Search results for: linear regression

Authors: Rizky Oktaviana

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The main purpose of studying lies in improving students’ understanding. Teachers usually use written test to measure students’ understanding about learning material especially mathematical learning material. This common method actually has a lack point, such that in mathematics content, written test only show procedural steps to solve mathematical problems. Therefore, teachers unable to see whether students actually understand about mathematical concepts and the relation between concepts or not. One of the best tools to observe students’ understanding about the mathematical concepts is concept map. The goal of this research is to describe junior high school students understanding about mathematical concepts through Concept Maps based on the difference of mathematical ability. There were three steps in this research; the first step was choosing the research subjects by giving mathematical ability test to students. The subjects of this research are three students with difference mathematical ability, high, intermediate and low mathematical ability. The second step was giving concept mapping training to the chosen subjects. The last step was giving concept mapping task about the function to the subjects. Nodes which are the representation of concepts of function were provided in concept mapping task. The subjects had to use the nodes in concept mapping. Based on data analysis, the result of this research shows that subject with high mathematical ability has formal understanding, due to that subject could see the connection between concepts of function and arranged the concepts become concept map with valid hierarchy. Subject with intermediate mathematical ability has relational understanding, because subject could arranged all the given concepts and gave appropriate label between concepts though it did not represent the connection specifically yet. Whereas subject with low mathematical ability has poor understanding about function, it can be seen from the concept map which is only used few of the given concepts because subject could not see the connection between concepts. All subjects have instrumental understanding for the relation between linear function concept, quadratic function concept and domain, co domain, range.

Keywords: concept map, concept mapping, mathematical concepts, understanding

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Authors: Mitra Saberi, Saeideh Fakhari, Amir Karam, Ali Ahmadabadi

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Geomorphology is the scientific study of the characteristics of form and shape of the Earth's surface. The existence of types of landforms and their variation is mainly controlled by changes in the shape and position of land and topography. In fact, the interest and application of fractal issues in geomorphology is due to the fact that many geomorphic landforms have fractal structures and their formation and transformation can be explained by mathematical relations. The purpose of this study is to identify and analyze the fractal behavior of landforms of macro geomorphologic regions of Iran, as well as studying and analyzing topographic and landform characteristics based on fractal relationships. In this study, using the Iranian digital elevation model in the form of slopes, coefficients of deposition and alluvial fan, the fractal dimensions of the curves were calculated through the box counting method. The morphometric characteristics of the landforms and their fractal dimension were then calculated for 4criteria (height, slope, profile curvature and planimetric curvature) and indices (maximum, Average, standard deviation) using ArcMap software separately. After investigating their correlation with fractal dimension, two-way regression analysis was performed and the relationship between fractal dimension and morphometric characteristics of landforms was investigated. The results show that the fractal dimension in different pixels size of 30, 90 and 200m, topographic curves of different landform units of Iran including mountain, hill, plateau, plain of Iran, from1.06in alluvial fans to1.17in The mountains are different. Generally, for all pixels of different sizes, the fractal dimension is reduced from mountain to plain. The fractal dimension with the slope criterion and the standard deviation index has the highest correlation coefficient, with the curvature of the profile and the mean index has the lowest correlation coefficient, and as the pixels become larger, the correlation coefficient between the indices and the fractal dimension decreases.

Keywords: box counting method, fractal dimension, geomorphology, Iran, landform

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Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

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Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

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Authors: Hany M. Fayed, Rehab F. Abdel-Rahman, Alyaa F. Hessin, Hanan A. Ogaly, Gihan F. Asaad, Abeer A. A. Salama, Sahar Abdelrahman, Mahmoud S. Arbid, Marwan Abd Elbaset Mohamed

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Liver fibrosis is a serious global health problem that occurs as a result of a variety of chronic liver disorders. Apigenin, a flavonoid found in many plants, has several pharmacological properties. The aim of this study was to evaluate the antifibrotic efficacy of apigenin (APG) against experimentally induced hepatic fibrosis in rats via using thioacetamide (TAA) and to explore the possible underlying mechanisms. TAA (100 mg/kg, i.p.) was given three times each week for two weeks to induce liver fibrosis. After TAA injections, APG was given orally (5 and 10 mg/kg) daily for two weeks. Biochemical, molecular, histological and immunohistochemical analyses were performed on blood and liver tissue samples. The functioning of the liver, oxidative stress, inflammation, and liver fibrosis indicators were all evaluated. The findings showed that TAA markedly increased the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as the levels of malondialdehyde (MDA), focal adhesion kinase (FAK), hypoxia-inducible factor-1 (HIF-1), nuclear factor-κB (NF-κB), transforming growth factor-beta (TGF-β), tumor necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β) with a reduction in albumin, total protein, A/G ratio, GSH content and interleukin-10 (IL-10). Moreover, TAA elevated the content of collagen I, α -smooth muscle actin (α-SMA), and hydroxyproline in the liver. The treatment with APG in a dose-dependent manner has obviously prevented these alterations and amended the harmful effects induced by TAA. The histopathological and immunohistochemical observations supported this biochemical evidence. The higher dose of APG produced the most significant antifibrotic effect. As a result of these data, APG appears to be a promising antifibrotic drug and could be used as a new herbal medication or dietary supplement in the future for the treatment of liver fibrosis. This effect might be related to the inhibition of the HIF-1/FAK signaling pathway.

Keywords: apigenin, FAK, HIF-1, liver fibrosis, rat, thioacetamide

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Authors: Mohammad Saber Eslamlou

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Morphology of Islamic cities has been extensively studied by researchers of Islamic cities and different theories could be found about it. In this regard, there exist much difference in method of analysis, classification, recognition, confrontation and comparative method of urban morphology. The present paper aims to examine the previous methods, approaches and insights and that how Dr. Giulia Annalinda Neglia dealt with the analysis of morphology of Islamic cities. Neglia is assistant professor in University of Bari, Italy (UNIBA) who has published numerous papers and books on Islamic cities. I introduce her works in the field of morphology of Islamic cities. And then, her thoughts, insights and research methodologies are presented and analyzed in critical perspective. This is a qualitative research on her written works, which have been classified in three major categories. The first category consists mainly of her works on morphology and physical shape of Islamic cities. The results of her works’ review suggest that she has used Moratoria typology in investigating morphology of Islamic cities. Moreover, overall structure of the cities under investigation is often described linear; however, she’s against to define a single framework for the recognition of morphology in Islamic cities. She states that ‘to understand the physical complexity and irregularities in Islamic cities, it is necessary to study the urban fabric by typology method, focusing on transformation processes of the buildings’ form and their surrounding open spaces’ and she believes that fabric of each region in the city follows from the principles of an specific period or urban pattern, in particular, Hellenistic and Roman structures. Furthermore, she believes that it is impossible to understand the morphology of a city without taking into account the obvious and hidden developments associated with it, because form of building and their surrounding open spaces are written history of the city.

Keywords: city, Islamic city, Giulia Annalinda Neglia, morphology

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Authors: Anju Joshi, C. N. Tharamani

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Diabetes is one of the leading cause of death at present and remains an important concern as the prevalence of the disease is increasing at an alarming rate. Therefore, it is crucial to diagnose the accurate levels of glucose for developing an efficient therapeutic for diabetes. Due to the availability of convenient and compact self-testing, continuous monitoring of glucose is feasible nowadays. Enzyme based electrochemical sensing of glucose is quite popular because of its high selectivity but suffers from drawbacks like complicated purification and immobilization procedures, denaturation, high cost, and low sensitivity due to indirect electron transfer. Hence, designing a robust enzyme free platform using transition metal oxides remains crucial for the efficient and sensitive determination of glucose. In the present work, manganese doped nickel oxide nanoparticles (Mn-NiO) has been synthesized onto the surface of multiwalled carbon nanotubes using a simple microwave assisted approach for non-enzymatic electrochemical sensing of glucose. The morphology and structure of the synthesized nanostructures were characterized using scanning electron microscopy (SEM) and X-Ray diffraction (XRD). We demonstrate that the synthesized nanostructures show enormous potential for electrocatalytic oxidation of glucose with high sensitivity and selectivity. Cyclic voltammetry and square wave voltammetry studies suggest superior sensitivity and selectivity of Mn-NiO decorated carbon nanotubes towards the non-enzymatic determination of glucose. A linear response between the peak current and the concentration of glucose has been found to be in the concentration range of 0.01 μM- 10000 μM which suggests the potential efficacy of Mn-NiO decorated carbon nanotubes for sensitive determination of glucose.

Keywords: diabetes, glucose, Mn-NiO decorated carbon nanotubes, non-enzymatic

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Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

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Authors: Nantale Prossy Nabatte, Josephat Nyagero, Elizabeth Kemigisha

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Background: Human Papilloma Virus (HPV) is a prevalent sexually transmitted infection (STI) in the world. It is important to screen for HPV so that women found positive receive early treatment to prevent the development of cervical cancer. The broad aim of the research was to explore the types, occurrence, and associated correlates of HPV infection by genotyping Human papillomavirus among a cohort of WLHIV attending an antiretroviral therapy clinic in Mukono, Uganda. Methods: A cross-sectional study was used to collect data for socio-demographic, sexual practices, and medical history factors associated with HPV genotypes using a pretested interview guide subjected to 342 WLHIV. The respondents’ results for HPV genotypes were obtained retrospectively from respective laboratory records. Data was entered in Epidata v4.6 and analysed using STATA V14. The prevalence of hr-HPV was estimated as a proportion of the entire sample size. Analysis for the correlates of hr-HPV infection was done using a modified Poisson regression model. Results: Slightly more than a half of respondents were aged below 35 years (56.7%), married (52.6%), and with a primary level of education (51.2%). The prevalence of hr-HPV was 39.8% at a 95% confidence interval (CI: 34.40- 44.78). The hr-HPV was higher among those between 30-34 years of age (n= 41, 30.2%) than those between the age of 45-49 years (n=16, 11.8%). In terms of associated correlates, age 45-49 years (aPR: 1.95, 95% CI: 1.41- 2.69), being married (aPR: 1.30, 95% CI: 1.00, 1.69), use of condoms (aPR: 1.31, 95% CI: 1.00 -1.71) and age of sexual debut (aPR: 1.42, 95% CI: 1.08-1.87) were significantly associated with Human papillomavirus genotypes. Conclusion and Recommendation: The prevalence of hr-HPV infection was high, indicative of a risk to the health of WLHIV in Mukono, Uganda, and worldwide at large. The correlates are age 45-49 years, being married, use of condoms, and age of sexual debut. Based on the results, it is recommended that the implementing teams in such projects put more emphasis on the diagnosis of hr-HPV infection and monitoring the treatment. More research is required to determine the effect of ART therapy on hr-HPV persistence.

Keywords: human papillomavirus genotypes, and their correlates, among women living with HIV, attending antiretroviral clinic

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Authors: Karolina Patora

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This article investigates liquidity risk management by banks, which has gained significant importance since the global financial crisis of 2008. The issue is of particular interest for countries like Poland, in which foreign capital plays a dominant role. Such an ownership structure poses certain risks to the local banking sector, which faces an increased probability of the withdrawal of funding or assets’ transfers abroad in case of a crisis. Both these factors can have a detrimental influence on the liquidity position of foreign-owned banks and hence negatively affect the financial stability of the whole banking sector. The aim of this study is to evaluate the impact of a dominating share of foreign investors in the Polish banking sector on the liquidity position of commercial banks. The study hypothesizes that the ownership structure of the Polish banking sector, in which there are banks predominantly controlled by foreign investors, does not pose a threat to the liquidity position of Polish banks. A supplementary research hypothesis is that the liquidity risk profile of foreign-owned banks differs from that of domestic banks. The sample consists of 14 foreign-owned banks and 5 domestic banks owned by local investors, which together constitute approximately 87% of the banking sector’s assets. The data covers the period of 2004–2014. The results of the regression models show no evidence of significant differences in terms of the dynamics of changes of the liquidity buffers between the foreign-owned and domestic banks, although the signs of the coefficients might suggest that the foreign-owned banks were decreasing the holdings of liquid assets at a slower pace over the examined period, compared to the domestic banks. However, no proof of the statistical significance of these findings has been found. The supplementary research hypothesis that the liquidity risk profile of foreign-controlled banks differs from that of domestic banks was rejected.

Keywords: foreign-owned banks, liquidity position, liquidity risk, financial stability

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Authors: Pavan K. Emani, Shashank Kothari, V. S. Phanikanth

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The ultimate load analysis of RC pile groups has assumed a lot of significance under liquefying soil conditions, especially due to post-earthquake studies of 1964 Niigata, 1995 Kobe and 2001 Bhuj earthquakes. The present study reports the results of numerical simulations on pile groups subjected to monotonically increasing lateral loads under design amounts of pile axial loading. The soil liquefaction has been considered through the non-linear p-y relationship of the soil springs, which can vary along the depth/length of the pile. This variation again is related to the liquefaction potential of the site and the magnitude of the seismic shaking. As the piles in the group can reach their extreme deflections and rotations during increased amounts of lateral loading, a precise modeling of the inelastic behavior of the pile cross-section is done, considering the complete stress-strain behavior of concrete, with and without confinement, and reinforcing steel, including the strain-hardening portion. The possibility of the inelastic buckling of the individual piles is considered in the overall collapse modes. The model is analysed using Riks analysis in finite element software to check the post buckling behavior and plastic collapse of piles. The results confirm the kinds of failure modes predicted by centrifuge test results reported by researchers on pile group, although the pile material used is significantly different from that of the simulation model. The extension of the present work promises an important contribution to the design codes for pile groups in liquefying soils.

Keywords: collapse load analysis, inelastic buckling, liquefaction, pile group

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Authors: Bienvenu Gael Fouda Mbanga

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This study reports a new approach of preparation of carbon nanoparticles coated cerium oxide nanorods (CNPs/CeONRs) nanocomposite and reusing the spent adsorbent of Cd2+- CNPs/CeONRs nanocomposite for latent fingerprint detection (LFP) after removing Cd2+ ions from aqueous solution. CNPs/CeONRs nanocomposite was prepared by using CNPs and CeONRs with adsorption processes. The prepared nanocomposite was then characterized by using UV-visible spectroscopy (UV-visible), Fourier transforms infrared spectroscopy (FTIR), X-ray diffraction pattern (XRD), scanning electron microscope (SEM), Transmission electron microscopy (TEM), Energy-dispersive X-ray spectroscopy (EDS), Zeta potential, X-ray photoelectron spectroscopy (XPS). The average size of the CNPs was 7.84nm. The synthesized CNPs/CeONRs nanocomposite has proven to be a good adsorbent for Cd2+ removal from water with optimum pH 8, dosage 0. 5 g / L. The results were best described by the Langmuir model, which indicated a linear fit (R2 = 0.8539-0.9969). The adsorption capacity of CNPs/CeONRs nanocomposite showed the best removal of Cd2+ ions with qm = (32.28-59.92 mg/g), when compared to previous reports. This adsorption followed pseudo-second order kinetics and intra particle diffusion processes. ∆G and ∆H values indicated spontaneity at high temperature (40oC) and the endothermic nature of the adsorption process. CNPs/CeONRs nanocomposite therefore showed potential as an effective adsorbent. Furthermore, the metal loaded on the adsorbent Cd2+- CNPs/CeONRs has proven to be sensitive and selective for LFP detection on various porous substrates. Hence Cd2+-CNPs/CeONRs nanocomposite can be reused as a good fingerprint labelling agent in LFP detection so as to avoid secondary environmental pollution by disposal of the spent adsorbent.

Keywords: Cd2+-CNPs/CeONRs nanocomposite, cadmium adsorption, isotherm, kinetics, thermodynamics, reusable for latent fingerprint detection

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Authors: Tanja Kreitenweis

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Lifelong learning is increasingly seen as essential for coping with the rapidly changing work environment. To this end, serious games can provide convenient and straightforward access to complex knowledge for all age groups. However, learning achievements depend largely on a learner’s non-cognitive skill disposition (e.g., motivation, self-belief, playfulness, and openness). With the aim of combining the fields of serious games and non-cognitive skills, this research focuses in particular on the use of a business simulation, which conveys change management insights. Business simulations are a subset of serious games and are perceived as a non-traditional learning method. The presented objectives of this work are versatile: (1) developing a scale, which measures learners’ knowledge and skills level before and after a business simulation was played, (2) investigating the influence of non-cognitive skills on learning in this business simulation environment and (3) exploring the moderating role of team preference in this type of learning setting. First, expert interviews have been conducted to develop an appropriate measure for learners’ skills and knowledge assessment. A pretest-posttest experimental design with German management students was implemented to approach the remaining objectives. By using the newly developed, reliable measure, it was found that students’ skills and knowledge state were higher after the simulation had been played, compared to before. A hierarchical regression analysis revealed two positive predictors for this outcome: motivation and self-esteem. Unexpectedly, playfulness had a negative impact. Team preference strengthened the link between grit and playfulness, respectively, and learners’ skills and knowledge state after completing the business simulation. Overall, the data underlined the potential of business simulations to improve learners’ skills and knowledge state. In addition, motivational factors were found as predictors for benefitting most from the applied business simulation. Recommendations are provided for how pedagogues can use these findings.

Keywords: business simulations, change management, (experiential) learning, non-cognitive skills, serious games

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Authors: Cruz Queen Allysa Rose, Bautista Joymeeh Anne, Lantoria Kaye, Barretto Katya Louise

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The study presents the preferences of passengers on the quality of service provided by the two airline check-in methods currently present in airports-traditional counter check-in and common-use self-service kiosks. Since a study has shown that airlines perceive self-service kiosks alone are sufficient enough to ensure adequate services and customer satisfaction, and in contrast, agents and passengers stated that it alone is not enough and that human interaction is essential. In reference with former studies that established opposing ideas about the choice of the more favorable airline check-in method to employ, it is the purpose of this study to present a recommendation that shall somehow fill-in the gap between the conflicting ideas by means of comparing the perceived quality of service through the RATER model. Furthermore, this study discusses the major competencies present in each method which are supported by the theories–FIRO Theory of Needs upholding the importance of inclusion, control and affection, and the Queueing Theory which points out the discipline of passengers and the length of the queue line as important factors affecting quality service. The findings of the study were based on the data gathered by the researchers from selected Thomasian third year and fourth year college students currently enrolled in the first semester of the academic year 2014-2015, who have already experienced both airline check-in methods through the implication of a stratified probability sampling. The statistical treatments applied in order to interpret the data were mean, frequency, standard deviation, t-test, logistic regression and chi-square test. The final point of the study revealed that there is a greater effect in passenger preference concerning the satisfaction experienced in common-use self-service kiosks in comparison with the application of the traditional counter check-in.

Keywords: traditional counter check-in, common-use self-service Kiosks, airline check-in methods

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Authors: Happy Zulu

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Neuropsychological examination is an important way of formally assessing brain function. While there is so much documentation about the influence that some factors, such as age and education, have on neuropsychological tests (NP), not so much has been done to assess the influence that residency (rural/urban) may have. The specific objectives of this study were to establish if there is a significant difference in mean test scores on NP tests between rural and urban participants and to assess which tests on the Zambia Neurobehavioural Test Battery (ZNTB) are more affected by the participants‘ residency (rural/urban) and to determine the extent to which education, gender, and age predict test performance on NP tests for rural and urban participants. The participants (324) were drawn from both urban and rural areas of Zambia (Rural = 152 and Urban = 172). However, only 234 participants (Rural = 152 and Urban 82) were used for all the analyses in this particular study. The 234 participants were used as the actual proportion of the rural vs urban population in Zambia was 65% : 35%, respectively (CSO, 2003). The rural-urban ratio for the participants that were captured during the data collection process was 152 : 172, respectively. Thus, all the rural participants (152) were included and 90 of the 172 urban participants were randomly excluded so that the rural/urban ratio reached the desired 65% : 35 % which was the required ideal statistic for appropriate representation of the actual population in Zambia. Data on NP tests were analyzed from 234 participants, rural (N=152) reflecting 65% and urban (N=82) reflecting 35%. T-tests indicated that urban participants had superior performances in all the seven NP test domains, and all the mean differences in all these domains were found to be statistically significant. Residency had a large or moderate effect in five domains, while its effect size was small only in two of the domains. A standard multiple regression revealed that education, age and residency as predictor variables made a significant contribution to variance in performance on various domains of the ZNTB. However, the gender of participants was not a major factor in determining one‘s performance on neuropsychological tests. This particular report is part of an ongoing, larger, cutting-edge study aimed at formulating the normative data for Zambia with regard to performance on neuropsychological tests. This is necessary for appropriate, effective, and efficient assessment or diagnosis of various neurocognitive and neurobehavioural deficits that a number of people may currently be suffering from. It has been shown in this study that it is vital to make careful analyses of the variables that may be associated with one‘s performance on neuropsychological tests.

Keywords: neuropsychology, neurobehavioural, residency, Zambia

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Authors: Mengying Wang, Dongjing Liu, Holger Schwender, Ping Wang, Hongping Zhu, Tao Wu, Terri H Beaty

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Background: Maternal smoking is a recognized risk factor for nonsyndromic cleft lip with or without cleft palate (NSCL/P). It has been reported that the effect of maternal smoking on oral clefts is mediated through genes that influence nicotine dependence. The polymorphisms of cholinergic receptor nicotinic alpha (CHRNA) and beta (CHRNB) subunits genes have previously shown strong associations with nicotine dependence. Here, we attempted to investigate whether the above genes are associated with clefting risk through testing for potential gene-gene (G×G) and gene-environment (G×E) interaction. Methods: We selected 120 markers in 14 genes associated with nicotine dependence to conduct transmission disequilibrium tests among 806 Chinese NSCL/P case-parent trios ascertained in an international consortium which conducted a genome-wide association study (GWAS) of oral clefts. We applied Cordell’s method using “TRIO” package in R to explore G×G as well as G×E interaction involving environmental tobacco smoke (ETS) based on conditional logistic regression model. Results: while no SNP showed significant association with NSCL/P after Bonferroni correction, we found signals for G×G interaction between 10 pairs of SNPs in CHRNA3, CHRNA5, and CHRNB4 (p<10-8), among which the most significant interaction was found between RS3743077 (CHRNA3) and RS11636753 (CHRNB4, p<8.2×10-12). Linkage disequilibrium (LD) analysis revealed only low level of LD between these markers. However, there were no significant results for G×ETS interaction. Conclusion: This study fails to detect association between nicotine dependence genes and NSCL/P, but illustrates the importance of taking into account potential G×G interaction for genetic association analysis in NSCL/P. This study also suggests nicotine dependence genes should be considered as important candidate genes for NSCL/P in future studies.

Keywords: Gene-Gene Interaction, Maternal Smoking, Nicotine Dependence, Non-Syndromic Cleft Lip with or without Cleft Palate

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Authors: Arezou Rezazadeh, Nasrin Omidvar, Hassan Eini-Zinab, Mahmoud Ghazi-Tabatabaie, Reza Majdzadeh, Saeid Ghavamzadeh, Sakineh Nouri-Saeidlou

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Dietary pattern analysis method can reflect more information about the nutritional etiology of chronic diseases such as obesity. The aim of this study was to determine the relationship between major dietary patterns and anthropometric measures in men and women living in the city of Urmia. In this cross-sectional study, 723 participants (427 women and 296 men), aged 20–64 in Urmia city were selected from all four zones of Urmia city, in the north-west of Iran. Anthropometrics (weight, height, waist and hip circumference) were measured with standard methods. Body Mass Index (BMI) was calculated by dividing weight (in kilograms) by the square of height (in meter). Dietary intake information was collected by a semi-quantitative food frequency questionnaire in the last year. Dietary patterns were determined using principal component analysis. The relationship between dietary patterns and obesity was analyzed by logistic regression. Three major dietary patterns (DPs) were identified that were named ‘Traditional Higher SES (THS)’, ‘Traditional Low SES (TLS)’ and ‘Transitional’. THS DP was positively and Transitional DP was negatively associated with BMI and waist circumference (W.C), however, after adjusting for confounding variables (age, gender, ethnicity, energy intake, physical activity and SES), the associations were not significant. The TLS was not significantly associated with BMI, but after adjusting for confounders, a significant positive association was detected with W.C and Waist to hip ratio (WHR). Findings showed that both traditional patterns were positively and the western type transitional pattern was reversely associated with anthropometric indices. But this relationship was highly affected by demographic, socioeconomic and energy input and output determinants. The results indicate the inevitable effect of environmental factors on the relationship between dietary patterns and anthropometric indices.

Keywords: anthropometric indices, dietary pattern, Iran, North-west

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Authors: Mehwish Sarfaraz Ahmad

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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: M. Almutairi, S. Hadjiloucas

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The harmonic distortion of voltage is important in relation to power quality due to the interaction between the large diffusion of non-linear and time-varying single-phase and three-phase loads with power supply systems. However, harmonic distortion levels can be reduced by improving the design of polluting loads or by applying arrangements and adding filters. The application of passive filters is an effective solution that can be used to achieve harmonic mitigation mainly because filters offer high efficiency, simplicity, and are economical. Additionally, possible different frequency response characteristics can work to achieve certain required harmonic filtering targets. With these ideas in mind, the objective of this paper is to determine what size single tuned passive filters work in distribution networks best, in order to economically limit violations caused at a given point of common coupling (PCC). This article suggests that a single tuned passive filter could be employed in typical industrial power systems. Furthermore, constrained optimization can be used to find the optimal sizing of the passive filter in order to reduce both harmonic voltage and harmonic currents in the power system to an acceptable level, and, thus, improve the load power factor. The optimization technique works to minimize voltage total harmonic distortions (VTHD) and current total harmonic distortions (ITHD), where maintaining a given power factor at a specified range is desired. According to the IEEE Standard 519, both indices are viewed as constraints for the optimal passive filter design problem. The performance of this technique will be discussed using numerical examples taken from previous publications.

Keywords: harmonics, passive filter, power factor, power quality

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Authors: Abu Hasan, Rochmadi, Hary Sulistyo, Suharto Honggokusumo

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This research purpose is to study the effect of Ingredients mixing sequence in rubber compounding onto the formation of bound rubber and cross link density of natural rubber and also the relationship of bound rubber and cross link density. Analysis of bound rubber formation of rubber compound and cross link density of rubber vulcanizates were carried out on a natural rubber formula having masticated and mixing, followed by curing. There were four methods of mixing and each mixing process was followed by four mixing sequence methods of carbon black into the rubber. In the first method of mixing sequence, rubber was masticated for 5 min and then rubber chemicals and carbon black N 330 were added simultaneously. In the second one, rubber was masticated for 1 min and followed by addition of rubber chemicals and carbon black N 330 simultaneously using the different method of mixing then the first one. In the third one, carbon black N 660 was used for the same mixing procedure of the second one, and in the last one, rubber was masticated for 3 min, carbon black N 330 and rubber chemicals were added subsequently. The addition of rubber chemicals and carbon black into masticated rubber was distinguished by the sequence and time allocated for each mixing process. Carbon black was added into two stages. In the first stage, 10 phr was added first and the remaining 40 phr was added later along with oil. In the second one to the fourth one, the addition of carbon black in the first and the second stage was added in the phr ratio 20:30, 30:20, and 40:10. The results showed that the ingredients mixing process influenced bound rubber formation and cross link density. In the three methods of mixing, the bound rubber formation was proportional with crosslink density. In contrast in the fourth one, bound rubber formation and cross link density had contradictive relation. Regardless of the mixing method operated, bound rubber had non linear relationship with cross link density. The high cross link density was formed when low bound rubber formation. The cross link density became constant at high bound rubber content.

Keywords: bound-rubber, cross-link density, natural rubber, rubber mixing process

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Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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Authors: J. Prathap Kumar, G. Vaitheeswaran

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The present study investigates the role of ammonium and potassium ion in the electronic, bonding and optical properties of dinitramide salts due to their stability and non-toxic nature. A detailed analysis of bonding between NH₄ and K with dinitramide, optical transitions from the valence band to the conduction band, absorption spectra, refractive indices, reflectivity, loss function are reported. These materials are well known as oxidizers in solid rocket propellants. In the present work, we use full potential linear augmented plane wave (FP-LAPW) method which is implemented in the Wien2k package within the framework of density functional theory. The standard DFT functional local density approximation (LDA) and generalized gradient approximation (GGA) always underestimate the band gap by 30-40% due to the lack of derivative discontinuities of the exchange-correlation potential with respect to an occupation number. In order to get reliable results, one must use hybrid functional (HSE-PBE), GW calculations and Tran-Blaha modified Becke-Johnson (TB-mBJ) potential. It is very well known that hybrid functionals GW calculations are very expensive, the later methods are computationally cheap. The new developed TB-mBJ functionals use information kinetic energy density along with the charge density employed in DFT. The TB-mBJ functionals cannot be used for total energy calculations but instead yield very much improved band gap. The obtained electronic band gap at gamma point for both the ammonium dinitramide and potassium dinitramide are found to be 2.78 eV and 3.014 eV with GGA functional, respectively. After the inclusion of TB-mBJ, the band gap improved by 4.162 eV for potassium dinitramide and 4.378 eV for ammonium dinitramide. The nature of the band gap is direct in ADN and indirect in KDN. The optical constants such as dielectric constant, absorption, and refractive indices, birefringence values are presented. Overall as there are no experimental studies we present the improved band gap with TB-mBJ functional following with optical properties.

Keywords: ammonium dinitramide, potassium dinitramide, DFT, propellants

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Authors: M. Reza Roshandel, Tannaz Aghaei Badr, Batoul Khoundabi, Sara C. Lewis, Soroush Rais-Bahrami, John Sfakianos, Reza Mehrazin, Ash K. Tewari

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Introduction: Prostate biopsy is the most reliable diagnostic method for choosing the appropriate management of prostate cancer. However, discrepancies between Gleason grade groups (GG) of different biopsies remain a significant concern. This study aims to assess the association of the radiological factors with GG discrepancies in patients with index Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, using radical prostatectomy (RP) specimens as the most accurate and informative pathology. Methods: This single-institutional retrospective study was performed on a total of 2289 consecutive prostate cancer patients with combined targeted and systematic prostate biopsy followed by radical prostatectomy (RP). The database was explored for patients with the index PI-RADS 3 lesions version 2 and 2.1. Cancers with PI-RADS 4 or 5 scoring were excluded from the study. Patient characteristics and radiologic features were analyzed by multivariable logistic regression. Number-density of lesions was defined as the number of lesions per prostatic volume. Results: Of the 151 prostate cancer cases with PI-RADS 3 index lesions, 27% and 17% had upgrades and downgrades at RP, respectively. Analysis of grade changes showed no significant associations between discrepancies and the number or the number density of PI-RADS 3 lesions. Moreover, the study showed no significant association of the GG changes with race, age, location of the lesions, or prostate volume. Conclusions: This study demonstrated that in PI-RADS 3 cancerous nodules, the chance of the pathology changes in the final pathology of RP specimens was low. Furthermore, having multiple PI-RADS 3 nodules did not change the conclusion, as the possibility of grade changes in patients with multiple nodules was similar to those with solitary lesions.

Keywords: prostate, adenocarcinoma, multiparametric MRI, Gleason score, robot-assisted surgery

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Authors: Jacinta Musyoka, Wesley Too

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Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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Authors: Vahid Nourani, Atefeh Ashrafi

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Prediction of treated wastewater quality is a matter of growing importance in water treatment procedure. In this way artificial neural network (ANN), as a robust data-driven approach, has been widely used for forecasting the effluent quality of wastewater treatment. However, developing ANN model based on appropriate input variables is a major concern due to the numerous parameters which are collected from treatment process and the number of them are increasing in the light of electronic sensors development. Various studies have been conducted, using different clustering methods, in order to classify most related and effective input variables. This issue has been overlooked in the selecting dominant input variables among wastewater treatment parameters which could effectively lead to more accurate prediction of water quality. In the presented study two ANN models were developed with the aim of forecasting effluent quality of Tabriz city’s wastewater treatment plant. Biochemical oxygen demand (BOD) was utilized to determine water quality as a target parameter. Model A used Principal Component Analysis (PCA) for input selection as a linear variance-based clustering method. Model B used those variables identified by the mutual information (MI) measure. Therefore, the optimal ANN structure when the result of model B compared with model A showed up to 15% percent increment in Determination Coefficient (DC). Thus, this study highlights the advantage of PCA method in selecting dominant input variables for ANN modeling of wastewater plant efficiency performance.

Keywords: Artificial Neural Networks, biochemical oxygen demand, principal component analysis, mutual information, Tabriz wastewater treatment plant, wastewater treatment plant

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Authors: S. Singh, P. Patel, D. Kachhadiya, Swapnil Dharaskar

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The research objective is to integrate nanoparticles into fuels- i.e. diesel, biodiesel, biodiesel blended with diesel, plastic derived fuels, etc. to increase the fuel efficiency. The metal oxide nanoparticles will reduce the carbon monoxide emissions by donating oxygen atoms from their lattices to catalyze the combustion reactions and to aid complete combustion; due to this, there will be an increase in the calorific value of the blend (fuel + metal nanoparticles). Aluminium oxide and cobalt oxide nanoparticles have been synthesized by sol-gel method. The characterization was done by Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Scanning Electron Microscope (SEM) and Energy Dispersive X-ray Spectroscopy (EDS). The size of the particles was determined by XRD to be 28.6 nm and 28.06 nm for aluminium oxide and cobalt oxide nanoparticles respectively. Different concentration blends- 50, 100, 150 ppm were prepared by adding the required weight of metal oxides in 1 liter of diesel and sonicating for 30 minutes at 500W. The blend properties- calorific value, viscosity, and flash point were determined by bomb calorimeter, Brookfield viscometer and pensky-martin apparatus. For the aluminum oxide blended diesel, there was a maximum increase of 5.544% in the calorific value, but at the same time, there was an increase in the flash point from 43°C to 58.5°C and an increase in the viscosity from 2.45 cP to 3.25 cP. On the other hand, for the cobalt oxide blended diesel there was a maximum increase of 2.012% in the calorific value while the flash point increased from 43°C to 51.5°C and the viscosity increased from 2.45 cP to 2.94 cP. There was a linear increase in the calorific value, viscosity and flash point when the concentration of the metal oxide nanoparticles in the blend was increased. For the 50 ppm Al₂O₃ and 50 ppm Co₃O₄ blend the increasing the calorific value was 1.228 %, and the viscosity changed from 2.45 cP to 2.64 cP and the flash point increased from 43°C to 50.5°C. Clearly the aluminium oxide nanoparticles increase the calorific value but at the cost of flash point and viscosity, thus it is better to use the 50 ppm aluminium oxide, and 50 ppm cobalt oxide blended diesel.

Keywords: aluminium oxide nanoparticles, cobalt oxide nanoparticles, fuel additives, fuel characteristics

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Authors: Tahani Hallek, Dhaou Akrout, Riadh Ahmadi, Mabrouk Montacer

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The present work is an organic geochemical study of the Fahdene Formation outcrops at the Mahjouba region belonging to the Eastern part of the Kalaat Senan structure in northwestern Tunisia (the Kef-Tedjerouine area). The analytical study of the organic content of the samples collected, allowed us to point out that the Formation in question is characterized by an average to good oil potential. This fossilized organic matter has a mixed origin (type II and III), as indicated by the relatively high values of hydrogen index. This origin is confirmed by the C29 Steranes abundance and also by tricyclic terpanes C19/(C19+C23) and tetracyclic terpanes C24/(C24+C23) ratios, that suggest a marine environment of deposit with high plants contribution. We have demonstrated that the heterogeneity of organic matter between the marine aspect, confirmed by the presence of foraminifera, and the continental contribution, is the result of an episodic anomaly in relation to the sequential stratigraphy. Given that the study area is defined as an outer platform forming a transition zone between a stable continental domain to the south and a deep basin to the north, we have explained the continental contribution by successive forced regressions, having blocked the albian transgression, allowing the installation of the lowstand system tracts. This aspect is represented by the incised valleys filling, in direct contact with the pelagic and deep sea facies. Consequently, the Fahdene Formation, in the Kef-Tedjerouine area, consists of transgressive system tracts (TST) brutally truncated by extras of continental progradation; resulting in a mixed influence deposition having retained a heterogeneous organic material.

Keywords: molecular geochemistry, biomarkers, forced regression, deposit environment, mixed origin, Northern Tunisia

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Authors: Alemayehu Agizew Woldeamanuel, Mekonnen Maschal Tarekegn, Raj Mohan Balakrishina

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Composting is one of the conventional techniques adopted for organic waste management, but the practice is very limited in emerging cities despite the most of the waste generated is organic. This paper aims to examine the viability of composting for organic waste management in the emerging city of Addis Ababa, Ethiopia, by addressing the composting practice, quality of compost, and application of compost in urban agriculture. The study collects data using compost laboratory testing and urban farm households’ survey and uses descriptive analysis on the state of compost production and application, physicochemical analysis of the compost samples, and regression analysis on the urban farmer’s willingness to pay for compost. The findings of the study indicated that there is composting practice at a small scale, most of the producers use unsorted feedstock materials, aerobic composting is dominantly used, and the maturation period ranged from four to ten weeks. The carbon content of the compost ranges from 30.8 to 277.1 due to the type of feedstock applied, and this surpasses the ideal proportions for C:N ratio. The total nitrogen, pH, organic matter, and moisture content are relatively optimal. The levels of heavy metals measured for Mn, Cu, Pb, Cd and Cr⁶⁺ in the compost samples are also insignificant. In the urban agriculture sector, chemical fertilizer is the dominant type of soil input in crop productions but vegetable producers use a combination of both fertilizer and other organic inputs, including compost. The willingness to pay for compost depends on income, household size, gender, type of soil inputs, monitoring soil fertility, the main product of the farm, farming method and farm ownership. Finally, this study recommends the need for collaboration among stakeholders’ along the value chain of waste, awareness creation on the benefits of composting and addressing challenges faced by both compost producers and users.

Keywords: composting, emerging city, organic waste management, urban agriculture

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

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Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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