Search results for: primary defects
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4943

Search results for: primary defects

4763 Primary and Secondary Psychopathic Traits: Assessing Differences in Interpersonal Relationships through Friendship, Emotional Contagion, and Social Rewards

Authors: Silene Ten Seldam, Kiara Margarita Lu, Melina Nicole Kyranides

Abstract:

Psychopathic traits are marked by a lack of empathy and an inability to maintain meaningful relationships. Yet little research has investigated differences in interpersonal relationships between primary and secondary psychopathic traits. Emotional contagion, the tendency to automatically mimic others’ facial expressions and movements, is a type of empathy contributing to relationship quality. Additionally, the motivating and pleasurable aspects of social interaction, social reward is integral to understanding relationships. Therefore, the current research investigated interpersonal relationships through relationship status, the quality of friendships, the susceptibility to positive (happiness, love) and negative (sadness, fear, anger) emotional contagion, and social reward. Recruited online, 389 participants between 18 and 76 years old (M = 33.61; of which 241 were female) completed self-report questionnaires assessing primary and secondary psychopathic traits, friendship, emotional contagion, and social rewards. Hierarchical multiple regression showed relationship status as a protective factor and that individuals with secondary psychopathic traits are less likely to be in a relationship. This study is the first to investigate emotional contagion with primary and secondary psychopathic traits. Emotional contagion for sadness predicted secondary psychopathic traits. Negative social potency (enjoying being cruel and antagonistic to others) predicted both primary and secondary traits. However, admiration and prosocial interactions only predicted primary psychopathic traits. Findings infer differences in maintaining relationships, regulating emotions, empathising with others through emotional contagion, and motivation to socially engage, perhaps due to each dimensions’distinct origins and manifestations.

Keywords: primary psychopathic traits, secondary psychopathic traits, interpersonal relationships, friendship, emotional contagion, social reward

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4762 Structural and Microstructural Investigation into Causes of Rail Squat Defects and Their Correlation with White Etching Layers

Authors: A. Al-Juboori, D. Wexler, H. Li, H. Zhu, C. Lu, A. McCusker, J. McLeod, S. Pannila, Z. Wang

Abstract:

Squats are a type railhead defect related to rolling contact fatigue (RCF) damage and are considered serious problem affecting a wide range of railway networks across the world. Squats can lead to partial or complete rail failure. Formation mechanics of squats on the surface of rail steel is still a matter of debate. In this work, structural and microstructural observations from ex-service damaged rail both confirms the phases present in white etching layer (WEL) regions and relationship between cracking in WEL and squat defect formation. XRD synchrotron results obtained from the top surfaces of rail regions containing both WEL and squat defects reveal that these regions contain both martensite and retained austenite. Microstructural analysis of these regions revealed the occurrence cracks extending from WEL down into the rail through the squat region. These findings obtained from field rail specimen support the view that WEL contains regions of austenite and martensitic transformation product, and that cracks in this brittle surface layer propagate deeper into the rail as squats originate and grow.

Keywords: squat, white etching layer, rolling contact fatigue, synchrotron diffraction

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4761 Impact of Water, Sanitation and Hygiene Interventions on Water Quality in Primary Schools of Pakistan

Authors: Jamil Ahmed, Li P. Wong, Yan P. Chua

Abstract:

The United Nation's sustainable development goals include the target to ensure access to water and sanitation for all; however, very few studies have assessed school-based drinking water in Pakistan. The purpose of this study was to characterize water quality in primary schools of Pakistan and to characterize how recent WASH interventions were associated with school water quality. We conducted a representative cross-sectional study of primary schools in the Sindh province of Pakistan. We used structured observations and structured interviews to ascertain the school’s WASH conditions. Our primary exposures of interest were the implementation of previous WASH interventions in the school and the water source type. Outcomes of interest included water quality (measured by various chemical and microbiological indicators) and water availability at the school’s primary drinking water source. We used log-binomial regression to characterize how WASH exposures were associated with water quality outcomes. We collected data from 256 schools. Groundwater was the primary drinking water source at most schools (87%). Water testing showed that 14% of the school’s water had arsenic above the WHO recommendations, and over 50% of the water samples exceeded recommendations for both lead and cadmium. A majority of the water sources (52%) had fecal coliform contamination. None of the schools had nitrate contamination (0%), and few had fluoride contamination (5%). Regression results indicated that having a recent WASH intervention at the school was not associated with either arsenic contamination (prevalence ratio=0.97; 95% CI: 0.46-2.1) or with fecal coliform contamination (PR=0.88; 95% CI: 0.67-1.17). Our assessment unveiled several water quality gaps that exist, including high heavy metal and fecal contamination. Our findings will help various stakeholders to take suitable action to improve water quality in Pakistani schools.

Keywords: WASH interventions, water quality, primary school children, heavy metals

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4760 On Consolidated Predictive Model of the Natural History of Breast Cancer Considering Primary Tumor and Secondary Distant Metastases Growth in Patients with Lymph Nodes Metastases

Authors: Ella Tyuryumina, Alexey Neznanov

Abstract:

This paper is devoted to mathematical modelling of the progression and stages of breast cancer. We propose Consolidated mathematical growth model of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases (CoM-III) as a new research tool. We are interested in: 1) modelling the whole natural history of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases; 2) developing adequate and precise CoM-III which reflects relations between primary tumor and secondary distant metastases; 3) analyzing the CoM-III scope of application; 4) implementing the model as a software tool. Firstly, the CoM-III includes exponential tumor growth model as a system of determinate nonlinear and linear equations. Secondly, mathematical model corresponds to TNM classification. It allows to calculate different growth periods of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases: 1) ‘non-visible period’ for primary tumor; 2) ‘non-visible period’ for secondary distant metastases growth in patients with lymph nodes metastases; 3) ‘visible period’ for secondary distant metastases growth in patients with lymph nodes metastases. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. Thus, the CoM-III model and predictive software: a) detect different growth periods of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases; b) make forecast of the period of the distant metastases appearance in patients with lymph nodes metastases; c) have higher average prediction accuracy than the other tools; d) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoM-III: the number of doublings for ‘non-visible’ and ‘visible’ growth period of secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of secondary distant metastases. The CoM-III enables, for the first time, to predict the whole natural history of primary tumor and secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on primary tumor sizes. Summarizing: a) CoM-III describes correctly primary tumor and secondary distant metastases growth of IA, IIA, IIB, IIIB (T1-4N1-3M0) stages in patients with lymph nodes metastases (N1-3); b) facilitates the understanding of the appearance period and inception of secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, primary tumor, secondary metastases, survival

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4759 Fluoride as Obturating Material in Primary Teeth

Authors: Syed Ameer Haider Jafri

Abstract:

The primary goal of a root canal treatment in deciduous teeth is to eliminate infection and to retain the tooth in a functional state until it gets physiologically exfoliated and replaced by permanent successor. Important requisite of a root canal filling material for primary teeth is that, it should resorb at a similar rate as the roots of primary tooth, be harmless to the periapical tissue and to the permanent tooth germ, resorb readily if pushed beyond the apex, be antiseptic, radio-opaque, should not shrink, adhere to the walls, not discolor the tooth and easy to fill & remove, if required at any stage. Presently available, commonly used obturating materials for primary teeth are zinc oxide eugenol, calcium hydroxide and iodoform based pastes. None of these materials so far meet the ideal requirement of root canal filling material. So in search of ideal obturating material, this study was planed, in which mixture of calcium hydroxide, zinc oxide & sodium fluoride and mixture of calcium hydroxide & sodium fluoride was compared clinically and radiographically with calcium hydroxide for the obturation of root canals of 75 carious exposed primary mandibular second molars of 59 children aged 4-9 years. All the three material shows good results, but after a follow-up of 9 months mixture of calcium hydroxide, two percent sodium fluoride & zinc oxide powder closely follow the resorption of root, mixture of calcium hydroxide, two percent sodium fluoride follow resorption of root in the beginning but later on majority of cases shows faster resorption whereas calcium hydroxide starts depleting from the canal from the beginning even as early as 3 months. Thus mixture of calcium hydroxide, two percent sodium fluoride & zinc oxide found to be best obturaring material for primary tooth.

Keywords: obturating material, primary teeth, root canal treatment, success rate

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4758 Synthesis of TiO₂/Graphene Nanocomposites with Excellent Visible-Light Photocatalytic Activity Based on Chemical Exfoliation Method

Authors: Nhan N. T. Ton, Anh T. N. Dao, Kouichirou Katou, Toshiaki Taniike

Abstract:

Facile electron-hole recombination and the broad band gap are two major drawbacks of titanium dioxide (TiO₂) when applied in visible-light photocatalysis. Hybridization of TiO₂ with graphene is a promising strategy to lessen these pitfalls. Recently, there have been many reports on the synthesis of TiO₂/graphene nanocomposites, in most of which graphene oxide (GO) was used as a starting material. However, the reduction of GO introduced a large number of defects on the graphene framework. In addition, the sensitivity of titanium alkoxide to water (GO usually contains) significantly obstructs the uniform and controlled growth of TiO₂ on graphene. Here, we demonstrate a novel technique to synthesize TiO₂/graphene nanocomposites without the use of GO. Graphene dispersion was obtained through the chemical exfoliation of graphite in titanium tetra-n-butoxide with the aid of ultrasonication. The dispersion was directly used for the sol-gel reaction in the presence of different catalysts. A TiO₂/reduced graphene oxide (TiO₂/rGO) nanocomposite, which was prepared by a solvothermal method from GO, and the commercial TiO₂-P25 were used as references. It was found that titanium alkoxide afforded the graphene dispersion of a high quality in terms of a trace amount of defects and a few layers of dispersed graphene. Moreover, the sol-gel reaction from this dispersion led to TiO₂/graphene nanocomposites featured with promising characteristics for visible-light photocatalysts including: (I) the formation of a TiO₂ nano layer (thickness ranging from 1 nm to 5 nm) that uniformly and thinly covered graphene sheets, (II) a trace amount of defects on the graphene framework (low ID/IG ratio: 0.21), (III) a significant extension of the absorption edge into the visible light region (a remarkable extension of the absorption edge to 578 nm beside the usual edge at 360 nm), and (IV) a dramatic suppression of electron-hole recombination (the lowest photoluminescence intensity compared to reference samples). These advantages were successfully demonstrated in the photocatalytic decomposition of methylene blue under visible light irradiation. The TiO₂/graphene nanocomposites exhibited 15 and 5 times higher activity than TiO₂-P25 and the TiO₂/rGO nanocomposite, respectively.

Keywords: chemical exfoliation, photocatalyst, TiO₂/graphene, sol-gel reaction

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4757 Innovative Handloom Design Techniques- an Experimental Study Based on Primary Colour Gradation

Authors: Akanksha Pareek

Abstract:

The Indian Handloom clusters are known for its tradition and heritage of excellent craftsmanship. The design development of Indian handloom clusters are oriented on traditionally dobby and jacquard design. This comprehensive paper proposes practises on handloom woven design based on primary colour gradation with the help of basic weaved on four shaft. The innovative design ideas are inspired from Nature and transferred into the handloom samples to achieve colour gradation with primary colours. In this paper, design methodology where in woven samples are strategically designed in such way that traditional knowledge of the weavers will be oriented to leveraged their skills.

Keywords: handloom, weaving, colour gradation, shaft

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4756 The Impact of Low-Systematization Level in Physical Education in Primary School

Authors: Wu Hong, Pan Cuilian, Wu Panzifan

Abstract:

The student’s attention during the class is one of the most important indicators for the learning evaluation; the level of attention is directly related to the results of primary education. In recent years, extensive research has been conducted across China on improving primary school students’ attention during class. During the specific teaching activities in primary school, students have the characteristics of short concentration periods, high probability of distraction, and difficulty in long-term immersive learning. In physical education teaching, where there are mostly outdoor activities, this characteristic is particularly prominent due to the large changes in the environment and the strong sense of freshness among students. It is imperative to overcome this characteristic in a targeted manner, improve the student’s experience in the course, and raise the degree of systematization. There are many ways to improve the systematization of teaching and learning, but most of them lack quantitative indicators, which makes it difficult to evaluate the improvements before and after changing the teaching methods. Based on the situation above, we use the case analysis method, combined with a literature review, to study the negative impact of low systematization levels in primary school physical education teaching, put forward targeted improvement suggestions, and make a quantitative evaluation of the method change.

Keywords: attention, adolescent, evaluation, systematism, training-method

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4755 Maternal Parenting Style and Moral Development of Primary School Students: Evidence from Pakistan

Authors: Ghulam Zahra

Abstract:

Parenting style affects the morality of their children. There is plenty of evidence to support the effect of parenting styles on the morality of their children. Therefore, this research is considered essential and suitable. Thus, the main objective of this study was to assess the correlation between the parenting style of mothers and the moral development of primary school students. The population consisted of all primary school students enrolled in the province of Punjab. The sample was comprised of twelve hundred thirty-nine primary school students. One questionnaire was adapted to explore the parenting styles of mothers and to assess the level of students’ level of morality; a moral development scale was adopted. The conclusions showed that there was a significant correlation exist among authoritarian parenting style, permissive parenting, and moral developments. Based on findings, it is recommended that parents should follow a warm style of parenting for the sake of the moral development of their children.

Keywords: maternal parenting style, moral development, authoritative parenting, authoritarian parenting, permissive parenting

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4754 Energy Detection Based Sensing and Primary User Traffic Classification for Cognitive Radio

Authors: Urvee B. Trivedi, U. D. Dalal

Abstract:

As wireless communication services grow quickly; the seriousness of spectrum utilization has been on the rise gradually. An emerging technology, cognitive radio has come out to solve today’s spectrum scarcity problem. To support the spectrum reuse functionality, secondary users are required to sense the radio frequency environment, and once the primary users are found to be active, the secondary users are required to vacate the channel within a certain amount of time. Therefore, spectrum sensing is of significant importance. Once sensing is done, different prediction rules apply to classify the traffic pattern of primary user. Primary user follows two types of traffic patterns: periodic and stochastic ON-OFF patterns. A cognitive radio can learn the patterns in different channels over time. Two types of classification methods are discussed in this paper, by considering edge detection and by using autocorrelation function. Edge detection method has a high accuracy but it cannot tolerate sensing errors. Autocorrelation-based classification is applicable in the real environment as it can tolerate some amount of sensing errors.

Keywords: cognitive radio (CR), probability of detection (PD), probability of false alarm (PF), primary user (PU), secondary user (SU), fast Fourier transform (FFT), signal to noise ratio (SNR)

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4753 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

Abstract:

Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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4752 Measuring the Level of Knowledge of Construction Contracts Procedures: A Case Study of Botswana

Authors: Babulayi B. Wilson

Abstract:

Unsatisfactory performance of construction projects in both the industrialised and developing countries indicate that there could be several defects in construction projects phases. Notwithstanding the fact that some project defects are often conceived at the initiation phase of construction projects, insufficient knowledge of contract procedures has been identified as one of the major sources of construction disputes. Contract procedures are a set of rules that outlines the primary obligations and liabilities of parties involved in the implementation of a construction project. Engineering professional bodies often codify contract procedures into standard forms of contract such as the Institution of Civil Engineers (ICE, UK) and Association of Consulting Engineers (ACE, UK) and keep them under constant review by updating any clause to reflect any change in case law or relevant piece of legislation. Even so, it is the responsibility of a professional body or conditions of contract draftsperson to introduce contract-specific clauses that may be necessary for business efficacy but not covered in the chosen standard conditions of contract. In Botswana, the use of clients’ drafted and/or un-adapted for environment of use international forms of contract in conjunction with client-drafted pricing schedules is common. The product of the latter often impact negatively upon contractors’ claims and payments, in that, tender rates and prices can only be deemed to be sufficient if the chosen conditions of contract compliment the pricing schedule (use of standardised procurement documents). In addition, client drafted and the use of borrowed forms of contract such as FIDIC often conflict with domicile law resulting in costly disputes on the part of the client. It is upon the preceding text that the object of the research is to measure the level of knowledge of contract procedures amongst key stakeholders in the Botswana construction industry by requesting a representative sample from the industry and academia to respond to tutorial questions prepared from two commonly used forms of contract for civil works, that is, FIDIC (International Form of Contract) and ICE (UK). The questions were prepared under the following captions: (a) preparation of tender documents (b) obligations of the parties (c) contract administration; and (d) claims, variations, and valuation of variations. After ascertaining that the level of knowledge of contract procedures is insufficient among most practitioners in the Botswana construction industry, major procurement entities, and engineering institutions of learning; a guide to drafting a condition of a construction contract was developed and then validated through seminars and workshops. In the present, the effectiveness of the guide is not yet measured but feedback from seminars and workshops conducted indicates an appreciation of the guide by the majority of major construction industry stakeholders.

Keywords: contract procedures, conditions of contract, professional practice, construction law, forms of contract

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4751 Quality Improvement of the Sand Moulding Process in Foundries Using Six Sigma Technique

Authors: Cindy Sithole, Didier Nyembwe, Peter Olubambi

Abstract:

The sand casting process involves pattern making, mould making, metal pouring and shake out. Every step in the sand moulding process is very critical for production of good quality castings. However, waste generated during the sand moulding operation and lack of quality are matters that influences performance inefficiencies and lack of competitiveness in South African foundries. Defects produced from the sand moulding process are only visible in the final product (casting) which results in increased number of scrap, reduced sales and increases cost in the foundry. The purpose of this Research is to propose six sigma technique (DMAIC, Define, Measure, Analyze, Improve and Control) intervention in sand moulding foundries and to reduce variation caused by deficiencies in the sand moulding process in South African foundries. Its objective is to create sustainability and enhance productivity in the South African foundry industry. Six sigma is a data driven method to process improvement that aims to eliminate variation in business processes using statistical control methods .Six sigma focuses on business performance improvement through quality initiative using the seven basic tools of quality by Ishikawa. The objectives of six sigma are to eliminate features that affects productivity, profit and meeting customers’ demands. Six sigma has become one of the most important tools/techniques for attaining competitive advantage. Competitive advantage for sand casting foundries in South Africa means improved plant maintenance processes, improved product quality and proper utilization of resources especially scarce resources. Defects such as sand inclusion, Flashes and sand burn on were some of the defects that were identified as resulting from the sand moulding process inefficiencies using six sigma technique. The courses were we found to be wrong design of the mould due to the pattern used and poor ramming of the moulding sand in a foundry. Six sigma tools such as the voice of customer, the Fishbone, the voice of the process and process mapping were used to define the problem in the foundry and to outline the critical to quality elements. The SIPOC (Supplier Input Process Output Customer) Diagram was also employed to ensure that the material and process parameters were achieved to ensure quality improvement in a foundry. The process capability of the sand moulding process was measured to understand the current performance to enable improvement. The Expected results of this research are; reduced sand moulding process variation, increased productivity and competitive advantage.

Keywords: defects, foundries, quality improvement, sand moulding, six sigma (DMAIC)

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4750 Reconstruction of Complex Post Oncologic Maxillectomy Defects

Authors: Vinay Kant Shankhdhar

Abstract:

Purpose: Maxillary defects are three dimensional and require complex bone and soft tissue reconstruction. Maxillary reconstruction using fibula osteocutaneous flaps in situation requiring orbital floor, orbital wall, palatal defects, and external skin, all at the same time require special planning and multiple osteotomies. We tried to improvise our reconstruction using multiple osteotomies and skin paddle designs for fibula and Flexor Hallucis Longus Muscle. This study aims at discussing the planning and outcome in complex maxillary reconstructions using fibula flaps and soft tissue flaps with or without bone grafts. Material and Methods: From 2011 to 2017 a total of 129 Free fibula flaps were done, 67 required two or more struts, 164 Anterolateral Thigh Flaps, 11 Deep Inferior Epigastric Artery perforator flaps and 3 vertical rectus abdominis muscle flaps with iliac crest bone graft. The age range was 2 to 70 years. The reconstruction was evaluated based on the post-operative rehabilitation including orbital support (prevention of diplopia), oral diet, speech and cosmetic appearance. Results: The follow- up is from 5 years to 1 year. In this series, we observed that the common complications were the de-vascularisation of most distal segment of osteotomised fibula and native skin necrosis. Commonest area of breakdown is the medial canthal region. Plate exposure occurs most commonly at the pyriform sinus. There was extrusion of one non-vascularized bone graft. All these complications were noticed post-radiotherapy. Conclusions: The use of free fibula osteocutaneous flap gives very good results when only alveolar reconstruction is required. The reconstruction of orbital floor with extensive skin loss with post operative radiotherapy has maximum complication rate in long term follow up. A soft tissue flap with non vascularized bone graft may be the best option in such cases.

Keywords: maxilla reconstruction, fibula maxilla, post cancer maxillary reconstruction

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4749 Reconstruction of Alveolar Bone Defects Using Bone Morphogenetic Protein 2 Mediated Rabbit Dental Pulp Stem Cells Seeded on Nano-Hydroxyapatite/Collagen/Poly(L-Lactide)

Authors: Ling-Ling E., Hong-Chen Liu, Dong-Sheng Wang, Fang Su, Xia Wu, Zhan-Ping Shi, Yan Lv, Jia-Zhu Wang

Abstract:

Objective: The objective of the present study is to evaluate the capacity of a tissue-engineered bone complex of recombinant human bone morphogenetic protein 2 (rhBMP-2) mediated dental pulp stem cells (DPSCs) and nano-hydroxyapatite/collagen/poly(L-lactide)(nHAC/PLA) to reconstruct critical-size alveolar bone defects in New Zealand rabbit. Methods: Autologous DPSCs were isolated from rabbit dental pulp tissue and expanded ex vivo to enrich DPSCs numbers, and then their attachment and differentiation capability were evaluated when cultured on the culture plate or nHAC/PLA. The alveolar bone defects were treated with nHAC/PLA, nHAC/PLA+rhBMP-2, nHAC/PLA+DPSCs, nHAC/PLA+DPSCs+rhBMP-2, and autogenous bone (AB) obtained from iliac bone or were left untreated as a control. X-ray and a polychrome sequential fluorescent labeling were performed post-operatively and the animals were sacrificed 12 weeks after operation for histological observation and histomorphometric analysis. Results: Our results showed that DPSCs expressed STRO-1 and vementin, and favoured osteogenesis and adipogenesis in conditioned media. DPSCs attached and spread well, and retained their osteogenic phenotypes on nHAC/PLA. The rhBMP-2 could significantly increase protein content, alkaline phosphatase (ALP) activity/protein, osteocalcin (OCN) content, and mineral formation of DPSCs cultured on nHAC/PLA. The X-ray graph, the fluorescent, histological observation and histomorphometric analysis showed that the nHAC/PLA+DPSCs+rhBMP-2 tissue-engineered bone complex had an earlier mineralization and more bone formation inside the scaffold than nHAC/PLA, nHAC/PLA+rhBMP-2 and nHAC/PLA+DPSCs, or even autologous bone. Implanted DPSCs contribution to new bone were detected through transfected eGFP genes. Conclutions: Our findings indicated that stem cells existed in adult rabbit dental pulp tissue. The rhBMP-2 promoted osteogenic capability of DPSCs as a potential cell source for periodontal bone regeneration. The nHAC/PLA could serve as a good scaffold for autologous DPSCs seeding, proliferation and differentiation. The tissue-engineered bone complex with nHAC/PLA, rhBMP-2, and autologous DPSCs might be a better alternative to autologous bone for the clinical reconstruction of periodontal bone defects.

Keywords: nano-hydroxyapatite/collagen/poly (L-lactide), dental pulp stem cell, recombinant human bone morphogenetic protein, bone tissue engineering, alveolar bone

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4748 Challenges to Quality Primary Health Care in Saudi Arabia and Potential Improvements Implemented by Other Systems

Authors: Hilal Al Shamsi, Abdullah Almutairi

Abstract:

Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

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4747 International Classification of Primary Care as a Reference for Coding the Demand for Care in Primary Health Care

Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

Abstract:

Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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4746 Thermal Stability of Hydrogen in ZnO Bulk and Thin Films: A Kinetic Monte Carlo Study

Authors: M. A. Lahmer, K. Guergouri

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In this work, Kinetic Monte Carlo (KMC) method was applied to study the thermal stability of hydrogen in ZnO bulk and thin films. Our simulation includes different possible events such as interstitial hydrogen (Hi) jumps, substitutional hydrogen (HO) formation and dissociation, oxygen and zinc vacancies jumps, hydrogen-VZn complexes formation and dissociation, HO-Hi complex formation and hydrogen molecule (H2) formation and dissociation. The obtained results show that the hidden hydrogen formed during thermal annealing or at room temperature is constituted of both hydrogen molecule and substitutional hydrogen. The ratio of this constituants depends on the initial defects concentration as well as the annealing temperature. For annealing temperature below 300°C hidden hydrogen was found to be constituted from both substitutional hydrogen and hydrogen molecule, however, for higher temperature it is composed essentially from HO defects only because H2 was found to be unstable. In the other side, our results show that the remaining hydrogen amount in sample during thermal annealing depend greatly on the oxygen vacancies in the material. H2 molecule was found to be stable for thermal annealing up to 200°C, VZnHn complexes are stable up to 350°C and HO was found to be stable up to 450°C.

Keywords: ZnO, hydrogen, thermal annealing, kinetic Monte Carlo

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4745 Application of the Material Point Method as a New Fast Simulation Technique for Textile Composites Forming and Material Handling

Authors: Amir Nazemi, Milad Ramezankhani, Marian Kӧrber, Abbas S. Milani

Abstract:

The excellent strength to weight ratio of woven fabric composites, along with their high formability, is one of the primary design parameters defining their increased use in modern manufacturing processes, including those in aerospace and automotive. However, for emerging automated preform processes under the smart manufacturing paradigm, complex geometries of finished components continue to bring several challenges to the designers to cope with manufacturing defects on site. Wrinklinge. g. is a common defectoccurring during the forming process and handling of semi-finished textile composites. One of the main reasons for this defect is the weak bending stiffness of fibers in unconsolidated state, causing excessive relative motion between them. Further challenges are represented by the automated handling of large-area fiber blanks with specialized gripper systems. For fabric composites forming simulations, the finite element (FE)method is a longstanding tool usedfor prediction and mitigation of manufacturing defects. Such simulations are predominately meant, not only to predict the onset, growth, and shape of wrinkles but also to determine the best processing condition that can yield optimized positioning of the fibers upon forming (or robot handling in the automated processes case). However, the need for use of small-time steps via explicit FE codes, facing numerical instabilities, as well as large computational time, are among notable drawbacks of the current FEtools, hindering their extensive use as fast and yet efficient digital twins in industry. This paper presents a novel woven fabric simulation technique through the application of the material point method (MPM), which enables the use of much larger time steps, facing less numerical instabilities, hence the ability to run significantly faster and efficient simulationsfor fabric materials handling and forming processes. Therefore, this method has the ability to enhance the development of automated fiber handling and preform processes by calculating the physical interactions with the MPM fiber models and rigid tool components. This enables the designers to virtually develop, test, and optimize their processes based on either algorithmicor Machine Learning applications. As a preliminary case study, forming of a hemispherical plain weave is shown, and the results are compared to theFE simulations, as well as experiments.

Keywords: material point method, woven fabric composites, forming, material handling

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4744 Investigate the Effect and the Main Influencing Factors of the Accelerated Reader Programme on Chinese Primary School Students’ Reading Achievement

Authors: Fujia Yang

Abstract:

Alongside technological innovation, the current “double reduction” policy and English Curriculum Standards for Compulsory Education in China both emphasise and encourage appropriately integrating educational technologies into the classroom. Therefore, schools are increasingly using digital means to engage students in English reading, but the impact of such technologies on Chinese pupils’ reading achievement remains unclear. To serve as a reference for reforming English reading education in primary schools under the double reduction policy, this study investigates the effects and primary influencing factors of a specific reading programme, Accelerated Reader (AR), on Chinese primary school students’ reading achievement. A quantitative online survey was used to collect 37 valid questionnaires from teachers, and the results demonstrate that, from teachers’ perspectives, the AR program seemed to positively affect students’ reading achievement by recommending material at the appropriate reading levels and developing students’ reading habits. Although the reading enjoyment derived from the AR program does not directly influence students’ reading achievement, these factors are strongly correlated. This can be explained by the self-paced, independent learning AR format, its high accuracy in predicting reading level, the quiz format and external motivation, and the importance of examinations and resource limitations in China. The results of this study may support reforming English reading education in Chinese primary schools.

Keywords: educational technology, reading programme, primary students, accelerated reader, reading effects

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4743 Consolidated Predictive Model of the Natural History of Breast Cancer Considering Primary Tumor and Secondary Distant Metastases Growth

Authors: Ella Tyuryumina, Alexey Neznanov

Abstract:

This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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4742 Predictors of School Safety Awareness among Malaysian Primary School Teachers

Authors: Ssekamanya, Mastura Badzis, Khamsiah Ismail, Dayang Shuzaidah Bt Abduludin

Abstract:

With rising incidents of school violence worldwide, educators and researchers are trying to understand and find ways to enhance the safety of children at school. The purpose of this study was to investigate the extent to which the demographic variables of gender, age, length of service, position, academic qualification, and school location predicted teachers’ awareness about school safety practices in Malaysian primary schools. A stratified random sample of 380 teachers was selected in the central Malaysian states of Kuala Lumpur and Selangor. Multiple regression analysis revealed that none of the factors was a good predictor of awareness about school safety training, delivery methods of school safety information, and available school safety programs. Awareness about school safety activities was significantly predicted by school location (whether the school was located in a rural or urban area). While these results may reflect a general lack of awareness about school safety among primary school teachers in the selected locations, a national study needs to be conducted for the whole country.

Keywords: school safety awareness, predictors of school safety, multiple regression analysis, malaysian primary schools

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4741 The Role of Teaching Assistants for Deaf Pupils in a Mainstream Primary School in England

Authors: Hatice Yildirim

Abstract:

This study was an investigation into the role of teaching assistants (TAs) for deaf pupils in an English primary school. This study aimed to provide knowledge about how TAs support deaf pupils in mainstream schools in England. It is accepted that TAs have an important role in the inclusion of students with disabilities in mainstream schools. However, there has been a lack of attention paid to the role of TAs for deaf pupils in the literature. A qualitative case study approach was used to address the research questions. Twelve semi-structured classroom observations and six semi-structured interviews were carried out with four TAs and two teachers in one English mainstream primary school. The data analysis followed a thematic analysis framework. The results indicated that TAs are utilised based on a one-on-one support model and are deployed under the class teachers in the classroom. The classroom activities are carried out in small groups with the TAs and the class teacher’s agreement, as per the school’s policy. Findings show that TAs carried out seven different roles in the education of deaf pupils in an English mainstream primary school. Supporting the academic and social development of deaf pupils is TA`s main role. Also, they record pupils’ progress, communicate with pupils’ parents, take on a pastoral care role, tutor pupils in additional support lessons and raise awareness of deaf pupils’ issues.

Keywords: deaf, mainstream primary school, teaching assistant, teaching assistant`s roles

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4740 General Awareness of Teenagers in Information Security

Authors: Magdaléna Náplavová, Tomáš Ludík, Petr Hrůza, František Božek

Abstract:

The use of IT equipment has become a part of every day. However, each device that is part of cyberspace should be secured against unauthorized use. It is very important to know the basics of these security devices, but also the basics of safe conduct their owners. This information should be part of every curriculum computer science education in primary and secondary schools. Therefore, the work focuses on the education of pupils in primary and secondary schools on the Internet. Analysis of the current state describes approaches to the education of pupils in security issues on the Internet. The paper presents a questionnaire-based survey which was carried out in the Czech Republic, whose task was to ascertain the level of opinion pupils in primary and secondary schools on the issue of communication in social networks. The research showed that awareness of socio-pathological phenomena on the Internet environment is very low. Based on the results it was proposed appropriate ways of teaching to this issue and its inclusion a proposal of curriculum for primary and secondary schools.

Keywords: information security, cyber space, general awareness, questionnaire, socio-pathological phenomena, educational system

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4739 ESL Material Evaluation: The Missing Link in Nigerian Classrooms

Authors: Abdulkabir Abdullahi

Abstract:

The paper is a pre-use evaluation of grammar activities in three primary English course books (two of which are international primary English course books and the other a popular Nigerian primary English course book). The titles are - Cambridge Global English, Collins International Primary English, and Nigeria Primary English – Primary English. Grammar points and grammar activities in the three-course books were identified, grouped, and evaluated. The grammar activity which was most common in the course books, simple past tense, was chosen for evaluation, and the units which present simple past tense activities were selected to evaluate the extent to which the treatment of simple past tense in each of the course books help the young learners of English as a second language in Nigeria, aged 8 – 11, level A1 to A2, who lack the basic grammatical knowledge, to know grammar/communicate effectively. A bespoke checklist was devised, through the modification of existing checklists for the purpose of the evaluation, to evaluate the extent to which the grammar activities promote the communicative effectiveness of Nigerian learners of English as a second language. The results of the evaluation and the analysis of the data reveal that the treatment of grammar, especially the treatment of the simple past tense, is evidently insufficient. While Cambridge Global English’s, and Collins International Primary English’s treatment of grammar, the simple past tense, is underpinned by state-of-the-art theories of learning, language learning theories, second language learning principles, second language curriculum-syllabus design principles, grammar learning and teaching theories, the grammar load is insignificantly low, and the grammar tasks do not promote creative grammar practice sufficiently. Nigeria Primary English – Primary English, on the other hand, treats grammar, the simple past tense, in the old-fashioned direct way. The book does not favour the communicative language teaching approach; no opportunity for learners to notice and discover grammar rules for themselves, and the book lacks the potency to promote creative grammar practice. The research and its findings, therefore, underscore the need to improve grammar contents and increase grammar activity types which engage learners effectively and promote sufficient creative grammar practice in EFL and ESL material design and development.

Keywords: evaluation, activity, second language, activity-types, creative grammar practice

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4738 A Study of Spatial Resilience Strategies for Schools Based on Sustainable Development

Authors: Xiaohan Gao, Kai Liu

Abstract:

As essential components of urban areas, primary and secondary schools are extensively distributed throughout various regions of the city. During times of urban disturbances, these schools become direct carriers of complex disruptions. Therefore, fostering resilient schools becomes a pivotal driving force to promote high-quality urban development and a cornerstone of sustainable school growth. This paper adopts the theory of spatial resilience and focuses on primary and secondary schools in Chinese cities as the research subject. The study first explores the potential disturbance risks faced by schools and delves into the origin and concept of spatial resilience in the educational context. Subsequently, the paper conducts a meta-analysis to characterize the spatial resilience of primary and secondary schools and devises a spatial resilience planning mechanism. Drawing insights from exemplary cases both domestically and internationally, the research formulates spatial and planning resilience strategies for primary and secondary schools to cope with perturbations. These strategies encompass creating an overall layout that integrates harmoniously with nature, promoting organic growth in the planning structure, fostering ecological balance in the landscape system, and enabling dynamic adaptation in architectural spaces. By cultivating the capacity for "resistance-adaptation-transformation," these approaches support sustainable development within the school space. The ultimate goal of this project is to establish a cohesive and harmonious layout that advances the sustainable development of primary and secondary schools while contributing to the overall resilience of urban areas.

Keywords: complex disruption, primary and secondary schools, spatial resilience, sustainable development

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4737 Driving Mechanism of Urban Sprawl in Chinese Context from the Perspective of Domestic and Overseas Comparison

Authors: Tingke Wu, Yaping Huang

Abstract:

Many cities in China have been experiencing serious urban sprawl since the 1980s, which pose great challenges to a country with scare cultivated land and huge population. Because of different social and economic context and development stage, driving forces of urban sprawl in China are quite different from developed countries. Therefore, it is of great importance to probe into urban sprawl driving mechanism in Chinese context. By a comparison study of the background and features of urban sprawl between China and developed countries, this research establishes an analytical framework for sprawl dynamic mechanism in China. By literature review and analyzing data from national statistical yearbook, it then probes into the driving mechanism and the primary cause of urban sprawl. The results suggest that population increase, economic growth, traffic and information technology development lead to rapid expansion of urban space; defects of land institution and lack of effective guidance give rise to low efficiency of urban land use. Moreover, urban sprawl is ultimately attributed to imperfections of policy and institution. On this basis, this research puts forward several sprawl control strategies in Chinese context.

Keywords: China, driving forces, driving mechanism, land institution, urban expansion, urban sprawl

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4736 Corrosion Analysis of Brazed Copper-Based Conducts in Particle Accelerator Water Cooling Circuits

Authors: A. T. Perez Fontenla, S. Sgobba, A. Bartkowska, Y. Askar, M. Dalemir Celuch, A. Newborough, M. Karppinen, H. Haalien, S. Deleval, S. Larcher, C. Charvet, L. Bruno, R. Trant

Abstract:

The present study investigates the corrosion behavior of copper (Cu) based conducts predominantly brazed with Sil-Fos (self-fluxing copper-based filler with silver and phosphorus) within various cooling circuits of demineralized water across different particle accelerator components at CERN. The study covers a range of sample service time, from a few months to fifty years, and includes various accelerator components such as quadrupoles, dipoles, and bending magnets. The investigation comprises the established sample extraction procedure, examination methodology including non-destructive testing, evaluation of the corrosion phenomena, and identification of commonalities across the studied components as well as analysis of the environmental influence. The systematic analysis included computed microtomography (CT) of the joints that revealed distributed defects across all brazing interfaces. Some defects appeared to result from areas not wetted by the filler during the brazing operation, displaying round shapes, while others exhibited irregular contours and radial alignment, indicative of a network or interconnection. The subsequent dry cutting performed facilitated access to the conduct's inner surface and the brazed joints for further inspection through light and electron microscopy (SEM) and chemical analysis via Energy Dispersive X-ray spectroscopy (EDS). Brazing analysis away from affected areas identified the expected phases for a Sil-Fos alloy. In contrast, the affected locations displayed micrometric cavities propagating into the material, along with selective corrosion of the bulk Cu initiated at the conductor-braze interface. Corrosion product analysis highlighted the consistent presence of sulfur (up to 6 % in weight), whose origin and role in the corrosion initiation and extension is being further investigated. The importance of this study is paramount as it plays a crucial role in comprehending the underlying factors contributing to recently identified water leaks and evaluating the extent of the issue. Its primary objective is to provide essential insights for the repair of impacted brazed joints when accessibility permits. Moreover, the study seeks to contribute to the improvement of design and manufacturing practices for future components, ultimately enhancing the overall reliability and performance of magnet systems within CERN accelerator facilities.

Keywords: accelerator facilities, brazed copper conducts, demineralized water, magnets

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4735 Epidemiology of Congenital Heart Defects in Kazakhstan: Data from Unified National Electronic Healthcare System 2014-2020

Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

Abstract:

Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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4734 Impact of Primary Care on Sexual and Reproductive Health for Migrant Women in Medellín Colombia

Authors: Alexis Piedrahita, Ludi Valencia, Aura Gutierrez

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The migration crisis that is currently being experienced in the world is a continuous phenomenon that has had solutions in form but not in substance, violating the international humanitarian law of people who are in transit through countries foreign to their roots, especially women of age reproductive, this has caused different governments and organizations worldwide to meet around this problem to define concise actions to protect the rights of migrant women in the world. This research compiles the stories of migrant women who arrive in Colombia seeking better opportunities, such as accessibility to comprehensive and quality health services, including primary health care. This is the gateway to the offer of health promotion and disease prevention services.

Keywords: accessibility, primary health care, sexual and reproductive health, sustainable development goals, women migrant

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