the potential to provide much-needed support to women with disabled children. These women face unique challenges, including discrimination, lack of access to education and employment, and limited support systems, making it even more difficult for them to break out of poverty and provide for their families. Microfinance, by providing small loans, savings products, and other financial services, can help these women to start or grow businesses, build assets, and achieve financial independence. India has adhered to an SHG-bank linkage model of microfinance since 1980, and programs like IRDP and SGSY were initiatives in the same direction. In the year 2011, India launched DAY-NRLM, a restructured version of SGSY. DAY-NRLM is an SHG-based microfinance program targeting the rural women of India. It aims to organise these poor women into SHGs and link them to banking institutions for creating sustainable livelihoods. The program has a reservation for disabled women but has no special status for mothers with disabled children. The impact of microfinance on women with disabilities and their families has been well documented. Studies have shown that women participating in microfinance programs are more likely to start businesses, increase their income, and improve their standard of living. Furthermore, these women are more likely to invest in their children's education and health, which can have long-term positive effects on their family’s well-being. In the Union territory of Jammu and Kashmir, the programme started in 2013 and is running smoothly to date. Women with children having a disability have not been documented as a category within the programme. The core aspect of this study is to delve into these women’s lives and analyse the impact of SHG membership on their lives and their children. The participants were selected purposively. For data collection, in-depth interviews were conducted. The findings of the paper show that microfinance has the potential to play a significant role in promoting financial inclusion and empowering women with children having disabilities in Kashmir. By providing access to small loans, savings products, and other financial services, microfinance can help these women to start or grow businesses, build assets, and achieve financial independence. However, more work is needed to ensure that these women have equal access to financial services and opportunities and that microfinance institutions are equipped to effectively serve this population. Working together to address these challenges can create a brighter future for women with children having disabilities and their families in India.

Keywords: DAY-NRLM, microfinance, SHGs, women, disabled children

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

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Authors: Norsuhana Omar, Amilia Aminuddina Zaiton Zakaria, Raifana Rosa Mohamad Sattar, Kalaivani Chellappan, Mohd Alauddin Mohd Ali, Norizam Salamt, Zanariyah Asmawi, Norliza Saari, Aini Farzana Zulkefli, Nor Anita Megat Mohd. Nordin

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Inflammation plays an important role in the pathogenesis of vascular dysfunction leading to arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AS), as tools for the assessment of vascular damages are widely used and have been shown to predict cardiovascular disease (CVD). C-reactive protein (CRP) is a marker of inflammation. Several studies noted that regular exercise is associated with reduced arterial stiffness. The lack of exercise among Malaysians and the increasing CVD morbidity and mortality among young men are of concern. In Malaysia data on the workplace exercise intervention is scarce. A programme was designed to enable subjects to increase their level of walking as part of their daily work routine and self-monitored by using pedometers. The aim of this study to evaluate the reducing of inflammation by measuring CRP and improvement arterial stiffness measured by carotid femoral PWV (PWVCF) and AI. A total of 70 young men (20 - 40 years) who were sedentary, achieving less than 5,000 steps/day in casual walking with 2 or more cardiovascular risk factors were recruited in Institute of Vocational Skills for Youth (IKBN Hulu Langat). Subjects were randomly assigned to a control (CG) (n=34; no change in walking) and pedometer group (PG) (n=36; minimum target: 8,000 steps/day). The CRP was measured by using immunological method while PWVCF and AI were measured using Vicorder. All parameters were measured at baseline and after 12 weeks. Data for analysis was conducted using Statistical Package of Social Sciences Version 22 (SPSS Inc., Chicago, IL, USA). At post intervention, the CG step counts were similar (4983 ± 366vs 5697 ± 407steps/day). The PG increased step count from 4996 ± 805 to 10,128 ±511 steps/day (P<0.001). The PG showed significant improvement in anthropometric variables and lipid (time and group effect p<0.001). For vascular assessment, the PG showed significantly decreased for time and effect (p<0.001) for PWV (7.21± 0.83 to 6.42 ± 0.89) m/s; AI (11.88± 6.25 to 8.83 ± 3.7) % and CRP (pre= 2.28 ± 3.09, post=1.08± 1.37mg/L). However, no changes were seen in CG. As a conclusion, a pedometer-based walking programme may be an effective strategy for promoting increased daily physical activity which reduces cardiovascular risk markers and thus improve cardiovascular health in terms of inflammation and arterial stiffness. The community intervention for health maintenance has potential to adopt walking as an exercise and adopting vascular fitness index as the performance measuring tools.

Keywords: arterial stiffness, exercise, inflammation, pedometer

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Authors: Faidon Kyriakou, William Dempster, David Nash

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Abdominal Aortic Aneurysm (AAA) is a major life-threatening pathology for which modern approaches reduce the need for open surgery through the use of stenting. The success of stenting though is sometimes jeopardized by the final position of the stent graft inside the human artery which may result in migration, endoleaks or blood flow occlusion. Herein, a finite element (FE) model of the commercial medical device AnacondaTM (Vascutek, Terumo) has been developed and validated in order to create a numerical tool able to provide useful clinical insight before the surgical procedure takes place. The AnacondaTM device consists of a series of NiTi rings sewn onto woven polyester fabric, a structure that despite its column stiffness is flexible enough to be used in very tortuous geometries. For the purposes of this study, a FE model of the device was built in Abaqus® (version 6.13-2) with the combination of beam, shell and surface elements; the choice of these building blocks was made to keep the computational cost to a minimum. The validation of the numerical model was performed by comparing the deployed position of a full stent graft device inside a constructed AAA with a duplicate set-up in Abaqus®. Specifically, an AAA geometry was built in CAD software and included regions of both high and low tortuosity. Subsequently, the CAD model was 3D printed into a transparent aneurysm, and a stent was deployed in the lab following the steps of the clinical procedure. Images on the frontal and sagittal planes of the experiment allowed the comparison with the results of the numerical model. By overlapping the experimental and computational images, the mean and maximum distances between the rings of the two models were measured in the longitudinal, and the transverse direction and, a 5mm upper bound was set as a limit commonly used by clinicians when working with simulations. The two models showed very good agreement of their spatial positioning, especially in the less tortuous regions. As a result, and despite the inherent uncertainties of a surgical procedure, the FE model allows confidence that the final position of the stent graft, when deployed in vivo, can also be predicted with significant accuracy. Moreover, the numerical model run in just a few hours, an encouraging result for applications in the clinical routine. In conclusion, the efficient modelling of a complicated structure which combines thin scaffolding and fabric has been demonstrated to be feasible. Furthermore, the prediction capabilities of the location of each stent ring, as well as the global shape of the graft, has been shown. This can allow surgeons to better plan their procedures and medical device manufacturers to optimize their designs. The current model can further be used as a starting point for patient specific CFD analysis.

Keywords: AAA, efficiency, finite element analysis, stent deployment

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Authors: Kenneth Okelo, Esther Waithaka, Maureen Mweru

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Development of oral language skills is a precursor to writing and reading acquisition. Oral skill is a means of communication through which people express their desires, ideas, excitements, amusements, disappointments and exchange information. In addition, oral skills have been found to be an important tool for thinking and concept development in children. Research carried out in industrialised countries have identified some appropriate teaching strategies used to enhance acquisition of oral language skills such as repetition, substitution, explanation, contrast, exemplification and code-switching. However, these studies’ geographical locations do not reflect the diversity of the Kenyan society. In addition, studies conducted in Kenya in the past have not established why pre-primary school teachers are not using appropriate teaching strategies. The purpose of this study was to find out whether teachers’ experience, academic qualification and type of training influences their choice of teaching strategies in the development of oral language skills inside and out of the classroom in selected preschools in Kibra Sub-County, Nairobi County. In addition, this study aimed at finding out the strategies used by teachers in Kibra Sub-County to promote oral skills development among pre-primary school children. The study was guided by Holdaway’s theory of language acquisition. Descriptive survey design was employed during this study. Questionnaires and observation schedules were used to collect data. Eighty-three (83) preschool teachers were sampled using multistage sampling methods for observation. Data was analysed using SPSS version 20. The researcher carried out content analysis on the qualitative data. The main descriptive methods used were tabulation of frequencies and percentages. Chi squire test was the inferential statistic used to test the relationship between variables. The main findings of the study indicate that teaching strategies that were mostly used by pre-primary school teachers were code-switching, examples, repetition, substitution and explanation. While questions, direction, expansion of children words and contrast were the least used teaching strategies when teaching oral language skills. The study revealed that the there is a slight correlation between the type of training of teachers and the teaching strategies as most of DICECE trained teachers used more teaching strategies when teaching oral skills compared to other teachers. The findings also revealed that there was a partial significant correlation between teacher’s academic qualifications and a few teaching strategies. A similar correlation was also observed between teaching experience and a few teaching strategies. Since the strategies used by pre-primary school teachers under the study were less than half of the recommended teaching strategies to promote oral skills, the study recommends that teachers should be encouraged to use more in structural strategies to improve children’s oral language skills.

Keywords: Kenya early childhood education, Kenya education, oral language skills acquisition, teaching methods

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Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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Authors: Julio Jesus Salazar, Manuel Andres Jesus De Lama

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There are very few models that serve to analyze the use of water in the socio-economic process. On the supply side, the joint use of groundwater has been considered in addition to the simple limits on the availability of surface water. In addition, we have worked on waterlogging and the effects on water quality (mainly salinity). In this paper, a 'complex' water economy is examined; one in which demands grow differentially not only within but also between sectors, and one in which there are limited opportunities to increase consumptive use. In particular, high-value growth, the growth of the production of irrigated crops of high value within the basins of the case study, together with the rapidly growing urban areas, provides a rich context to examine the general problem of water management at the basin level. At the same time, the long-term aridity of nature has made the eco-environment in the basins located on the coast of Peru very vulnerable, and the exploitation and immediate use of water resources have further deteriorated the situation. The presented methodology is the optimization with embedded simulation. The wide basin simulation of flow and water balances and crop growth are embedded with the optimization of water allocation, reservoir operation, and irrigation scheduling. The modeling framework is developed from a network of river basins that includes multiple nodes of origin (reservoirs, aquifers, water courses, etc.) and multiple demand sites along the river, including places of consumptive use for agricultural, municipal and industrial, and uses of running water on the coast of Peru. The economic benefits associated with water use are evaluated for different demand management instruments, including water rights, based on the production and benefit functions of water use in the urban agricultural and industrial sectors. This work represents a new effort to analyze the use of water at the regional level and to evaluate the modernization of the integrated management of water resources and socio-economic territorial development in Peru. It will also allow the establishment of policies to improve the process of implementation of the integrated management and development of water resources. The input-output analysis is essential to present a theory about the production process, which is based on a particular type of production function. Also, this work presents the Computable General Equilibrium (CGE) version of the economic model for water resource policy analysis, which was specifically designed for analyzing large-scale water management. As to the platform for CGE simulation, GEMPACK, a flexible system for solving CGE models, is used for formulating and solving CGE model through the percentage-change approach. GEMPACK automates the process of translating the model specification into a model solution program.

Keywords: water economy, simulation, modeling, integration

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Alexandru-Ion Marinescu

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There exist a plethora of methods in the scientific literature which tackle the well-established task of credit score evaluation. In its most abstract form, a credit scoring algorithm takes as input several credit applicant properties, such as age, marital status, employment status, loan duration, etc. and must output a binary response variable (i.e. “GOOD” or “BAD”) stating whether the client is susceptible to payment return delays. Data imbalance is a common occurrence among financial institution databases, with the majority being classified as “GOOD” clients (clients that respect the loan return calendar) alongside a small percentage of “BAD” clients. But it is the “BAD” clients we are interested in since accurately predicting their behavior is crucial in preventing unwanted loss for loan providers. We add to this whole context the constraint that the algorithm must yield an actual, tractable mathematical formula, which is friendlier towards financial analysts. To this end, we have turned to genetic algorithms and genetic programming, aiming to evolve actual mathematical expressions using specially tailored mutation and crossover operators. As far as data representation is concerned, we employ a very flexible mechanism – LINQ expression trees, readily available in the C# programming language, enabling us to construct executable pieces of code at runtime. As the title implies, they model trees, with intermediate nodes being operators (addition, subtraction, multiplication, division) or mathematical functions (sin, cos, abs, round, etc.) and leaf nodes storing either constants or variables. There is a one-to-one correspondence between the client properties and the formula variables. The mutation and crossover operators work on a flattened version of the tree, obtained via a pre-order traversal. A consequence of our chosen technique is that we can identify and discard client properties which do not take part in the final score evaluation, effectively acting as a dimensionality reduction scheme. We compare ourselves with state of the art approaches, such as support vector machines, Bayesian networks, and extreme learning machines, to name a few. The data sets we benchmark against amount to a total of 8, of which we mention the well-known Australian credit and German credit data sets, and the performance indicators are the following: percentage correctly classified, area under curve, partial Gini index, H-measure, Brier score and Kolmogorov-Smirnov statistic, respectively. Finally, we obtain encouraging results, which, although placing us in the lower half of the hierarchy, drive us to further refine the algorithm.

Keywords: expression trees, financial credit scoring, genetic algorithm, genetic programming, symbolic evolution

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Authors: Waseem Makai

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The term ‘political Islam’ now seem to have gained the centre stage in every discourse pertaining to Islamic legitimacy and compatibility in modern civilisations. A never ceasing tradition of the philosophy of caliphate that has kept overriding the options of any alternate political institution in the Muslim world still permeates a huge faction of believers. Fully accustomed with the proliferation of changes and developments in individual, social and natural dispositions of the world, Islamic theologians retaliated to this flux through both conventional and modernist approaches. The so-called conventional approach was quintessential of the interpretations put forth by Syed Maududi, with new comprehensive, academic and powerful vigour, as never seen before. He generated the avant-garde scholarship which would bear testimony to his statements, made to uphold the political institution of Islam as supreme and noble. However, it was not his trait to challenge the established views but to codify them in such a bracket which a man of the 20th century would find captivating to his heart and satisfactory to his rationale. The delicate microcosms like selection of a caliph, implementation of Islamic commandments (Sharia), interest free banking sectors, imposing tax (Jazyah) on non-believers, waging the holy crusade (Jihad) for the expansion of Islamic boundaries, stoning for committing adulteration and capital punishment for apostates were all there in his scholarship which he spent whole of his life defending in the best possible manner. What and where did he went wrong with all this, was supposedly to be notified later, by his once been disciple, Javed Ahmad Ghamidi. Ghamidi is being accused of struggling between Scylla and Charybdis as he tries to remain steadfast to his basic Islamic tenets while modernising their interpretations to bring them in harmony with the Western ideals of democracy and liberty. His blatant acknowledgement of putting democracy at a high pedestal, calling the implementation of Sharia a non-mandatory task and denial to bracket people in the categories of Zimmi and Kaafir fully vindicates his stance against conventional narratives like that of Syed Maududi. Ghamidi goes to the extent of attributing current forms of radicalism and extremism, as exemplified in the operations of organisations like ISIS in Iraq and Syria and Tehreek-e-Taliban in Pakistan, to such a version of political Islam as upheld not only by Syed Maududi but by other prominent theologians like Ibn-Timyah, Syed Qutub and Dr. Israr Ahmad also. Ghamidi is wretched, in a way that his allegedly insubstantial claims gained him enough hostilities to leave his homeland when two of his close allies were brutally murdered. Syed Maududi and Javed Ghamidi, both stand poles apart in their understanding of Islam and its political domain. Who has the appropriate methodology, scholarship and execution in his mode of comprehension, is an intriguing task, worth carrying out in detail.

Keywords: caliphate, democracy, ghamidi, maududi

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Authors: Eva Masson, Andrea Kübler

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Anxiety disorders (AD) are the most prevalent psychological disorders. However, far from most affected individuals are diagnosed and receive treatment. This gap is probably due to the diagnosis criteria, relying on symptoms (according to the DSM-5 definition) with no objective biomarker. Approach-avoidance conflict tasks are one common approach to simulate such disorders in a lab setting, with most of the paradigms focusing on the relationships between behavior and neurophysiology. Approach-avoidance conflict tasks typically place participants in a situation where they have to make a decision that leads to both positive and negative outcomes, thereby sending conflicting signals that trigger the Behavioral Inhibition System (BIS). Furthermore, behavioral validation of such paradigms adds credibility to the tasks – with overt conflict behavior, it is safer to assume that the task actually induced a conflict. Some of those tasks have linked asymmetrical frontal brain activity to induced conflicts and the BIS. However, there is currently no consensus for the direction of the frontal activation. The authors present here a modified version of the T-Maze paradigm, a motivational conflict desktop task, in which behavior is recorded simultaneously to the recording of high-density EEG (HD-EEG). Methods: In this within-subject design, HD-EEG and behavior of 35 healthy participants was recorded. EEG data was collected with a 128 channels sponge-based system. The motivational conflict desktop task consisted of three blocks of repeated trials. Each block was designed to record a slightly different behavioral pattern, to increase the chances of eliciting conflict. This variety of behavioral patterns was however similar enough to allow comparison of the number of trials categorized as ‘overt conflict’ between the blocks. Results: Overt conflict behavior was exhibited in all blocks, but always for under 10% of the trials, in average, in each block. However, changing the order of the paradigms successfully introduced a ‘reset’ of the conflict process, therefore providing more trials for analysis. As for the EEG correlates, the authors expect a different pattern for trials categorized as conflict, compared to the other ones. More specifically, we expect an elevated alpha frequency power in the left frontal electrodes at around 200ms post-cueing, compared to the right one (relative higher right frontal activity), followed by an inversion around 600ms later. Conclusion: With this comprehensive approach of a psychological mechanism, new evidence would be brought to the frontal asymmetry discussion, and its relationship with the BIS. Furthermore, with the present task focusing on a very particular type of motivational approach-avoidance conflict, it would open the door to further variations of the paradigm to introduce different kinds of conflicts involved in AD. Even though its application as a potential biomarker sounds difficult, because of the individual reliability of both the task and peak frequency in the alpha range, we hope to open the discussion for task robustness for neuromodulation and neurofeedback future applications.

Keywords: anxiety, approach-avoidance conflict, behavioral inhibition system, EEG

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Authors: Diane Ghanem, Oscar Covarrubias, Michael Raad, Dawn LaPorte, Babar Shafiq

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Introduction: Standardized exams have long been considered a cornerstone in measuring cognitive competency and academic achievement. Their fixed nature and predetermined scoring methods offer a consistent yardstick for gauging intellectual acumen across diverse demographics. Consequently, the performance of artificial intelligence (AI) in this context presents a rich, yet unexplored terrain for quantifying AI's understanding of complex cognitive tasks and simulating human-like problem-solving skills. Publicly available AI language models such as ChatGPT have demonstrated utility in text generation and even problem-solving when provided with clear instructions. Amidst this transformative shift, the aim of this study is to assess ChatGPT’s performance on the orthopaedic surgery in-training examination (OITE). Methods: All 213 OITE 2021 web-based questions were retrieved from the AAOS-ResStudy website. Two independent reviewers copied and pasted the questions and response options into ChatGPT Plus (version 4.0) and recorded the generated answers. All media-containing questions were flagged and carefully examined. Twelve OITE media-containing questions that relied purely on images (clinical pictures, radiographs, MRIs, CT scans) and could not be rationalized from the clinical presentation were excluded. Cohen’s Kappa coefficient was used to examine the agreement of ChatGPT-generated responses between reviewers. Descriptive statistics were used to summarize the performance (% correct) of ChatGPT Plus. The 2021 norm table was used to compare ChatGPT Plus’ performance on the OITE to national orthopaedic surgery residents in that same year. Results: A total of 201 were evaluated by ChatGPT Plus. Excellent agreement was observed between raters for the 201 ChatGPT-generated responses, with a Cohen’s Kappa coefficient of 0.947. 45.8% (92/201) were media-containing questions. ChatGPT had an average overall score of 61.2% (123/201). Its score was 64.2% (70/109) on non-media questions. When compared to the performance of all national orthopaedic surgery residents in 2021, ChatGPT Plus performed at the level of an average PGY3. Discussion: ChatGPT Plus is able to pass the OITE with a satisfactory overall score of 61.2%, ranking at the level of third-year orthopaedic surgery residents. More importantly, it provided logical reasoning and justifications that may help residents grasp evidence-based information and improve their understanding of OITE cases and general orthopaedic principles. With further improvements, AI language models, such as ChatGPT, may become valuable interactive learning tools in resident education, although further studies are still needed to examine their efficacy and impact on long-term learning and OITE/ABOS performance.

Keywords: artificial intelligence, ChatGPT, orthopaedic in-training examination, OITE, orthopedic surgery, standardized testing

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Authors: Francis Gyapong, Denis Yar

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The use of cell phones has become an indispensable tool in the hospital's settings. Cell phones are used in hospitals without restrictions regardless of their unknown microbial load. However, the indiscriminate use of mobile devices, especially at health facilities, can act as a vehicle for transmitting pathogenic bacteria and other microorganisms. These potential pathogens become exogenous sources of infection for the patients and are also a potential health hazard for self and as well as family members. These are a growing problem in many health care institutions. Innovations in mobile communication have led to better patient care in diabetes, asthma, and increased in vaccine uptake via SMS. Notwithstanding, the use of cell phones can be a great potential source for nosocomial infections. Many studies reported heavy microbial contamination of cell phones among healthcare workers and communities. However, limited studies have been reported in our region on bacterial contamination on cell phones among healthcare workers. This study assessed microbial contamination of cell phones of health care workers (HCWs) at the Mampong Municipal Government Hospital (MMGH), Ghana. A cross-sectional design was used to characterize bacterial microflora on cell phones of HCWs at the MMGH. A total of thirty-five (35) swab samples of cell phones of HCWs at the Laboratory, Dental Unit, Children’s Ward, Theater and Male ward were randomly collected for laboratory examinations. A suspension of the swab samples was each streak on blood and MacConkey agar and incubated at 37℃ for 48 hours. Bacterial isolates were identified using appropriate laboratory and biochemical tests. Kirby-Bauer disc diffusion method was used to determine the antimicrobial sensitivity tests of the isolates. Data analysis was performed using SPSS version 16. All mobile phones sampled were contaminated with one or more bacterial isolates. Cell phones from the Male ward, Dental Unit, Laboratory, Theatre and Children’s ward had at least three different bacterial isolates; 85.7%, 71.4%, 57.1% and 28.6% for both Theater and Children’s ward respectively. Bacterial contaminants identified were Staphylococcus epidermidis (37%), Staphylococcus aureus (26%), E. coli (20%), Bacillus spp. (11%) and Klebsiella spp. (6 %). Except for the Children ward, E. coli was isolated at all study sites and predominant (42.9%) at the Dental Unit while Klebsiella spp. (28.6%) was only isolated at the Children’s ward. Antibiotic sensitivity testing of Staphylococcus aureus indicated that they were highly sensitive to cephalexin (89%) tetracycline (80%), gentamycin (75%), lincomycin (70%), ciprofloxacin (67%) and highly resistant to ampicillin (75%). Some of these bacteria isolated are potential pathogens and their presence on cell phones of HCWs could be transmitted to patients and their families. Hence strict hand washing before and after every contact with patient and phone be enforced to reduce the risk of nosocomial infections.

Keywords: mobile phones, bacterial contamination, patients, MMGH

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Authors: Vidhya Venugopal, Rekha S.

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Introduction: Climate change and the growing frequency of higher average temperatures and heat waves have detrimental health effects, especially for certain vulnerable groups with limited socioeconomic status (SES) or physiological capacity to adapt to or endure high temperatures. Little research has been conducted on the effects of heat stress on pregnant women and fetuses in tropical regions such as India. Very high ambient temperatures may worsen Adverse Pregnancy Outcomes (APOs) and are a major worry in the scenario of climate change. The relationship between rising temperatures and APO must be better understood in order to design more effective interventions. Methodology: We conducted an observational cohort study involving 865 pregnant women in various districts of Tamil Nadu districts between 2014 and 2021. Physiological Heat Strain Indicators (HSI) such as morning and evening Core Body Temperature (CBT) and Urine Specific Gravity (USG) were monitored using an infrared thermometer and refractometer, respectively. A validated, modified version of the HOTHAPS questionnaire was utilised to collect self-reported health symptoms. A follow-up was undertaken with the mothers to collect information regarding birth outcomes and APOs, such as spontaneous abortions, stillbirths, Preterm Birth (PTB), birth abnormalities, and Low Birth Weight (LBW). Major findings of the study: According to the findings of our study, ambient temperatures (mean WBGT°C) were substantially higher (>28°C) for approximately 46% of women performing moderate daily life activities. 82% versus 43% of these women experienced dehydration and heat-related complaints. 34% of women had USG >1.020, which is symptomatic of dehydration. APOs, which include spontaneous abortions, were prevalent at 2.2%, stillbirth/preterm birth/birth abnormalities were prevalent at 2.2%, and low birth weight was prevalent at 16.3%. With exposures to WBGT>28°C, the incidence of miscarriage or unexpected abortion rose by approximately 2.7 times (95% CI: 1.1-6.9). In addition, higher WBGT exposures were associated with a 1.4-fold increased risk of unfavorable birth outcomes (95% Confidence Interval [CI]: 1.02-1.09). The risk of spontaneous abortions was 2.8 times higher among women who conceived during the hotter months (February – September) compared to those women who conceived in the cooler months (October – January) (95% CI: 1.04-7.4). Positive relationships between ambient heat and APOs found in this study necessitate further exploration into the underlying factors for extensive cohort studies to generate information to enable the formulation of policies that can effectively protect these women against excessive heat stress for enhanced maternal and fetal health.

Keywords: heat exposures, community, pregnant women, physiological strain, adverse outcome, interventions

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Authors: Christian Andrä, Pauline Hähner, Sebastian Ludyga

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Introduction: In the recent past, discussions on the importance of physical activity for child development have contributed to a growing interest in executive functions, which refer to cognitive processes. By controlling, modulating and coordinating sub-processes, they make it possible to achieve superior goals. Major components include working memory, inhibition and cognitive flexibility. While executive functions can be trained easily in school children, there are still research deficits regarding the trainability during preschool age. Methodology: This quasi-experimental study with pre- and post-design analyzes 23 children [age: 5.0 (mean value) ± 0.7 (standard deviation)] from four different sports groups. The intervention group was made up of 13 children (IG: 4.9 ± 0.6), while the control group consisted of ten children (CG: 5.1 ± 0.9). Between pre-test and post-test, children from the intervention group participated special games that train executive functions (i.e., changing rules of the game, introduction of new stimuli in familiar games) for ten units of their weekly sports program. The sports program of the control group was not modified. A computer-based version of the Eriksen Flanker Task was employed in order to analyze the participants’ inhibition ability. In two rounds, the participants had to respond 50 times and as fast as possible to a certain target (direction of sight of a fish; the target was always placed in a central position between five fish). Congruent (all fish have the same direction of sight) and incongruent (central fish faces opposite direction) stimuli were used. Relevant parameters were response time and accuracy. The main objective was to investigate whether children from the intervention group show more improvement in the two parameters than the children from the control group. Major findings: The intervention group revealed significant improvements in congruent response time (pre: 1.34 s, post: 1.12 s, p<.01), while the control group did not show any statistically relevant difference (pre: 1.31 s, post: 1.24 s). Likewise, the comparison of incongruent response times indicates a comparable result (IG: pre: 1.44 s, post: 1.25 s, p<.05 vs. CG: pre: 1.38 s, post: 1.38 s). In terms of accuracy for congruent stimuli, the intervention group showed significant improvements (pre: 90.1 %, post: 95.9 %, p<.01). In contrast, no significant improvement was found for the control group (pre: 88.8 %, post: 92.9 %). Vice versa, the intervention group did not display any significant results for incongruent stimuli (pre: 74.9 %, post: 83.5 %), while the control group revealed a significant difference (pre: 68.9 %, post: 80.3 %, p<.01). The analysis of three out of four criteria demonstrates that children who took part in a special sports program improved more than children who did not. The contrary results for the last criterion could be caused by the control group’s low results from the pre-test. Conclusion: The findings illustrate that inhibition can be trained as early as in preschool age. The combination of familiar games with increased requirements for attention and control processes appears to be particularly suitable.

Keywords: executive functions, flanker task, inhibition, preschool children

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Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera

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Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.

Keywords: abuse, child, gender differences, sexual

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Authors: Regis Pochon, Nicolas Stefaniak, Veronique Baltazart, Pamela Gobin

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Anxiety is known to have an impact on working memory. In reasoning or memory tasks, individuals with anxiety tend to show longer response times and poorer performance. Furthermore, there is a memory bias for negative information in anxiety. Given the crucial role of working memory in lexical learning, anxious students may encounter more difficulties in learning to read and spell. Anxiety could even affect an earlier learning, that is the activation of phonological representations, which are decisive for the learning of reading and writing. The aim of this study is to compare the access to phonological representations of beginning readers and writers according to their level of anxiety, using an auditory lexical decision task. Eighty students of 6- to 9-years-old completed the French version of the Revised Children's Manifest Anxiety Scale and were then divided into four anxiety groups according to their total score (Low, Median-Low, Median-High and High). Two set of eighty-one stimuli (words and non-words) have been auditory presented to these students by means of a laptop computer. Stimuli words were selected according to their emotional valence (positive, negative, neutral). Students had to decide as quickly and accurately as possible whether the presented stimulus was a real word or not (lexical decision). Response times and accuracy were recorded automatically on each trial. It was anticipated a) longer response times for the Median-High and High anxiety groups in comparison with the two others groups, b) faster response times for negative-valence words in comparison with positive and neutral-valence words only for the Median-High and High anxiety groups, c) lower response accuracy for Median-High and High anxiety groups in comparison with the two others groups, d) better response accuracy for negative-valence words in comparison with positive and neutral-valence words only for the Median-High and High anxiety groups. Concerning the response times, our results showed no difference between the four groups. Furthermore, inside each group, the average response times was very close regardless the emotional valence. Otherwise, group differences appear when considering the error rates. Median-High and High anxiety groups made significantly more errors in lexical decision than Median-Low and Low groups. Better response accuracy, however, is not found for negative-valence words in comparison with positive and neutral-valence words in the Median-High and High anxiety groups. Thus, these results showed a lower response accuracy for above-median anxiety groups than below-median groups but without specificity for the negative-valence words. This study suggests that anxiety can negatively impact the lexical processing in young students. Although the lexical processing speed seems preserved, the accuracy of this processing may be altered in students with moderate or high level of anxiety. This finding has important implication for the prevention of reading and spelling difficulties. Indeed, during these learnings, if anxiety affects the access to phonological representations, anxious students could be disturbed when they have to match phonological representations with new orthographic representations, because of less efficient lexical representations. This study should be continued in order to precise the impact of anxiety on basic school learning.

Keywords: anxiety, emotional valence, childhood, lexical access

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Authors: Victoria L. Chester, Usha Kuruganti

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The forest industry is a major economic sector of Canada and also one of the most dangerous industries for workers. The use of mechanized mobile forestry harvesting machines has successfully reduced the incidence of injuries in forest workers related to manual labor. However, these machines have also created additional concerns, including a high machine operation learning curve, increased the length of the workday, repetitive strain injury, cognitive load, physical and mental fatigue, and increased postural loads due to sitting in a confined space. It is critical to obtain objective performance data for employers to develop appropriate work practices for this industry, however ergonomic field studies of this industry are lacking mainly due to the difficulties in obtaining comprehensive data while operators are cutting trees in the woods. The purpose of this study was to establish a measurement and experimental protocol to examine the effects of worker skill level and movement training speed (joystick crane speed) on harvesting performance using a forestry simulator. A custom wrist angle measurement device was developed as part of the study to monitor Euler angles during operation of the simulator. The device of the system consisted of two accelerometers, a Bluetooth module, three 3V coin cells, a microcontroller, a voltage regulator and an application software. Harvesting performance and crane data was provided by the simulator software and included tree to frame collisions, crane to tree collisions, boom tip distance, number of trees cut, etc. A pilot study of 3 operators with various skill levels was tested to identify factors that distinguish highly skilled operators from novice or intermediate operators. Dependent variables such as reaction time, math skill, past work experience, training movement speed (e.g. joystick control speeds), harvesting experience level, muscle activity, and wrist biomechanics were measured and analyzed. A 10-channel wireless surface EMG system was used to monitor the amplitude and mean frequency of 10 upper extremity muscles during pre and postperformance on the forestry harvest stimulator. The results of the pilot study showed inconsistent changes in median frequency pre-and postoperation, but there was the increase in the activity of the flexor carpi radialis, anterior deltoid and upper trapezius of both arms. The wrist sensor results indicated that wrist supination and pronation occurred more than flexion and extension with radial-ulnar rotation demonstrating the least movement. Overall, wrist angular motion increased as the crane speed increased from slow to fast. Further data collection is needed and will help industry partners determine those factors that separate skill levels of operators, identify optimal training speeds, and determine the length of training required to bring new operators to an efficient skill level effectively. In addition to effective and employment training programs, results of this work will be used for selective employee recruitment strategies to improve employee retention after training. Further, improved training procedures and knowledge of the physical and mental demands on workers will lead to highly trained and efficient personnel, reduced risk of injury, and optimal work protocols.

Keywords: EMG, forestry, human factors, wrist biomechanics

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Authors: Fatemeh Modirzare

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Smart interior design represents a transformative approach to creating living spaces that integrate technology seamlessly into our daily lives, enhancing comfort, convenience, and sustainability. This paper explores the concept of smart interior design, its principles, benefits, challenges, and future prospects. It also highlights various examples and applications of smart interior design to illustrate its potential in shaping the way we live and interact with our surroundings. In an increasingly digitized world, the boundaries between technology and interior design are blurring. Smart interior design, also known as intelligent or connected interior design, involves the incorporation of advanced technologies and automation systems into residential and commercial spaces. This innovative approach aims to make living environments more efficient, comfortable, and adaptable while promoting sustainability and user well-being. Smart interior design seamlessly integrates technology into the aesthetics and functionality of a space, ensuring that devices and systems do not disrupt the overall design. Sustainable materials, energy-efficient systems, and eco-friendly practices are central to smart interior design, reducing environmental impact. Spaces are designed to be adaptable, allowing for reconfiguration to suit changing needs and preferences. Smart homes and spaces offer greater comfort through features like automated climate control, adjustable lighting, and customizable ambiance. Smart interior design can significantly reduce energy consumption through optimized heating, cooling, and lighting systems. Smart interior design integrates security systems, fire detection, and emergency response mechanisms for enhanced safety. Sustainable materials, energy-efficient appliances, and waste reduction practices contribute to a greener living environment. Implementing smart interior design can be expensive, particularly when retrofitting existing spaces with smart technologies. The increased connectivity raises concerns about data privacy and cybersecurity, requiring robust measures to protect user information. Rapid advancements in technology may lead to obsolescence, necessitating updates and replacements. Users must be familiar with smart systems to fully benefit from them, requiring education and ongoing support. Residential spaces incorporate features like voice-activated assistants, automated lighting, and energy management systems. Intelligent office design enhances productivity and employee well-being through smart lighting, climate control, and meeting room booking systems. Hospitals and healthcare facilities use smart interior design for patient monitoring, wayfinding, and energy conservation. Smart retail design includes interactive displays, personalized shopping experiences, and inventory management systems. The future of smart interior design holds exciting possibilities, including AI-powered design tools that create personalized spaces based on user preferences. Smart interior design will increasingly prioritize factors that improve physical and mental health, such as air quality monitoring and mood-enhancing lighting. Smart interior design is revolutionizing the way we interact with our living and working spaces. By embracing technology, sustainability, and user-centric design principles, smart interior design offers numerous benefits, from increased comfort and convenience to energy efficiency and sustainability. Despite challenges, the future holds tremendous potential for further innovation in this field, promising a more connected, efficient, and harmonious way of living and working.

Keywords: smart interior design, home automation, sustainable living spaces, technological integration, user-centric design

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Authors: Daniel Martin Fellows, Sean P. Walton, Jennifer Thompson, Oubay Hassan, Kevin Tinkham, Ella Quigley

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Structural integrity for cladding products is a key performance parameter, especially concerning fire performance. Cladding products such as PIR-based sandwich panels are tested rigorously, in line with industrial standards. Physical fire tests are necessary to ensure the customer's safety but can give little information about critical behaviours that can help develop new materials. Numerical modelling is a tool that can help investigate a fire's behaviour further by replicating the fire test. However, fire is an interdisciplinary problem as it is a chemical reaction that behaves fluidly and impacts structural integrity. An analysis using Computational Fluid Dynamics (CFD) and Finite Element Analysis (FEA) is needed to capture all aspects of a fire performance test. One method is a two-way coupling analysis that imports the updated changes in thermal data, due to the fire's behaviour, to the FEA solver in a series of iterations. In light of our recent work with Tata Steel U.K using a two-way coupling methodology to determine the fire performance, it has been shown that a program called FDS-2-Abaqus can make predictions of a BS 476 -22 furnace test with a degree of accuracy. The test demonstrated the fire performance of Tata Steel U.K Trisomet product, a Polyisocyanurate (PIR) based sandwich panel used for cladding. Previous works demonstrated the limitations of the current version of the program, the main limitation being the computational cost of modelling three Trisomet panels, totalling an area of 9 . The computational cost increases substantially, with the intention to scale up to an LPS 1181-1 test, which includes a total panel surface area of 200 .The FDS-2-Abaqus program is developed further within this paper to overcome this obstacle and better accommodate Tata Steel U.K PIR sandwich panels. The new developments aim to reduce the computational cost and error margin compared to experimental data. One avenue explored is a multi-scale approach in the form of Reduced Order Modeling (ROM). The approach allows the user to include refined details of the sandwich panels, such as the overlapping joints, without a computationally costly mesh size.Comparative studies will be made between the new implementations and the previous study completed using the original FDS-2-ABAQUS program. Validation of the study will come from physical experiments in line with governing body standards such as BS 476 -22 and LPS 1181-1. The physical experimental data includes the panels' gas and surface temperatures and mechanical deformation. Conclusions are drawn, noting the new implementations' impact factors and discussing the reasonability for scaling up further to a whole warehouse.

Keywords: fire testing, numerical coupling, sandwich panels, thermo fluids

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