1st Level Research Articles

Discrepancies in breast cancer screening and hypothesis of artificial intelligence support

Abstract In Italy,the National Breast Screening Programme offers mammography as the 1st level examination, blindly assessed by two radiologists.In the context of continuous quality control,discrepancies in the assessment of mammograms between the 1st and 2nd reader have been studied,focusing on the most significant ones.The aims of the present study are:to evaluate the outcome of women sent to the 2nd level of review;to evaluate the possibility of using artificial intelligence (AI) software to assist radiologists in case of discrepancies. In the Local Health Authority Roma2,radiologists use a standardised classification that rates radiographs on a five-level scale from R1 to R5:R1=no abnormalities,R2=benign findings,R3=equivocal findings,R4=suspected cancer,R5=strongly suspected cancer.Data were extracted from the mammograms performed in 2023 that showed discrepancies (R1/R2 vs. R4/R5).2nd level mammography≥R4 and 2nd level histology≥B4 were considered positive. For the second aim,”IA Lunit INSIGHT” software was used to create specific target groups using the following cut-offs:G1<10%, G2 11-29%; G3 30-59%; G4 60-85%; G5 86-100%(groups ≥G3 were considered positive). Of the 36,339 mammograms,524(1.5%) were discordant:347(66.2%) were considered suspicious by the second radiologist.49(9.4%) were confirmed positive by Level II mammography and 23(4.4%) reported histology≥B4. The AI red a random sample of 247 mammograms and classified 34 women as positive (1 G5, 6 G4, 9 G3), of whom 11 (4.5%) were confirmed positive by Level II mammography and 6 (2.4%) were histologically positive. Of the negative women, 2 had histology≥B4. Discrepancies may be one of the factors leading to inappropriate referral to second level investigation. In such cases, the use of AI may improve the appropriateness of further investigation, although this hypothesis needs to be tested in larger numbers, with additional comparisons with experienced radiologists and consideration of retraining. Key messages • Continuous monitoring in cancer screening programs are vital to assure a sustainability of the process. • Artificial Intelligence software are promising in aiding health care professionals in case of discrepancies.

An Analytical Study of the Recognition of Silent Letters in the Pronunciation of English Words by Baghdadi Arabic Speakers

The phonetic system in English differs to some extent from that of Arabic. Novice Baghdadi Iraqi speakers encounter numerous challenges in pronouncing English words as a result of this. As an illustration, it is common to hear English learners articulate "assign” /əˈsaɪn/ as / əˈsaɪgn / or "kneel," / niːl/ as /k niːl/. The objective of this study is to detect prevalent distortions in the pronunciation of silent letters in English words among Baghdadi Iraqi English as a Foreign Language (EFL) learners. The methodology employed in this analysis was a qualitative descriptive study. Utilizing purposive sampling methods, a sample of 5 English as a Foreign Language (EFL) novices was chosen from the 1st level of the English Department, Dijlah University, Iraq. These learners were categorized as novice high-level learners (beginners). Analytically descriptive methodology was employed to analyze the data obtained from tests. The findings of this study indicate that EFL novices make errors when pronouncing words that include silent letters such as b, c, d, g, gh, h, k, l, m, n, p, s, t, th, and w. The writers examine three positions of the silent letters in words (beginning, medial, and final), and, by that understanding, it becomes feasible to create valuable instructional resources and teaching techniques to address this matter.

Analisis Perilaku Konsumtif Mahasiswa pada Penggunaan E-commerce dalam Perspektif Maqashid al-Syariah

This research is based on many of university students who use e-commerce. The purpose of this study is to find out students' behavior in buying goods in e-commerce and whether they use the principles of maqashid al-sharia or not. The principles of maqashid al-sharia used are the maintenance of religion (hifz al-din), the maintenance of the soul (hifz al-nafs), the maintenance of reason (hifz al-‘aql), the maintenance of offspring (hifz al-nasl), the maintenance of assets (hifz al-mal), and the maintenance of the environment (hifz al-biah). This research is qualitative research with a phenomenological abbreviation. The sampling technique in this study is purposive sampling. This sample of research totaled 45 1st level students of Sultan Ageng Tirtayasa University. The results of the study show that students have not fully used the principles of maqashid sharia in the use of e-commerce, so students behave consumptuantly. In the principle of religious protection, it is known that not all students buy goods with the intention of worship, in the principle of preserving reason, students cannot decide properly the priority of the goods to be purchased, on the principle of spiritual care, students cannot resist the lust to buy goods that are by the usefulness, on the principle that the descendants of students have not been able to save money for the future, In the principle of assets, students were found to use the pay later feature. And on the principle of protecting the environment, students still need education in the recycling system of goods that have been purchased.

Comparison of the use of biocompatible materials and titanium in the treatment of midshaft clavicle fractures with a patient-specific plate: a finite element analysis study.

Clavicular midshaft fractures treated with titanium plates may encounter complications like implant failure. We assess if alternative biocompatible materials suchs as PLA, PLA/HA, PEEK offer comparable stability. Our study evaluates the biomechanical performance of these materials in surgical management of midshaft clavicle fractures. We simulated a personalized fixation implant with four different materials and conducted finite element analysis in ANSYS to assess maximum von Mises stress (MvMs). The MvMs occurring on the plates, screws, clavicle, and fracture site were recorded. MvMs on titanium material at the 6th hole level (764.79MPa) and the 6th screw level (503.38MPa), with the highest stresses observed at 48.52MPa on the lateral clavicle at the 1st hole level and 182.27MPa on the medial clavicle at the 6th hole level. In PLA material analyses, the highest MvMs were observed at the 3rd hole level (340.6MPa) and the 3rd screw level (157.83MPa), with peak stresses at 379.63MPa on the lateral clavicle fracture line and 505.44MPa on the medial clavicle fracture line. In PLA/HA material analyses, the highest MvMs were at the 3rd hole (295.99MPa) and 3rd screw (128.27MPa), with peak stresses at 220.33MPa on the lateral clavicle and 229.63MPa on the medial clavicle fracture line. In PEEK material analyses, the highest MvMs were at the 3rd hole (234.74MPa) and 6th screw (114.48MPa), with peak stresses at 184.36MPa on the lateral clavicle and 180.1MPa on the medial clavicle. Our findings indicate that titanium material shows significantly higher stresses on plates and screws compared to those on the clavicle, suggesting a risk of implant failure. PLA and PLA/HA were inadequate for fixation. Although stress on the plate with PEEK material is higher than on the clavicle, it remains lower than titanium, indicating potential stability at fracture site. Further research is needed to confirm these findings.

Cognitive potential of children and adolescents with CHARGE syndrome and deafblindness

BackgroundThe present study aimed to test the hypothesis stating that the cognitive potential of individuals with deafblindness is equal to those without a deafblind condition, an assumption that until now has been empirically unsubstantiated within the field of deafblindness.MethodsTo explore the assumption, 15 children and adolescents with CHARGE underwent cognitive assessment with WISC-V using a sequential two-level assessment design. The 1st level involved standardized test conditions. The 2nd level was designed as a continuation of the performances obtained from the 1st level and involved accommodations to compensate for sensory motor impairment. Statistical procedures involved the sample as a whole and when divided into two subgroups: (i) participants with CHARGE without deafblindness; (ii) participants with CHARGE and deafblindness using the 1st level scores as base line.ResultsAlthough results showed significantly lower scores in the deafblind subgroup with standardized procedures, they approximated the others after accommodating for their sensory deficits. This positive increase proved significant.ConclusionFindings supported the assumption of equal cognitive potential of individuals with and without deafblindness. Results indicated that the children and adolescents with deafblindness had most effect of the accommodations, enabling them to approximate the results of the subgroup without deafblindness. These gains were attributed enhanced accessibility endorsed by the accommodations and represented the participants latent cognitive dispositions only realized under certain circumstances.

Successful sport psychology within 1st team football: Perceptions of senior strategic stakeholders at elite football clubs

This study focussed on the perceptions of senior strategic stakeholders (e.g, sporting director, head of performance, manager, coach) working within 1st team football at elite professional clubs (English Premier League & Championship). Although recent research has made progress within the practitioner professional development literature it has, so far, failed to gain an explicit understanding of the perceptions around ‘successful sport psychology’ or what makes a sport psychologist successful - in their respective sporting environments. Therefore, the main purpose of this research was to gain an explicit insight into what senior strategic stakeholders perceived makes a sport psychologist successful within their role at an elite football club, at 1st team level. Following institutional ethical approval, purposeful sampling was used and semi-structured interviews were conducted with five senior strategic stakeholders. Following data collection, a thematic analysis was conducted and 19 general dimensions were arranged across three phases: (a) knowledge and experiences of sport psychology in elite football, (b) explicit understanding of sport psychology success in elite football and (c) perceived barriers and challenges to sport psychology in an elite football club. In particular, senior strategic stakeholders’ explicit understanding of sport psychology success in elite football included 7 general dimensions: (1) importance of role clarity during induction into new role, (2) success viewed as subjective due to difficulty quantifying influence of work, (3) success perceived as best judged by individuals worked with most closely, (4) preference for club appointed full time sport psychologist, (5) implementation of balanced approach perceived as successful, (6) implementation of forceful approach perceived as unsuccessful and (7) success attributed to positive influence on culture and player performances. Thus, it’s recommended that sport psychologists aspiring to work in applied football contexts should consider the findings of this research to positively influence their entry and/or practice in an elite football environment, at 1st team level. Similarly, it’s equally recommended that senior strategic stakeholders within elite football clubs use these findings to help develop their knowledge and understanding of sport psychology so they’re better informed and aware of the perceived key attributes of successful sport psychology provision within 1st team football. Consequently, this may assist with navigating the diversity of challenges perceived to be associated to the presence of a sport psychologist, within an elite 1st team football environment, and therefore increase and improve utilisation of sport psychology services across players, coaches, and wider footballing staff.

Effectiveness of test-and-treat model with direct-acting antiviral for hepatitis C virus infection in migrants: a prospective interventional study in Italy.

Migrants, mainly undocumented and low-income refugees, are at high risk of hepatitis C virus (HCV) infection, but are a difficult-to-reach and to-treat population. The aim of the study was to evaluate the effectiveness of a test and treat model with direct-acting antiviral for HCV infection in these migrants coming from low-income and living in southern Italy. A prospective, multicenter, collaborative study based on a four-phase-program (educational counseling, screening, linkage-to-care and treatment) was designed in southern Italy; the study started in June 2018, was stopped in February 2020 because of the outbreak of SARS-CoV2 infection in Italy and was resumed in February 2021 until November 2021. After educational counseling on infectious diseases that are transmitted through blood or sexually pseudonymized HCV screening was offered to all undocumented migrants and low-income refugees observed at one of the 1st level clinical centers. The HCV-RNA-positive subjects were referred to one of the 3rd level units of Infectious Diseases (ID) and treated with a 12-week course of sofosbuvir-velpatasvir and observed for 12 weeks after the end of direct antiviral agents (DAA) treatment. For the descriptive analysis, the categorical variables were reported as absolute numbers and relative frequencies. Continuous variables were summarized as mean and standard deviation (SD) if normally distributed, or as a median and interquartile range (IQR) if not normally distributed. We used Pearson chi-square or Fisher's exact test for categorical variables and Student's t test or Mann-Whitney test for continuous variables. A P value < 0.05 was considered to be statistically significant. Analyses were performed with SPSS 21.0. Of the 3501migrants observed in the study period, 3417 (97.6%) agreed to be screened; 185 (4.7%) were anti-HCV-positive and, of these, 53 (28.6%) were HCV-RNA-positive. Of these 53 subjects, 48 (90.5%) were referred to an ID unit and started DAA treatment. The HCV-RNA-positive-subjects were older [median 36 years (IQR: 32-21) vs 27.19 (IQR: 30.5-19.25); P = 0.001], and less frequently males [35 (66.03 %) vs 119 (90.1%), P < 0 .0001] than seronegative participants. They more frequently came from Eastern Europe (70.8%) stayed longer in Italy [months of stay in Italy, mean ± SD: 51.02±52.84 vs 25.7 ± 42.65, P = 0.001], and had more years of schooling [years of schooling, mean ± SD: 9.61±2.81 vs 7.10 ± 4, P = 0.0001]. HCV-RNA-positive-subjects less frequently reported piercing, tattoos and tribal scars as risk factors (23.6%). Of these 48 HCV RNA positive subjects who started DAA, 47 (97.9%) showed a sustained virological response and one dropped-out in follow-up after DAA treatment. No subject had any adverse event. This model of HCV screening and linkage to care seems effective to eliminate HCV infectionin a difficult-to-reach and to-treat population, such as undocumented migrants and low-income refugees. The participation of cultural mediators in the study made possible a better interaction between migrants and physicians, as is evident from the large number of subjects enrolled. Eliminating HCV among migrants will have a long-term positive impact from a public health and healthcare perspective by reducing the number of individuals who potentially develop HCV-related complications such as liver cirrhosis and hepatocellular carcinoma and reducing the circulation of HCV in the regions that host them which often, as in the case of Italy, are low endemic for HCV infection.

Measurement and prediction of road traffic noise at different floor levels of buildings in a mid-sized Indian city

It is widely accepted that residents of high-rise buildings located beside roads are inevitably exposed to significant levels of noise pollution due to traffic operation. This study aims to unveil crucial insights into the dynamic fluctuations of noise levels within the vertical dimensions of high-rise buildings nestled amidst the bustling streets of mid-sized Indian cities where heterogeneous traffic is under operation. Two cycles of data were collected on all floors for hourly duration on the façade line for two high-rise buildings. Traffic volume, speed, distance of the building from centre of the carriageway and honking were used to develop models for Leq and L10 using Artificial Neural Network (ANN). The R2 values obtained for Leq and L10 were 0.93 and 0.90, respectively indicating the efficacy of the models in predicting noise level at all floors. Results show that the sound level rises to a certain height of the building and then begins to decrease. Floor level 3, 4, 5 and 6 (height approx. 8.4–21 m) had the maximum noise level compared to the other floors, while the 1st and floor level above 10 were quieter floors. Frequency analysis reveals that buildings closer to roadways experience dominant honking noise, particularly at 3.15 kHz, whereas traffic noise prevails at frequencies up to 200 Hz. This work has the novelty of addressing the impact of heterogeneous traffic noise at various floor levels of Varanasi mid-sized city which has narrow carriageway. Such a traffic has prominence of honking which is modelled perhaps for the first time. The outcome of this research has importance in urban planning and formulating legislations.

A Properly Chosen Rate of NPK Fertilizers Has a Positive Effect on C Sequestration in Sandy Soils in the Conditions of a Changing Climate

Abstract Soil organic carbon (SOC) plays a significant role in climate change. Its content can be modified by soil management practices, however, the effect of mineral fertilization on SOC is not clear. For this reason, a long-term effect of gradually increasing rates of NPK fertilizers on changes in soil organic carbon (SOC) in bulk soil and in water-stable aggregates (WSA) in soils with sandy loam and loamy sand texture at two experimental sites (Skierniewice, Poland, and Dražovce, Slovakia) was quantified. In both sites, soil samples were collected from the following treatments: NF – no fertilization, NPK1 and NPK2 – 1st level and 2nd level of NPK fertilization, respectively. The results showed that 100-year long application of NPK1 increased total carbon (TC) and SOC content by 24%, while NPK2 decreased it by 5% compared to NF at the Skierniewice site. The content of water-stable macroaggregates (WSAma) increased because of NPK application. In NPK1, the content of WSAma was higher and the content of water-stable microaggregates (WSAmi) was lower than in NPK2 or NF. However, as a result of NPK application, the content of agronomically favorable WSAma in size fraction 0.5–3 mm was reduced by 8 and 24% in NPK1 and NPK2, respectively, compared to NF. Overall, SOC in WSAma was lower than in bulk soil. The SOC in WSAma in NF, NPK1 and NPK2 treatments was 6.51, 7.77 and 5.89 g.kg−1, respectively. Similar tendency of SOC in WSAma 0.5–3 mm was observed (NF: 6.12 g.kg−1, NPK1: 7.35 g.kg−1, and NPK2: 6.88 g.kg−1). The SOC in WSAmi in NF, NPK1 and NPK2 was 8.33, 7.39 and 7.24 g.kg−1, respectively. At Dražovce site, TC content decreased significantly due to the graded rates of NPK, not because of SOC mineralization but as a result of carbonate dissolution for a period of 14 years. The carbonate content decreased from 20 g.kg−1 in NF to 6.5 g.kg-1 in NPK1 and 3.0 g.kg-1 in NPK2, while SOC did not change significantly: (NF: 23.8 g.kg−1, NPK1: 25.9 g.kg−1, and NPK2: 23.4 g.kg−1). In NPK1, the WSAma content was reduced significantly when compared to NPK2 and NF treatments. No significant difference was observed between NF and NPK2. On the contrary, the content of WSAma 0.5–3 mm significantly increased when compared to NF and NPK1. No difference was observed between NF and NPK1. Lower SOC content was found in WSA than in the bulk soil. Overall, higher SOC content was observed in WSAma when compared with WSAmi. The application of NPK1 and NPK2 increased SOC in WSAma as well as in WSAma 0.5–3 mm. The effect was more significant in NPK1 than NPK2 treatments when compared to NF.

Exploring the Relationship Between Manpower and Economic Indicator in Indonesia: A 30-Year Analysis

This research investigates the relationship between manpower and economic Indicator in Indonesia over a 30-year period from 1992 to 2022. Specifically, it examines the influence of Gross Domestic Product (GDP), Education, Age, Final Consumption Expenditure, Foreign Direct Investment, and Inflation on Wages, alongside the effects of employment and economic growth instruments. This study using Error Correction Model (ECM) along with unit root test, cointegration test, and Autoregressive Distributed Lag (ARDL) dependent test approach with the result that all of variables are stationary at the 1st difference level, this study aims to see the long-run and to know short-run relationship among the variables. The findings reveal a significant long-term relationship between wages and factors such as GDP (0.0000), higher education level (0.0006), secondary education level (0.0009) government spending (0.0149), and inflation (0.0312), while other variables such as basic education (0.0751), age of labour (0.3256), and Foreign Direct Investment (0.3417) are insignificant, while the short-run impact is seen to be less significant. This research proves that economic growth will always affect wages and the importance of controlling inflation as well as stabilising economic conditions to influence wages positively. Through rigorous statistical testing, this study contributes to understanding the dynamics affecting wages in Indonesia, highlighting the critical role of economic and demographic factors.

Agonal strategies in the american election campaign discourse (a case study of the political debates of the 2023 republican primary candidates)

The article analyses the methods of implementing the agonal strategies of political debate as one of the prototypical agonal genres of political discourse. For analysis, the speeches of politicians were selected during the 1st Republican primary debates held in the City of Milwaukee on August 23, 2023, streamed by the Fox News channel. The analysis allowed us to identify a 3-level structure of agonal strategies implemented by politicians within the framework of political debate. The 1st (basic) level of strategies – an introductive one – includes strategies for self-positioning, self-presentation and opponent defamation. The purpose of these strategies in terms of their agonal character is to position oneself as a leader worth winning the campaign, demonstrating individual undeniable advantages compared to other candidates and the expulsion of negative features of rivals. The verifying strategies of the 2nd level consist in operating with information received from the opponent aimed at producing an impact on the recipient, and include such strategies as self-defence and the opponent defamation. The additive strategy of the 3rd (highest) level combines the goals and objectives of the strategies of both lower levels; however, it has a special purpose inherent only to it – to give new meaning to the facts and phenomena reported by opponents, by introducing a new angle of tackling the problem. The main strategies at this level include ones of rational and emotional convictions realised by the tactics of introducing new facts and the new aspect ultimately aiming at establishing new semantic linkages in the recipient minds at the site of the destruction of semantic linkages, initially present in the speech of the political opponent. Thus, the study made it possible to ascertain that the genre of political debate, being a tactical repertoire of agonal behaviour strategies. is verbalised by various means, while strategies of a higher level can intersect with the lower ones’ strategies, nevertheless making explication of these strategies different, depending on the place of the strategy in the hierarchy.

E-Governance Responsiveness in Primary Local Levels of Developing Countries: Study of South Asian Countries 1st Level Administrative Units

E-Governance Responsiveness in Primary Local Levels of Developing Countries: Study of South Asian Countries 1st Level Administrative Units

Effects of kitchen waste compost and chemical fertilizer application on spinach (Spinacia oleracea L.) c.v. Matador plant growth and nitrate accumulation

In this study, the effects of organic and chemical fertilizer sources on some essential nutrient elements content, nitrate (NO3 −-N) accumulation, and the growth of spinach plant (Spinacia oleracea L.) were investigated. The experiment was carried out in a randomized plot design under greenhouse conditions, with two levels. 1st level; applications with chemical fertilizer. 2nd level; applications without chemical fertilizer. One compost material (kitchen waste compost = KWC), five different doses (0, 0.4, 0.8, 1.2, and 1.6%), and three replications. For chemical fertilization, nitrogen (N) dose of 150 kg ha−1 was applied by using 15-15-15 NPK (N:P2O5:K2O) fertilizer. Overall, KWC applications increased plant growth and nutrient content. However, the most significant increases occurred in the trial subjects where chemical fertilizer and KWC were applied together. The use of KWC together with chemical fertilization increased the leaf width, leaf and stem length, fresh weight, and dry weight, as well as nitrate accumulation, N, potassium (K), and iron (Fe) content of the plant. The highest values of these parameters were obtained at 0.8% dose of KWC + NPK medium. As a result, compost applications were effectively uptake of nutrients and nitrate accumulation remained at acceptable values.

Boundary Devices for Reflexive Teachers

Reflexivity appears to be a key focus when designing teachers’ training; therefore, designers and trainers need to plan and put in place situated and proactive learning contexts in which reflexivity is supported by specific participatory devices. During a 1st level master’s degree for teachers and educators, based on the Trialogical Learning Approach, learners are involved in several collaborative activities to create meaningful objects. Divided into 14 groups of four members covering specific roles (the coordinator, the researcher, the storyboarder, and the diarist), the participants collaboratively built a multimedia teaching resource about a chosen methodological–didactic theme. Applying a qualitative approach, this study analyzes the online diaries compiled during the activity to understand its impact as a “meta” boundary object able to support reflexivity on one’s professionalism. The content analysis focused on analyzing how objects and practices enabled learning and participation and how students’ identity evolved during group work. The results show that a diary may act as a reflexive tool, allowing for the externalization of the processes that underly the construction of individual and collective knowledge and promoting reflection on practices and identity positioning within a community composed of professionals working in educational fields. In the end, practical implications and recommendations are provided to enhance the reflexive diaries both in teachers’ training and in the daily practice with students.

Characterization of the tree length structure of the Nectarine tree before flowering by metric measurements in Sefrou, Morocco

This study aims to describe the architecture of Nectarine fruit trees located in Sefrou region. This characterization concerned the length variation of all the tree structure before flowering by metric exhaustive and non-destructive measurements. The study conducted on Nectarine variety of Spring Bright, by measuring 10 trunk, 40 frames, 157 1st underframe, 280 2nd underframe, 361 3rd underframe, 308 4th underframe, 134 5th underframe and 1250 of mixed branches, that have been labelled and numbered. The characterization of the tree revealed the underlying logic of the plant’s construction, The lengths, decrease from scaffold to 5th level under frame but it experiences a 357% increase in length ratio for the mixed branch due to its role as the primary fructification structure. This type of distribution is logic for the goblet training pruning program. The mean number of structure evolution was (scaffold) 4/(1st level) 4/(2nd level)1/3rd level 2/(mixt branch) 9 . The raw length data was not homogeneous probably due to the pruning effect, so they were grouped in three to four class to enhance the homogeneity.

The Impact of Plateletcrit on the Diagnosis and Management of Gestational Diabetes Mellitus

Aim: Gestational diabetes mellitus (GDM) is a condition that can cause serious maternal and fetal complications. Platelets are one of the cells that play an important role in inflammation in our body. In this study, we aimed to investigate whether there is a relationship between platelet values obtained by a simple blood count and GDM. Materials and Methods: Two groups consisting of 60 individuals with GDM and 250 healthy populations were created. Demographic characteristics, the sugar loading test results performed between 24th-28th weeks and simple complete blood count results including platelets, plateletcrit (PCT), platelet distribution width (PDW), and mean platelet volume (MPV)) were analyzed with SPSS. Results: When comparing the ages, BMI, average blood pressure, heights, and gestational weeks of both groups, there was no any significant differences (p&gt;0.05). In terms of the hemoglobin, platelet, and white blood cell counts, there wasn’t any significant differences between the two groups (p&gt;0.05). MPV, PDW and PCT values were significantly increased in patients with GDM compared to healthy pregnant women (p&lt;0.02, p&lt;0.009, and p&lt;0.001, respectively). Specifically, there was a significant positive correlation was found between PCT and the 1st hour glucose level (r: 0.585, p=0.001). Conclusion: We predict that a simple blood count (especially MPV, PDW and PCT values) performed during the first routine visit of pregnant women may be useful in predicting the risk of GDM.

An intermediate-sized donor registry experience: HLA barriers in matching procedures.

The data enabling the estimation of the possibility of finding a matched unrelated donor (MUD) within a relatively short time is important for the success of hematopoietic stem cell transplantation (HSCT). In the present study, 738 unrelated Croatian patients in the program of unrelated HSCT were retrospectively analyzed for gender matching, donor origin (national or international), the distribution of HLA alleles and haplotypes, as well as for the probability of finding a 9-10/10 MUD. Almost 70% of the patients in our study group had a 10/10 MUD, while among the patients with a 9/10 MUD, a 1st field resolution level mismatched donor was selected for 55.0% of patients. The majority of pairs were HLA-A mismatched (33.8%). A comparison of HLA allele frequencies between two subgroups of patients revealed significant differences for 13 alleles. However, after p value correction, the difference in frequency remained significant only for four alleles; three HLA alleles (B*08:01, C*07:01, and DRB1*03:01) demonstrated a significantly higher frequency among patients with a 10/10 MUD (Pcorr < 0.0001, Pcorr = 0.0096, and Pcorr < 0.0001, respectively), while the B*35:08 allele was significantly more present among patients with a 9/10 MUD (Pcorr = 0.0328). The comparison of the distribution of HLA haplotypes between patients with a 10/10 MUD and patients with a 9/10 MUD showed significant differences for a number of two-locus and three-locus haplotypes, as well as for one five-locus haplotype (HLA-A*01:01~B*08:01~C*07:01~DRB1*03:01~DQB1*02:01), which was significantly more present in the group of patients with a 10/10 MUD. At least one HLA haplotype from the group of non-frequent HLA haplotypes (positions >1000) was carried by patients with a 9/10 MUD. The data obtained by the present study will contribute to a better estimation of the probability of finding a suitable 9-10/10 MUD for Croatian patients in need of HSCT.

ВИЗНАЧЕННЯ ПОКАЗНИКА ЦИРКУЛЯРНОСТІ В ЛІСОВОМУ СЕКТОРІ ЗА ПРИНЦИПАМИ ЦИРКУЛЯРНОЇ ЕКОНОМІКИ

It is substantiated that the implementation of the circular economy in the forest sector is important and relevant, as it helps to preserve forest resources, contributing to the efficient use of materials and the reduction of wood residues, as well as the restoration and reuse of wood products. Analyzed and ranked according to the degree of importance of the principles of the hierarchy of 10R strategies of the circular economy in the forest sector in the form of a watering can, where the upper levels have a higher priority compared to the lower ones. The percentage of importance of each strategy according to the priority of actions of 10R strategies to achieve maximum circularity and sustainability was determined, in particular: Refuse (18.72%); Rethink (17.05%); Reduce (15.05%); Reuse (13.05); Repair (11.04%); Repurpose (9.03%); Remanufacturing (7.03%); Refurbish (5.02%); Recycle (3.01%); Recover (1.00%); Dispose (0.00 %). The state of the circular economy in the processes of logging, production of products from primary raw materials and processing of used (consumed) wood products in Ukraine was analyzed, which made it possible to determine the indicator of circularity in the forest sector. The method of determining the circularity index according to the 10R strategies of the circular economy for the three main components of the forest sector with the formation of three possible growth scenarios has been developed. The indicators of circularity for scenario No. 1 were determined, which characterize the 1st lowest level of efficiency for traditional technologies of utilization and useful use of wood resources with values for the processes: logging 6.02%, manufacturing of wood products 10.03%, processing of used wood 25, 09% Circularity indicators are calculated for scenario No. 2, which characterizes the 2nd middle level of efficiency, with emphasis on advanced technologies and business models based on the extension of the service life and life cycle of products with values for the processes: logging 26.09%, manufacturing of wood products 43.14%, processing of used wood 61.71%. Circularity indicators were calculated for scenario No. 3, characterizing a developed circular economy – the 3rd maximum level of efficiency, built on smart production and smart consumption with values for the processes: logging 43.15%, manufacturing of wood products 76.24%, recycling of used wood 93.15%. Possible weighted average indicators of circularity according to three scenarios were determined: No. 1, which characterizes the situation in the forest sector of Ukraine and is 13.71%; No. 2, which predicts the situation in the forest sector of Ukraine in the next 10-15 years at the level of 43.65%; No. 3, which predicts the situation in the forest sector of Ukraine in the perspective of 2050 at the level of 70.85%. Ways to increase the circularity index in the forest sector based on the principles of the circular economy, which include minimizing waste, optimizing the use of resources, and preserving natural capital, are outlined.

Clinical Characteristics and Hearing Aid Uptake Rate of Patients Seen at the Community Hearing Clinic: A Model of Upstream Preventive Care and Earlier Intervention

Background and Aim: Presbyacusis is one of the most common causes of hearing loss for seniors age above 60 years. Yet diagnostic hearing tests are not readily accessible to seniors in the community. Since 2018, the Ministry of Health in Singapore started a pilot program to screen them for their visual, oral, and hearing health in the community and improve accessibility to hearing healthcare. We describe the clinical characteristics of seniors presenting to Community Hearing Clinic (CHC) and compared hearing aid uptake rates with patients seen at a tertiary hospital. Methods: Retrospective cross-sectional descriptive study on Singaporeans with hearing difficulties presenting to the community clinics. Results: Attendance rates were generally positive at more than 80% and is comparable to the specialist outpatient clinic at the tertiary hospital. Hearing aid uptake rates were comparable between CHC and tertiary hospital at 61.9% and 66.9% respectively. Despite having better accessibility with direct access to the audiologists, and more financial subsidies, the eventual uptake rates of hearing aids are not clinically different at the CHC. Conclusion: CHC may be a viable model of improving accessibility to hearing healthcare with audiologists providing the 1st level of triaging safely. However, the cost-effectiveness of this model remains to be seen. Further health service research studies are warranted to determine the cost-effectiveness of sandbox CHC. Right-siting and expanding the sandbox to include access to hearing aid subsidies in private clinics may further help with this move beyond hospital to the community in line with our public health vision. Keywords: Community health services; audiology; hearing aids; financing; governmental

Increasing Literacy and Numerization by Holding A 1st Primary Level Ranking Competition in Tambusai Village, Rumbio Jaya District, Kampar Regency

Literacy has a broad scope, not only talking about reading and writing letters, but also the ability to capture information with logical and critical thinking, ultimately being able to use it effectively to achieve certain goals. Reading is a process carried out to obtain a message and then convey it using written words. The reading literacy movement for students is an activity designed so that when students read, they are not only proficient at reading. However, students can also understand the content of the reading. The aim of this research is to improve students' reading skills. The method for implementing community service KKN activities is carried out through several stages, including the following: (1) Contacting cooperation partners with the Tambusai Village head to ask for permission to carry out KKN activities, (2) Discussing the work program that our group has prepared and linked it to the problem. what happens to children in the Tambusai Village environment, (3) Contacting elementary schools to carry out activities, (4) Measuring children's learning abilities by helping teachers carry out teaching activities, (5) Carrying out 1st ranking competition activities at Tambusai village elementary schools. The result of this service is children's reading ability by holding competitions that foster students' enthusiasm for reading and learning in order to win the competition.