Search results for: Lean Tool

Authors: Mahtab Makaremi Masouleh, Günter Wozniak

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This research is part of an interdisciplinary project, promoting the design of a light temporary installable textile defence system against flood. In case river water levels increase abruptly especially in winter time, one can expect massive extra load on a textile protective structure in term of impact as a result of floating debris and even tree trunks. Estimation of this impulsive force on such structures is of a great importance, as it can ensure the reliability of the design in critical cases. This fact provides the motivation for the numerical analysis of a fluid structure interaction application, comprising flexible slender shaped and free-surface water flow, where an accelerated heavy flotsam tends to approach the membrane. In this context, the analysis on both the behavior of the flexible membrane and its interaction with moving flotsam is conducted by finite elements based solvers of the explicit solver and implicit Abacus solver available as products of SIMULIA software. On the other hand, a study on how free surface water flow behaves in response to moving structures, has been investigated using the finite volume solver of Star CCM+ from Siemens PLM Software. An automatic communication tool (CSE, SIMULIA Co-Simulation Engine) and the implementation of an effective partitioned strategy in form of an implicit coupling algorithm makes it possible for partitioned domains to be interconnected powerfully. The applied procedure ensures stability and convergence in the solution of these complicated issues, albeit with high computational cost; however, the other complexity of this study stems from mesh criterion in the fluid domain, where the two structures approach each other. This contribution presents the approaches for the establishment of a convergent numerical solution and compares the results with experimental findings.

Keywords: co-simulation, flexible thin structure, fluid-structure interaction, implicit coupling algorithm, moving flotsam

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Authors: Wai Ha Leung

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Mother tongue language (MTL) curriculum is core to school education in most countries/regions' school curriculum. Through mother tongue language learning, students are expected to enhance their understanding of the nation's culture and foster the sense of cultural and ethnic identity. However, MTL education in Hong Kong is complicated by the colonial history. This study examines Hong Kong Chinese language teachers' perceptions of MTL education, and the implication on MTL curriculum development. The questionnaire was administrated to 97 teachers, and interviews were carried out on 17 teachers. Usually, MTL is both the tool with which knowledge and skills are taught and learned and the vehicle for students to learn about the traditions of the countries' literature and culture. In Hong Kong, 95% of the population is of Chinese descent. Traditionally, education in China was a mixture of philosophy, history, politics and literacy. Chinese as an MTL subject in pre-colonial Hong Kong has always been assigned the mission of developing students' cultural identity in addition to the development of linguistic proficiency. During the colonial period, the Chinese Language curriculum shifted to be more language skills based with less emphasis on Chinese culture and moral education. After the sovereignty of Hong Kong was returned to China in 1997, although a new curriculum was implemented in 2002, teaching and learning in school as well as public examinations seem to be remaining language skills oriented instead of culturally based. This deviation from the trend of both Chinese traditional education and global mother tongue language education makes some Chinese language teachers feel confused. In addition, there is comment that in general Hong Kong students' Chinese language proficiency is becoming weaker and weaker in recent years. Thus, effectiveness of the skills oriented language curriculum has come under question. How a language teacher views the aims and objectives of the language subject he or she is teaching has a direct effect on the curriculum delivery and pedagogies used. It is, therefore, important to investigate what is the language teachers' perception of MTL education, and whether the current school curriculum can meet the teachers' expectation as well as achieve the aims of MTL education. Given this context, this study explored the views of Hong Kong Chinese language teachers on MTL education. The data indicate that teachers showed a strong resentment towards the current curriculum. Results may have implications on mother tongue language curriculum development.

Keywords: Chinese language education, curriculum development, mother tongue language education, teachers' perception

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Authors: Fikru Fentaw Abera

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Climate changes alter regional hydrologic conditions and results in a variety of impacts on water resource systems. Such hydrologic changes will affect almost every aspect of human well-being. The goal of this paper is to assess the impact of climate change on the hydrology of Upper Guder catchment located in northwest of Ethiopia. The GCM derived scenarios (HadCM3 A2a & B2a SRES emission scenarios) experiments were used for the climate projection. The statistical downscaling model (SDSM) was used to generate future possible local meteorological variables in the study area. The down-scaled data were then used as input to the soil and water assessment tool (SWAT) model to simulate the corresponding future stream flow regime in Upper Guder catchment of the Abay River Basin. A semi distributed hydrological model, SWAT was developed and Generalized Likelihood Uncertainty Estimation (GLUE) was utilized for uncertainty analysis. GLUE is linked with SWAT in the Calibration and Uncertainty Program known as SWAT-CUP. Three benchmark periods simulated for this study were 2020s, 2050s and 2080s. The time series generated by GCM of HadCM3 A2a and B2a and Statistical Downscaling Model (SDSM) indicate a significant increasing trend in maximum and minimum temperature values and a slight increasing trend in precipitation for both A2a and B2a emission scenarios in both Gedo and Tikur Inch stations for all three bench mark periods. The hydrologic impact analysis made with the downscaled temperature and precipitation time series as input to the hydrological model SWAT suggested for both A2a and B2a emission scenarios. The model output shows that there may be an annual increase in flow volume up to 35% for both emission scenarios in three benchmark periods in the future. All seasons show an increase in flow volume for both A2a and B2a emission scenarios for all time horizons. Potential evapotranspiration in the catchment also will increase annually on average 3-15% for the 2020s and 7-25% for the 2050s and 2080s for both A2a and B2a emissions scenarios.

Keywords: climate change, Guder sub-basin, GCM, SDSM, SWAT, SWAT-CUP, GLUE

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Authors: Mikiale Gebreslase Gebremariam, Chai Huaqi, Tesfay Gebretsdkan Gebremichael, Dawit Nega Bekele

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In recent years, brownfield redevelopment projects (BRPs) have contributed to the overarching paradigm of the United Nations 2030 agendas. In the present circumstance, most developed nations adopted BRPs, an efficacious urban policy tool. However, in developing and some advanced countries, BRPs are lacking due to limitations of awareness, policy tools, and financial capability for cleaning up brownfield sites. For example, the growth and development of Ethiopian cities were achieved at the cost of poor urban planning, including no community consultations and excessive urbanization for future growth. The demand for land resources is more and more urgent as the result of an intermigration to major cities and towns for socio-economic reasons and population growth. In the past, the development mode of spreading major cities has made horizontal urbanizations stretching outwards. Expansion in search of more land resources, while the outer cities are growing, the inner cities are polluted by environmental pollution. It is noteworthy that the rapid development of cities has not brought about an increase in people's happiness index. Thus, the proposed management framework for managing brownfields in Ethiopia as a lesson to the developing nation facing similar challenges and growth will add immense value in solving the problems and give insights into brownfield land utilization. Under the umbrella of the grey incidence decision-making model and with the consideration of multiple stakeholders and tight environmental and economic constraints, the proposed management framework integrates different criteria from economic, social, environmental, technical, and risk aspects into the grey incidence decision-making model and gives useful guidance to manage brownfields in Ethiopia. Furthermore, it will contribute to the future development of the social economy and the missions of the 2030 UN sustainable development goals.

Keywords: Brownfields, environmental sustainability, Ethiopia, grey-incidence decision-making, sustainable urban development

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Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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Authors: Verarisa Ujung

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The Anthropocene – as scientists define as a new geological epoch where human intervention has the dominant influence on the geological, atmospheric, and ecological processes challenges the contemporary discourse in architecture and interior. The dominant influence characterises the incapability to distinguish the notion of nature, subnature, human and non-human. Consequently, living in the Anthropocene demands sensitivity and responsiveness to heighten our sense of the rhythm of transformation and recognition of our environment as a product of natural, social and historical processes. The notion of subnature is particularly emphasised in this paper to investigate the poetic sense of living with subnature. It could be associated with the critical tool for exploring the aesthetic and programmatic implications of subnature on interiority. The ephemeral immaterial attached to subnature promotes the sense of atmospheric delineation of interiority, the very inner significance of body-surface interaction, which central to interior architecture discourse. This would then reflect human’s activities; examine the transformative change, the architectural motion and the traces that left between moments. In this way, engaging the notion of subnature enable us to better understand the critical subject on interiority and might provide an in-depth study on interior architecture. Incorporating the exploration on the form, materiality, and pattern of subnature, this research seeks to grasp the inner significance of micro to macro approaches so that the future of interior might be compelled to depend more on the investigation and development of responsive environment. To reflect upon the form, materiality and intensity of subnature that specifically characterized by the natural, social and historical processes, this research examines a volcanic land, White Island/Whakaari, New Zealand as the chosen site of investigation. Emitting various forms and intensities of subnatures - smokes, mud, sulphur gas, this volcanic land also open to the new inhabitation within the sulphur factory ruins that reflects human’s past occupation. In this way, temporal and natural selected manifestations of materiality, artefact, and performance can be traced out and might reveal the meaningful relations among space, inhabitation, and well-being of inhabitants in the Anthropocene.

Keywords: anthropocene, body, intensification, intensity, interior architecture, subnature, surface

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Authors: Tamara Zappaterra

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The Learning Difficulties have an evolutionary nature. The international research has focused its analysis on the characteristics of Learning Difficulties in childhood, but we are still far from a thorough understanding of the nature of such disorders in adolescence and adulthood. Such issues become even more urgent in the university context. Spelling, meaning, and appropriate use of the specific vocabulary of the various disciplines represent an additional challenge for the dyslexic student. This paper explores the characteristics of Learning Difficulties in adulthood and the impact with the university teaching. It presents the results of an interdisciplinary project (educational, medical and engineering area) at University of Florence. The purpose of project is to design of a protocol for usability of teaching and individual study at university level. The project, after a first reconnaissance of user needs that have been reached with the participation of the very same protagonists, is at the stage of guidelines drafting for inclusion and education, to be used by teachers, students and administrative staff. The methodologies used are a questionnaire built on purpose and a series of focus groups with users. For collecting data during the focus groups it was decided to use a method typical of the Quality Function Deployment, a tool originally used for quality management, whose versatility makes it easy to use in a number of different context. The paper presents furthermore the findings of the project, the most significant elements of the guidelines for teaching, i.e. the section for teachers, whose aim is to implement a Learning Difficulties-friendly teaching, even at the university level, in compliance with italian Law 170/2010. The Guidelines for the didactic and inclusion of Learning Difficulties students of the University of Florence are articulated around a global and systemic plan of action, meant to accompany and protect the students during their study career, even before enrolling at the University, with different declination: the logistical, relational, educational, and didactic levels have been considered. These guidelines in Italy received the endorsement of the CNUDD. It is a systemic intervention plan for Learning Difficulties students, which roused and keeps rousing the interest of all the university system, with a radical consideration on academic teaching. Since while we try to provide the best Learning Difficulties-friendly didactic in compliance with the rules, no one can be exempted from a wider consideration on the nature and the quality of university teaching offered to all students.

Keywords: didactic tools, learning difficulties, special and inclusive education, university teaching

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Authors: Najia Zulfiqar

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Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

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Authors: Mina Salamatmanesh, Elizabeth Fitzpatrick, Tim Ramsay, Josee Lagacé, Lindsey Sikora, JoAnne Whittingham

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Introduction: Hearing loss (HL) is one of the most common disorders that presents at birth and in early childhood. Universal newborn hearing screening (UNHS) has been adopted based on the assumption that with early identification of HL, children will have access to optimal amplification and intervention at younger ages, therefore, taking advantage of the brain’s maximal plasticity. One particular challenge for parents in the early years is achieving consistent hearing aid (HA) use which is critical to the child’s development and constitutes the first step in the rehabilitation process. This study examined the consistency of hearing aid use in young children based on data logging information documented during audiology sessions in the first three years after hearing aid fitting. Methodology: The first 100 children who were diagnosed with bilateral HL before 72 months of age since 2003 to 2015 in a pediatric audiology clinic and who had at least two hearing aid follow-up sessions with available data logging information were included in the study. Data from each audiology session (age of child at the session, average hours of use per day (for each ear) in the first three years after HA fitting) were collected. Clinical characteristics (degree of hearing loss, age of HA fitting) were also documented to further understanding of factors that impact HA use. Results: Preliminary analysis of the results of the first 20 children shows that all of them (100%) have at least one data logging session recorded in the clinical audiology system (Noah). Of the 20 children, 17(85%) have three data logging events recorded in the first three years after HA fitting. Based on the statistical analysis of the first 20 cases, the median hours of use in the first follow-up session after the hearing aid fitting in the right ear is 3.9 hours with an interquartile range (IQR) of 10.2h. For the left ear the median is 4.4 and the IQR is 9.7h. In the first session 47% of the children use their hearing aids ≤5 hours, 12% use them between 5 to 10 hours and 22% use them ≥10 hours a day. However, these children showed increased use by the third follow-up session with a median (IQR) of 9.1 hours for the right ear and 2.5, and of 8.2 hours for left ear (IQR) IQR is 5.6 By the third follow-up session, 14% of children used hearing aids ≤5 hours, while 38% of children used them ≥10 hours. Based on the primary results, factors like age and level of HL significantly impact the hours of use. Conclusion: The use of data logging information to assess the actual hours of HA provides an opportunity to examine the: a) challenges of families of young children with HAs, b) factors that impact use in very young children. Data logging when used collaboratively with parents, can be a powerful tool to identify problems and to encourage and assist families in maximizing their child’s hearing potential.

Keywords: hearing loss, hearing aid, data logging, hours of use

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Authors: Bagher Bayat, Wouter Verhoef, Behnaz Arabi, Christiaan Van der Tol

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The aim of this study was to follow the canopy reflectance patterns in response to soil water deficit and to detect trends of changes in biophysical and biochemical parameters of grass (Poa pratensis species). We used visual interpretation, imaging spectroscopy and radiative transfer model inversion to monitor the gradual manifestation of water stress effects in a laboratory setting. Plots of 21 cm x 14.5 cm surface area with Poa pratensis plants that formed a closed canopy were subjected to water stress for 50 days. In a regular weekly schedule, canopy reflectance was measured. In addition, Leaf Area Index (LAI), Chlorophyll (a+b) content (Cab) and Leaf Water Content (Cw) were measured at regular time intervals. The 1-D bidirectional canopy reflectance model SAIL, coupled with the leaf optical properties model PROSPECT, was inverted using hyperspectral measurements by means of an iterative optimization method to retrieve vegetation biophysical and biochemical parameters. The relationships between retrieved LAI, Cab, Cw, and Cs (Senescent material) with soil moisture content were established in two separated groups; stress and non-stressed. To differentiate the water stress condition from the non-stressed condition, a threshold was defined that was based on the laboratory produced Soil Water Characteristic (SWC) curve. All parameters retrieved by model inversion using canopy spectral data showed good correlation with soil water content in the water stress condition. These parameters co-varied with soil moisture content under the stress condition (Chl: R2= 0.91, Cw: R2= 0.97, Cs: R2= 0.88 and LAI: R2=0.48) at the canopy level. To validate the results, the relationship between vegetation parameters that were measured in the laboratory and soil moisture content was established. The results were totally in agreement with the modeling outputs and confirmed the results produced by radiative transfer model inversion and spectroscopy. Since water stress changes all parts of the spectrum, we concluded that analysis of the reflectance spectrum in the VIS-NIR-MIR region is a promising tool for monitoring water stress impacts on vegetation.

Keywords: hyperspectral remote sensing, model inversion, vegetation responses, water stress

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Authors: Jefferson S. Galanza, Jewel An Mischelle R.Camcam, Alyssa Karryl C. Co, Stephanie P. De Guzman, Jet Jet K. Dongui-is, Rodolfo Dane C. Frias, Ovelle C. Jueco, Harvey L. Matbagan, Victoria Luzette T. Rillon, Christelle Romyna H. Saruca, Jeanette Roma M. Villasper

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Background: Amidst numerous studies conducted on learning styles of students from a variety of courses, levels and school, a recent study recommended a great need for research on learning styles of student nurses. Moreover, related literatures have not been found exploring both the learning and teaching style of student nurses. Aims: The study aimed to determine the learning and teaching styles of student nurses and if there is an association between them. It also intended to discover whether student nurses are unimodal or multimodal in their styles and identified which faculty teaching style affords maximum outcome for student’s learning styles. Methods: Quantitative Descriptive-Correlational design was used. Participants were randomly selected 312 student nurses at School of Nursing X, Baguio City, Philippines. The questionnaire utilized a modified version of an adopted tool from Fleming’s VARK learning style version 7.2 (Visual, Auditory, Reader/Writer, Kinaesthetic) and Grasha’s teaching styles (Formal Authority, Demonstrator, Facilitator, Delegator). SPSS 19 was used for statistical treatment of data, where Chi square was used for the correlation of unimodal learning and teaching styles. Results/Finding: Majority of student nurses’ learning style is Kinesthetic and their teaching style is Demonstrator, which was also found to be significantly associated. Moreover, 8 out of 10 students are Unimodal in their learning and teaching modalities. In general, their preferred faculty teaching style is similar to their teaching style, which supports the concept, that teachers teach the way they learn. Conclusion: Study concludes that student nurses’ learning styles and teaching styles are varied, which exemplifies the uniqueness of every learner.This diversity in styles provided more evidence that a variety of mode of teaching and learning should be used by faculty and students to increase learning outcome and academic achievement. Recommendation: Future studies could be carried out in various schools of nursing utilizing faculty as respondents. Conduct assessment of learning style at the onset of classes/clinical placements so that faculty will become aware of the diversity of learners leading them to deliver diverse teaching methods.

Keywords: learning, learning styles, teaching styles, student nurses

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Authors: Maryam Nzari

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Today, with the advancement of Internet technology, one of the tools used by humans is a tool that allows them to do what they need easily. Online platforms in different forms and by providing different services make it possible for users to communicate with each other and users with platforms. Audience communication with mass media is not the same as in the past. Today the conditions are different; With online platforms that provide the latest news minute by minute, he has access to all the content and can choose more quickly and easily. According to professionals Galloway, Apple, Amazon, Facebook and Google companies create a wide range. They are among the products and services that are connected with the daily life of billions of people all over the planet. Over time, platforms gain high economic value and in this way gain power that will influence the social, cultural, economic and political aspects of people’s lives. As a result of the effects of the process of platformization on all areas of individual and collective life, we now live in a platform society, which communicates It is close to “platform politics”. Nowadays, with social media platforms, users can interact with many people and people can share their data on various topics with others in this space. In this research, what will be investigated is the role of these online platforms in economic growth and the introduction of local culture areas in tourist areas. Tourism in a region is linked with various factors; One of the important factors that attract tourists to a region is its culture, and on the other hand, this culture can also affect economic growth. Without a proper understanding of the culture of these tourist areas, it is not possible to plan properly for the growth of the tourism industry and the subsequent increase in economic growth. The interaction of local people and tourists will have social and cultural effects on each other and will give them the opportunity to get to know each other. Therefore, the purpose of this research is to examine issues such as the role that online platforms play in cultural interaction in tourist areas and to understand that online platforms are only seeking to show the good aspects of a region and then generate enough extra income or that platforms can They play a role beyond what we imagine and introduce the culture of a region in a proper way so that we don’t see disagreements in the tourism planning of that region. in this article It has been tried by using library and field methods Answer the questions.

Keywords: online platforms, economic growth, culture Indigenous, tourism

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Authors: Ladda Her, Juntip Kanjanasilp, Ratree Sawangjit, Nathorn Chaiyakunapruk

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Cough is the common symptom of the respiratory tract infections or non-infections; the duration of cough indicates a classification and severity of disease. Herbal medicines can be used as the alternative to drugs for relief of cough symptoms from acute and chronic disease. Eucalyptus was used for reducing cough with evidences suggesting it has an active role in reduction of airway inflammation. The present study aims to evaluate efficacy and safety of eucalyptus for relief of cough symptom in respiratory disease. Method: The Cochrane Library, MEDLINE (PubMed), Scopus, CINAHL, Springer, Science direct, ProQuest, and THAILIS databases. From its inception until 01/02/2019 for randomized control trials. We follow for the efficacy and safety of eucalyptus for reducing cough. Methodological quality was evaluated by using the Cochrane risk of bias tool; two reviewers in our team screened eligibility and extracted data. Result: Six studies were included for the review and five studies were included in the meta-analysis, there were 1.911 persons including children (n: 1) and adult (n: 5) studies; for study in children and adult were between 1 and 80 years old, respectively. Eucalyptus was used as mono herb (n: 2) and in combination with other herbs form (n: 4). All of the studies with eucalyptus were compared for efficacy and safety with placebo or standard treatment, Eucalyptus dosage form in studies included capsules, spray, and syrup. Heterogeneity was 32.44 used random effect model (I² = 1.2%, χ² = 1.01; P-value = 0.314). The efficacy of eucalyptus was showed a reduced cough symptom statistically significant (n = 402, RR: 1.40, 95%CI [1.19, 1.65], P-value < 0.0001) when compared with placebo. Adverse events (AEs) were reported mild to moderate intensity with mostly gastrointestinal symptom. The methodological quality of the included trials was overall poor. Conclusion: Eucalyptus appears to be beneficial and safe for relieving in respiratory diseases focus on cough frequency. The evidence was inconclusive due to limited quality trial. Well-designed trials for evaluating the effectiveness in humans, the effectiveness for reducing cough symptom in human is needed. Eucalyptus had safety as monotherapy or in combination with other herbs.

Keywords: cough, eucalyptus, cineole, herbal medicine, systematic review, meta-analysis

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Authors: Pouyan Motamedi, Ken Bosnick, Ken Cadien, James Hogan

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Growth of conformal ultrathin metal films has attracted a considerable amount of attention recently. Plasma-enhanced atomic layer deposition (PEALD) is a method capable of growing conformal thin films at low temperatures, with an exemplary control over thickness. The authors have recently reported on growth of metastable epitaxial nickel thin films via PEALD, along with a comprehensive characterization of the films and a study on the relationship between the growth parameters and the film characteristics. The goal of the current study is to use the mentioned films as a case study to investigate the temperature-activated phase transformation and agglomeration in ultrathin metallic films. For this purpose, metastable hexagonal nickel thin films were annealed using a controlled heating/cooling apparatus. The transformations in the crystal structure were observed via in-situ synchrotron x-ray diffraction. The samples were annealed to various temperatures in the range of 400-1100° C. The onset and progression of particle formation were studied in-situ via laser measurements. In addition, a four-point probe measurement tool was used to record the changes in the resistivity of the films, which is affected by phase transformation, as well as roughening and agglomeration. Thin films annealed at various temperature steps were then studied via atomic force microscopy, scanning electron microscopy and high-resolution transmission electron microscopy, in order to get a better understanding of the correlated mechanisms, through which phase transformation and particle formation occur. The results indicate that the onset of hcp-to-bcc transformation is at 400°C, while particle formations commences at 590° C. If the annealed films are quenched after transformation, but prior to agglomeration, they show a noticeable drop in resistivity. This can be attributed to the fact that the hcp films are grown epitaxially, and are under severe tensile strain, and annealing leads to relaxation of the mismatch strain. In general, the results shed light on the nature of structural transformation in nickel thin films, as well as metallic thin films, in general.

Keywords: atomic layer deposition, metastable, nickel, phase transformation, thin film

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Authors: Miceska Simona, Škof Erik, Frković Grazio Snježana, Jeričević Anja, Smrkolj Špela, Cvjetićanin Branko, Novaković Srdjan, Grčar Kuzmanov Biljana, Kloboves-Prevodnik Veronika

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Objectives: High-grade serous ovarian cancer (HGSOC) is characterized by the dissemination of the tumor cells (TC) in the peritoneal cavity forming malignant ascites at the time of diagnosis or recurrence. Still, cytology itself has been underutilized as a modality for the diagnosis of HGSOC from ascites, and histological examination from the tumor tissue is yet the only validated method used. The objective of this study was to evaluate the reliability of cytology in the diagnosis of HGSOC in relation to the histopathological examination. Methods: The study included 42 patients with histologically confirmed HGSOC, accompanied by malignant ascites. To confirm the malignancy of the TC in the ascites and to define their immunophenotype, immunohistochemical reaction (IHC) of the following antigens: Calretinin, MOC, WT1, PAX8, p53, p16 & Ki-67 was evaluated on ascites cytospins and tissue blocks. For complete cytological determination of HGSOC, BRCA 1/2 gene mutation was determined from ascites, tissue block, and blood. BRCA1/2 mutation from blood was performed to define the type of mutation, somatic vs germline. Results: Among 42 patients, the immunophenotype of HGSOC from ascites was confirmed in 36 cases (86%). For more profound analysis, the patients were divided in 3 groups regarding the number of TC present in the ascites: patients with less than 10% TC, 10% TC, and more than 10% TC. From all included patients, in the group with less than 10% TC, there were 10 cases, and only 5 of them(50%) showed HGSOC phenotype; 12 cases had equally 10% of TC, and 11 cases (92%) showed HGSOC phenotype; 20 cases had more than 10% TC and all of them (100%) confirmed the HGSOC immunophenotype from ascites. Only 33 patients were eligible for further BRCA1/2 analysis. Eleven BRCA1/2 mutations were detected from thetissue block: 6 germline and 5 somatic. In 2 cases with less than 10% TC, BRCA1/2 mutation was not detected; 4 cases had 10% TC, and 2 of them (50%) confirmed the mutation; 4 cases had more than 10% TC, and all showed 100% reliability with the tumor tissue. Conclusions: Cytology is a highly reliable method for determining the immunophenotype of HGSOC and BRCA1/2 mutation if more than 10% of tumor cells are present in the ascites. This may present an additional non-invasive clinical approach for fast and effective diagnose in the future, especially in inoperable conditions or relapses.

Keywords: cytology, ascites, high-grade serous ovarian cancer, immunophenotype, BRCA1/2

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Authors: Chi-Chang Lin, Jian-Rong Wu, Jiun-Yan Chiu

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Myopia, ubiquitous symptom that is necessary to correct the eyesight by optical lens struggles many people for their daily life. Recent years, younger people raise interesting on using contact lens because of its convenience and aesthetics. In clinical, the risk of eye infections increases owing to the behavior of incorrectly using contact lens unsupervised cleaning which raising the infection risk of cornea, named ocular keratitis. In order to overcome the identification needs, new detection or analysis method with rapid and more accurate identification for clinical microorganism is importantly needed. In our study, we take advantage of Raman spectroscopy having unique fingerprint for different functional groups as the distinct and fast examination tool on microorganism. As we know, Raman scatting signals are normally too weak for the detection, especially in biological field. Here, we applied special SERS enhancement substrates to generate higher Raman signals. SERS filter we designed in this article that prepared by deposition of silver nanoparticles directly onto cellulose filter surface and suspension nanoparticles - gold nanostars (AuNSs) also be introduced together to achieve better enhancement for lower concentration analyte (i.e., various bacteria). Research targets also focusing on studying the shape effect of synthetic AuNSs, needle-like surface morphology may possible creates more hot-spot for getting higher SERS enhance ability. We utilized new designed SERS technology to distinguish the bacteria from ocular keratitis under strain level, and specific Raman and SERS fingerprint were grouped under pattern recognition process. We reported a new method combined different SERS substrates can be applied for clinical microorganism detection under strain level with simple, rapid preparation and low cost. Our presenting SERS technology not only shows the great potential for clinical bacteria detection but also can be used for environmental pollution and food safety analysis.

Keywords: bacteria, gold nanostars, Raman spectroscopy surface-enhanced Raman scattering filter

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Authors: Asif Arshid, Ying Huang, Denver Tolliver

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Finite Element (FE) method coupled with ever-increasing computational powers has substantially advanced the reliability of deterministic three dimensional structural analyses of a structure with uniform material properties. However, railways trackbed is made up of diverse group of materials including steel, wood, rock and soil, while each material has its own varying levels of heterogeneity and imperfections. It is observed that the application of probabilistic methods for trackbed structural analysis while incorporating the material and geometric variabilities is deeply underworked. The authors developed and validated a 3-dimensional FE based numerical trackbed model and in this study, they investigated the influence of variability in Young modulus and thicknesses of granular layers (Ballast and Subgrade) on the reliability index (-index) of the subgrade layer. The influence of these factors is accounted for by changing their Coefficients of Variance (COV) while keeping their means constant. These variations are formulated using Gaussian Normal distribution. Two failure mechanisms in subgrade namely Progressive Shear Failure and Excessive Plastic Deformation are examined. Preliminary results of risk-based probabilistic analysis for Progressive Shear Failure revealed that the variations in Ballast depth are the most influential factor for vertical stress at the top of subgrade surface. Whereas, in case of Excessive Plastic Deformations in subgrade layer, the variations in its own depth and Young modulus proved to be most important while ballast properties remained almost indifferent. For both these failure moods, it is also observed that the reliability index for subgrade failure increases with the increase in COV of ballast depth and subgrade Young modulus. The findings of this work is of particular significance in studying the combined effect of construction imperfections and variations in ground conditions on the structural performance of railroad trackbed and evaluating the associated risk involved. In addition, it also provides an additional tool to supplement the deterministic analysis procedures and decision making for railroad maintenance.

Keywords: finite element analysis, numerical modeling, probabilistic methods, risk and reliability analysis, subgrade

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Authors: Gayani Ranawake

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Effective communication is widely regarded as an important aspect of any discipline. This particular study deals with written communication in science. Writing conventions and linguistic choices play a key role in conveying the message effectively to a target audience. Scientists are responsible for conveying their findings or research results not only to their discourse community but also to the general public. Recognizing appropriate linguistic choices is crucial since they vary depending on the target audience. The majority of scientists can communicate effectively with their discourse community, but public engagement seems more challenging to them. There is a lack of research into the language use of scientists, and in particular how it varies by discipline and audience (genre). A better understanding of the different linguistic conventions used in effective science writing by scientists for scientists and by scientists for the public will help to guide scientists who are familiar with their discourse community norms to write effectively for the public. This study investigates the differences and similarities of linguistic choices in biology articles written by scientists for their discourse community and biology magazine articles written by scientists and science communicators for the general public. This study is a part of a larger project investigating linguistic differences in different genres of science academic writing. The sample for this particular study is composed of 20 research articles from the journal Biological Reviews and 20 magazine articles from the magazine Australian Popular Science. Differences in the linguistic devices were analyzed using Hyland’s metadiscourse model for academic writing proposed in 2005. The frequency of the usage of interactive resources (transitions, frame markers, endophoric markers, evidentials and code glosses) and interactional resources (hedges, boosters, attitude markers, self-mentions and engagement markers) were compared and contrasted using the NVivo textual analysis tool. The results clearly show the differences in the frequency of usage of interactional and interactive resources in the two disciplines under investigation. The findings of this study provide a reference guide for scientists and science writers to understand the differences in the linguistic choices between the two genres. This will be particularly helpful for scientists who are proficient at writing for their discourse community, but not for the public.

Keywords: discourse analysis, linguistic choices, metadiscourse, science writing

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Authors: Hammad Majeed, Hanna Knuutila, Magne Hillestad, Hallvard F. Svendsen

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Formation of aerosols can cause serious complications in industrial exhaust gas CO2 capture processes. SO3 present in the flue gas can cause aerosol formation in an absorption based capture process. Small mist droplets and fog formed can normally not be removed in conventional demisting equipment because their submicron size allows the particles or droplets to follow the gas flow. As a consequence of this aerosol based emissions in the order of grams per Nm3 have been identified from PCCC plants. In absorption processes aerosols are generated by spontaneous condensation or desublimation processes in supersaturated gas phases. Undesired aerosol development may lead to amine emissions many times larger than what would be encountered in a mist free gas phase in PCCC development. It is thus of crucial importance to understand the formation and build-up of these aerosols in order to mitigate the problem. Rigorous modelling of aerosol dynamics leads to a system of partial differential equations. In order to understand mechanics of a particle entering an absorber an implementation of the model is created in Matlab. The model predicts the droplet size, the droplet internal variable profiles and the mass transfer fluxes as function of position in the absorber. The Matlab model is based on a subclass method of weighted residuals for boundary value problems named, orthogonal collocation method. The model comprises a set of mass transfer equations for transferring components and the essential diffusion reaction equations to describe the droplet internal profiles for all relevant constituents. Also included is heat transfer across the interface and inside the droplet. This paper presents results describing the basic simulation tool for the characterization of aerosols formed in CO2 absorption columns and gives examples as to how various entering droplets grow or shrink through an absorber and how their composition changes with respect to time. Below are given some preliminary simulation results for an aerosol droplet composition and temperature profiles.

Keywords: absorption columns, aerosol formation, amine emissions, internal droplet profiles, monoethanolamine (MEA), post combustion CO2 capture, simulation

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Authors: Gashaw Gismu Chakilu

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Climate and land cover change are very important issues in terms of global context and their responses to environmental and socio-economic drivers. The dynamic of these two factors is currently affecting the environment in unbalanced way including watershed hydrology. In this paper individual and combined impacts of climate change and land use land cover change on hydrological processes were evaluated through applying the model Soil and Water Assessment Tool (SWAT) in Gumara watershed, Upper Blue Nile basin Ethiopia. The regional climate; temperature and rainfall data of the past 40 years in the study area were prepared and changes were detected by using trend analysis applying Mann-Kendall trend test. The land use land cover data were obtained from land sat image and processed by ERDAS IMAGIN 2010 software. Three land use land cover data; 1973, 1986, and 2013 were prepared and these data were used for base line, model calibration and change study respectively. The effects of these changes on high flow and low flow of the catchment have also been evaluated separately. The high flow of the catchment for these two decades was analyzed by using Annual Maximum (AM) model and the low flow was evaluated by seven day sustained low flow model. Both temperature and rainfall showed increasing trend; and then the extent of changes were evaluated in terms of monthly bases by using two decadal time periods; 1973-1982 was taken as baseline and 2004-2013 was used as change study. The efficiency of the model was determined by Nash-Sutcliffe (NS) and Relative Volume error (RVe) and their values were 0.65 and 0.032 for calibration and 0.62 and 0.0051 for validation respectively. The impact of climate change was higher than that of land use land cover change on stream flow of the catchment; the flow has been increasing by 16.86% and 7.25% due to climate and LULC change respectively, and the combined change effect accounted 22.13% flow increment. The overall results of the study indicated that Climate change is more responsible for high flow than low flow; and reversely the land use land cover change showed more significant effect on low flow than high flow of the catchment. From the result we conclude that the hydrology of the catchment has been altered because of changes of climate and land cover of the study area.

Keywords: climate, LULC, SWAT, Ethiopia

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Authors: C. G. Mendez-Garcia, E. T. Romero-Guzman, H. Hernandez-Mendoza, C. Solis, E. Chavez-Lomeli, E. Chamizo, R. Garcia-Tenorio

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Plutonium is present in different concentrations in the environment and biological samples related to nuclear weapons testing, nuclear waste recycling and accidental discharges of nuclear plants. This radioisotope is considered the most radiotoxic substance, particularly when it enters the human body through inhalation of powders insoluble or aerosols. This is the main reason of the determination of the concentration of this radioisotope in the atmosphere. Besides that, the isotopic ratio of ²⁴⁰Pu/²³⁹Pu provides information about the origin of the source. PM₂.₅ sampling was carried out in the Metropolitan Zone of the Valley of Mexico (MZVM) from February 18th to March 17th in 2015 on quartz filter. There have been significant developments recently due to the establishment of new methods for sample preparation and accurate measurement to detect ultra trace levels as the plutonium is found in the environment. The accelerator mass spectrometry (AMS) is a technique that allows measuring levels of detection around of femtograms (10-15 g). The AMS determinations include the chemical isolation of Pu. The Pu separation involved an acidic digestion and a radiochemical purification using an anion exchange resin. Finally, the source is prepared, when Pu is pressed in the corresponding cathodes. According to the author's knowledge on these aerosols showed variations on the ²³⁵U/²³⁸U ratio of the natural value, suggesting that could be an anthropogenic source altering it. The determination of the concentration of the isotopes of Pu can be a useful tool in order the clarify this presence in the atmosphere. The first results showed a mean value of activity concentration of ²³⁹Pu of 280 nBq m⁻³ thus the ²⁴⁰Pu/²³⁹Pu was 0.025 corresponding to the weapon production source; these results corroborate that there is an anthropogenic influence that is increasing the concentration of radioactive material in PM₂.₅. According to the author's knowledge in Total Suspended Particles (TSP) have been reported activity concentrations of ²³⁹⁺²⁴⁰Pu around few tens of nBq m⁻³ and 0.17 of ²⁴⁰Pu/²³⁹Pu ratios. The preliminary results in MZVM show high activity concentrations of isotopes of Pu (40 and 700 nBq m⁻³) and low ²⁴⁰Pu/²³⁹Pu ratio than reported. These results are in the order of the activity concentrations of Pu in weapons-grade of high purity.

Keywords: aerosols, fallout, mass spectrometry, radiochemistry, tracer, ²⁴⁰Pu/²³⁹Pu ratio

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Authors: Romulo D. C. Santos, Silvio M. A. Gama, Ramiro G. R. Camacho

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In this present paper, the thermos-fluid dynamics considering the mixed convection (natural and forced convections) and the principles of turbulence flow around complex geometries have been studied. In these applications, it was necessary to analyze the influence between the flow field and the heated immersed body with constant temperature on its surface. This paper presents a study about the Newtonian incompressible two-dimensional fluid around isothermal geometry using the immersed boundary method (IBM) with the virtual physical model (VPM). The numerical code proposed for all simulations satisfy the calculation of temperature considering Dirichlet boundary conditions. Important dimensionless numbers such as Strouhal number is calculated using the Fast Fourier Transform (FFT), Nusselt number, drag and lift coefficients, velocity and pressure. Streamlines and isothermal lines are presented for each simulation showing the flow dynamics and patterns. The Navier-Stokes and energy equations for mixed convection were discretized using the finite difference method for space and a second order Adams-Bashforth and Runge-Kuta 4th order methods for time considering the fractional step method to couple the calculation of pressure, velocity, and temperature. This work used for simulation of turbulence, the Smagorinsky, and Spalart-Allmaras models. The first model is based on the local equilibrium hypothesis for small scales and hypothesis of Boussinesq, such that the energy is injected into spectrum of the turbulence, being equal to the energy dissipated by the convective effects. The Spalart-Allmaras model, use only one transport equation for turbulent viscosity. The results were compared with numerical data, validating the effect of heat-transfer together with turbulence models. The IBM/VPM is a powerful tool to simulate flow around complex geometries. The results showed a good numerical convergence in relation the references adopted.

Keywords: immersed boundary method, mixed convection, turbulence methods, virtual physical model

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Authors: Divyani Redhu, Manisha Rathaur

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India has emerged as a very lucrative market for the smartphones in a very short span of time. The number of smartphone users here is growing massively with each passing day. Also, the expansion of internet services to far corners of the nation has also given a push to the smartphone revolution in India. Millennial, also known as Generation Y or the Net Generation is the generation born between the early 1980s and mid-1990s (some definitions extending further to early 2000s). Spanning roughly over 15 years, different social classes, cultures, and continents; it is irrational to imagine that millennial have a unified identity. But still, it cannot be denied that the growing millennial population is not only young but is highly tech-savvy too. It is not just the appearance of the device that today; we call it ‘smart’. Rather, it is the numerous tasks and functions that it can perform which has led its name to evolve as that of a ‘smartphone’. From usual tasks that were earlier performed by a simple mobile phone like making calls, sending messages, clicking photographs, recording videos etc.; today, the time has come where most of our day – to – day tasks are being taken care of by our all-time companion, i.e. smartphones. From being our alarm clock to being our note-maker, from our watch to our radio, our book-reader to our reminder, smartphones are present everywhere. Smartphone has now become an essential device for particularly the millennial to communicate not only with their friends but also with their family, colleagues, and teachers. The study by the researchers would be quantitative in nature. For the same, a survey would be conducted in particularly the capital of India, i.e. Delhi and the National Capital Region (NCR), which is the metropolitan area covering the entire National Capital Territory of Delhi and urban areas covering states of Haryana, Uttarakhand, Uttar Pradesh and Rajasthan. The tool of the survey would be a questionnaire and the number of respondents would be 200. The results derived from the study would primarily focus on the increasing reach of smartphones in India, smartphones as technological innovation and convergent tools, smartphone usage pattern of millennial in India, most used applications by the millennial, the average time spent by them, the impact of smartphones on the personal interactions of millennial etc. Thus, talking about the smartphone technology and the millennial in India, it would not be wrong to say that the growth, as well as the potential of the smartphones in India, is still immense. Also, very few technologies have made it possible to give a global exposure to the users and smartphone, if not the only one is certainly an immensely effective one that comes to the mind in this case.

Keywords: Delhi – NCR, India, millennial, smartphone

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Authors: Huda Alyami

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The present study aims to measure the effectiveness of an "Interactive eBook" in order to develop skills of designing and employing webquests for female intern teachers. The study uses descriptive analytical methodology as well as quasi-experimental methodology. The sample of the study consists of (30) female intern teachers from the Department of Special Education (in the tracks of Gifted Education and Learning Difficulties), during the first semester of the academic year 2015, at King Abdul-Aziz University in Jeddah city. The sample is divided into (15) female intern teachers for the experimental group, and (15) female intern teachers for the control group. A set of qualitative and quantitative tools have been prepared and verified for the study, embodied in: a list of the designing webquests' skills, a list of the employing webquests' skills, a webquests' knowledge achievement test, a product rating card, an observation card, and an interactive ebook. The study concludes the following results: 1. After pre-control, there are statistically significant differences, at the significance level of (α ≤ 0.05), between the mean scores of the experimental and the control groups in the post measurement of the webquests' knowledge achievement test, in favor of the experimental group. 2. There are statistically significant differences, at the significance level of (α ≤ 0.05), between the mean scores of experimental and control groups in the post measurement of the product rating card in favor of the experimental group. 3. There are statistically significant differences, at the significance level of (α ≤ 0.05), between the mean scores of experimental and control groups in the post measurement of the observation card for the experimental group. In the light of the previous findings, the study recommends the following: taking advantage of interactive ebooks when teaching all educational courses for various disciplines at the university level, creating educational participative platforms to share educational interactive ebooks for various disciplines at the local and regional levels. The study suggests conducting further qualitative studies on the effectiveness of interactive ebooks, in addition to conducting studies on the use of (Web 2.0) in webquests.

Keywords: interactive eBook, webquest, design, employing, develop skills

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Authors: Carin Lindskog

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Introduction: Long-term success requires an organizational balance between continuity (exploitation) and change (exploration). The problem of balancing exploitation and exploration is a common issue in studies of organizational learning. In order to better face the tough competition in the face of changes, organizations need to exploit their current business and explore new business fields by developing new capabilities. The purpose of this work in progress is to develop a conceptual framework to shed light on the relevance of 'learning activities', i.e., exploitation and exploration, on different levels. The research questions that will be addressed are as follows: What sort of learning activities are found in the Business Process Management (BPM) field? How can these activities be linked to the individual level, group, level, and organizational level? In the work, a literature review will first be conducted. This review will explore the status of learning activities in the BPM field. An outcome from the literature review will be a conceptual framework of learning activities based on the included publications. The learning activities will be categorized to focus on the categories exploitation, exploration or both and into the levels of individual, group, and organization. The proposed conceptual framework will be a valuable tool for analyzing the research field as well as identification of future research directions. Related Work: BPM has increased in popularity as a way of working to strengthen the quality of the work and meet the demands of efficiency. Due to the increase in BPM popularity, more and more organizations reporting on BPM failure. One reason for this is the lack of knowledge about the extended scope of BPM to other business contexts that include, for example, more creative business fields. Yet another reason for the failures are the fact of the employees’ are resistant to changes. The learning process in an organization is an ongoing cycle of reflection and action and is a process that can be initiated, developed and practiced. Furthermore, organizational learning is multilevel; therefore the theory of organizational learning needs to consider the individual, the group, and the organization level. Learning happens over time and across levels, but it also creates a tension between incorporating new learning (feed-forward) and exploiting or using what has already been learned (feedback). Through feed-forward processes, new ideas and actions move from the individual to the group to the organization level. At the same time, what has already been learned feeds back from the organization to a group to an individual and has an impact on how people act and think.

Keywords: business process management, exploitation, exploration, learning activities

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Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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Authors: R. W. Walker, J. M. Lynch, K. Anderson, R. G. Middleton

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Hip and knee arthritis are two of the commonest conditions that result in elective orthopaedic outpatient referral. At clinic appointments advice given regarding lifestyle modifications or treatment options may not be fully understood by patients. The majority of patients now use the internet to research their condition and use this to inform their decision about treatments. This study assessed the quality of patient information regarding hip and knee arthritis. To assess the quality of patient information regarding knee and hip arthritis available on the internet. Two internet searches were carried out one month apart using the search terms “knee arthritis” and “hip arthritis” on Google, a search engine that accounts for over 90% or internet searches in the UK. Sites were evaluated using the DISCERN instrument, a validated tool for measuring the quality of consumer health information. The first 50 results for each search were analysed by two different observers and discrepancies in scores were reviewed by both observers together and a score was agreed upon. In total 200 search result websites were assessed, of which 84 fulfilled the inclusion criteria. 53% (n=44) were funded directly by commercial healthcare businesses and of these, 70% (n=31) were funded by a surgeon/hospital promoting end-user purchase of surgical intervention. Overall 35% (n=29) websites were “for-profit” information websites where funding was from advertising revenues from pharmaceutical and prosthesis companies. 81% (n=67) offered information about surgical treatments however only 43% (n=36) mentioned the risk of complications of surgery. 67% (n=56) did not have any reference to sources for the information they detailed and 57% (n=47) had no apparent date for the production of the information they offered. Overall 17% (n=14) of websites were judged as being of high quality, with 29% (n=24) being of moderate quality and 54% (n=45) being of low quality. The quality of health information regarding hip and knee arthritis on the internet is highly variable and the majority of websites assessed were of poor quality. A preponderance of websites were funded by a commercial surgical service offering athroplasty at consumer cost, with a further third being funded indirectly via advertising revenues from commercial businesses. The vast majority of websites only mentioned surgery as a treatment and nearly half of all websites did not mention the risks or complications of surgical intervention at all. This has implications for the consent process. As such, Clinicians should be aware of the heterogeneous nature of patient information on the internet and be prepared to advise their patients about good quality websites where further reliable information can be sought.

Keywords: hip osteoarthritis, informed consent, knee osteoarthritis, patient information

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Authors: Xuan Pang, Alvin L. Lee, Peggy Glatthaar

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Libraries across the world have been an innovation engine of creativity and opportunityin many decades. The on-going global epidemiology outbreak and health crisis experience illuminates potential reforms, rethinking beyond traditional library operations and services. Controlled Digital Lending (CDL) is one of the emerging technologies libraries used to deliver information digitally in support of online learning and teachingand make educational materials more affordable and more accessible. CDL became a popular term in the United States of America (USA) as a result of a white paper authored by Kyle K. Courtney (Harvard University) and David Hansen (Duke University). The paper gave the legal groundwork to explore CDL: Fair Use, First Sale Doctrine, and Supreme Court rulings. Library professionals implemented this new technology to fulfill their users’ needs. Three libraries in the state of Florida (University of Florida, Florida Gulf Coast University, and Florida A&M University) started a conversation about how to develop strategies to make CDL work possible at each institution. This paper shares the stories of piloting and initiating a CDL program to ensure students have reliable, affordable access to course materials they need to be successful. Additionally, this paper offers an overview of the emerging trends of Controlled Digital Lending in the USA and demonstrates the development of the CDL platforms, policies, and implementation plans. The paper further discusses challenges and lessons learned and how each institution plans to sustain the program into future library services. The fundamental mission of the library is providing users unrestricted access to library resources regardless of their physical location, disability, health status, or other circumstances. The professional due diligence of librarians, as information professionals, is to makeeducational resources more affordable and accessible.CDL opens a new frontier of library services as a mechanism for library practice to enhance user’s experience of using libraries’ services. Libraries should consider exploring this tool to distribute library resources in an effective and equitable way. This new methodology has potential benefits to libraries and end users.

Keywords: controlled digital lending, emerging technologies, equitable access, collaborations

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Authors: Ketan Tamirisa, Kathleen P. Tebb

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In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.

Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners

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Authors: Mohammed Abdullah Alshahrani

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The research focuses on investigating the use of partial least squares (PLS) methodology for addressing challenges associated with high-dimensional correlated data. Recent technological advancements have led to experiments producing data characterized by a large number of variables compared to observations, with substantial inter-variable correlations. Such data patterns are common in chemometrics, where near-infrared (NIR) spectrometer calibrations record chemical absorbance levels across hundreds of wavelengths, and in genomics, where thousands of genomic regions' copy number alterations (CNA) are recorded from cancer patients. PLS serves as a widely used method for analyzing high-dimensional data, functioning as a regression tool in chemometrics and a classification method in genomics. It handles data complexity by creating latent variables (components) from original variables. However, applying PLS can present challenges. The study investigates key areas to address these challenges, including unifying interpretations across three main PLS algorithms and exploring unusual negative shrinkage factors encountered during model fitting. The research presents an alternative approach to addressing the interpretation challenge of predictor weights associated with PLS. Sparse estimation of predictor weights is employed using a penalty function combining a lasso penalty for sparsity and a Cauchy distribution-based penalty to account for variable dependencies. The results demonstrate sparse and grouped weight estimates, aiding interpretation and prediction tasks in genomic data analysis. High-dimensional data scenarios, where predictors outnumber observations, are common in regression analysis applications. Ordinary least squares regression (OLS), the standard method, performs inadequately with high-dimensional and highly correlated data. Copy number alterations (CNA) in key genes have been linked to disease phenotypes, highlighting the importance of accurate classification of gene expression data in bioinformatics and biology using regularized methods like PLS for regression and classification.

Keywords: partial least square regression, genetics data, negative filter factors, high dimensional data, high correlated data

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