Search results for: visual outcome

Authors: Rosa S. Wong, Keith T.S. Tung, Winnie W. Y. Tso, King-Wa Fu, Nirmala Rao, Patrick Ip

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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.

Keywords: early childhood, electronic device, psychosocial wellbeing, parenting

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Authors: Isabella B. Davidman

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Violence used against Jewish women in both the Eastern European pogroms and during the Nazi era was specifically gendered, targeting their female identity and dignity of womanhood. Not only did these acts of gendered violence dehumanize Jewish women, but they also hurt the Jewish community as a whole. The devastating sexual violence that women endured during the pogroms and the Nazi era caused profound trauma. Out of shame and fear, silence about women’s experiences of sexual abuse manifests in forms that words cannot translate. Women have turned to art and other means of storytelling to convey their female experiences in visual and non-verbal ways. Therefore, this paper aims to address the historical accounts of gendered violence against Jewish women during the pogroms and Nazi era, as well as art that reflects upon the female experience, in order to understand the emotional impact resulting from these events. To analyze the artwork, a feminist analysis was used to understand the intersection of gender with the other systems of inequality, such as systemic anti-semitism, in women’s lives; this ultimately explained the ways in which cultural productions undermine and reinforce the political and social oppression of women by exploring how art confronts the exploitation of women's bodies. By analyzing the art in the context of specific acts of violence, such as public rape, as a strategic weapon, we are able to understand women’s experiences and how these experiences, in turn, challenged their womanhood. Additionally, these atrocities, which often occurred in the public space, were dismissed and forgotten due to the social stigma of rape. In this sense, the experiences of women in pogroms and the Nazi era were both highly unacknowledged and forgotten. Therefore, the art that was produced during those time periods, as well as those after those events, gives voice to the profound silence on the narratives of Jewish women. Sexual violence is a weapon of war used to cause physical and psychological destruction, not only as a product of war. In both the early twentieth-century pogroms and the Holocaust, the sexual violence that Jewish women endured was fundamentally the same: the rape of Jewish women became a focal target in the theater of violence– women were not raped because they were women, but specifically, because they were Jewish women. Although the events of the pogroms and the Holocaust are in the past, the art that serves as testimony to the experience of Jewish women remains an everlasting reminder of the gendered violence that occurred. Even though covert expressions, such as an embroidered image of a bird eating an apple, the artwork gives voice to the many silenced victims of sexualized and gendered violence.

Keywords: gendered violence, holocaust, Nazi era, pogroms

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Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

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Abstract Objectives. Rituximab (RTX) shown a positive effect in the treatment of systemic sclerosis (SSc). But there is still not enough data on comparing the effectiveness of RTX with immunosuppressants (IS). The aim of our study was to compare changes of lung function and skin score in SSc between two groups of patients (pts) - on RXT therapy (prescribed after ineffectiveness of previous therapy with IS) and on therapy with IS only. Methods. This study included 103 pts received RTX as an addition to previous therapy (group 1) and 65 pts received therapy with IS and prednisolone (group 2). The mean follow-up period was 12.6±10.7months. In group 1 the mean age was 47±12.9 years, female – 88 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. 82% pts had interstitial lung disease (ILD) and 92% were positive for ANA, 67% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 11.3±4.5 mg/day, IS at inclusion received 47% of them. The cumulative mean dose of RTX was 1.7±0.6 g. In group 2 the mean age was 50.8±13.8 years, female-53 pts (82%), the diffuse cutaneous subset of the disease had 44 pts (68%). The mean disease duration was 8.8±7.7 years. 81% pts had ILD and 88% were positive for ANA, 58% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 8.69±4.28 mg/day, IS received 57% of them. Cyclophosphamide (CP) received 45% of pts. The cumulative mean dose of CP was 10.2±15.1g. D-penicillamine received 30% of pts. Other pts was on mycophenolate mofetil or methotrexate therapy in single cases. The pts of the compared groups did not differ in the main demographic and clinical parameters. The results are presented as delta (Δ) - difference between the baseline parameter and follow up point. Results. In group 1 there was an improvement of all outcome parameters: increased of forced vital capacity, % predicted - ΔFVC=4% (p=0.0004); Diffusing capacity for carbon monoxide, % predicted remained stable (ΔDLCO=0.1%); improvement of the Rodnan skin score-ΔmRss=3.4 (p=0.001); decrease of Activity index (EScSG-AI) - ΔActivity index=1.7 (p=0.001). In group 2 the changes was insignificant: ΔFVC=-2.3%, ΔmRss=0.87, ΔActivity index=0.3. But there was a significant decrease of DLCO: ΔDLCO=-5.1% (p=0.001). Conclusion. The results of our study confirm the data on the positive effect of RTX in complex therapy in pts with SSc (decrease of skin induration, increase of FVC, stabilization of DLCO). Meantime, pts on IS and prednisolone therapy shown the worsening of lung function and insignificant changes of other clinical parameters. RTX could be considered as a more effective option in complex treatment of SSc in comparison with IS therapy

Keywords: immunosuppressants, interstitial lung disease, systemic sclerosis, rituximab

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Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

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Authors: S. Jamshidi, E. Feizi Ashtiani, M. Ardestani, A. Feizi Ashtiani

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Waste load allocation (WLA) strategies usually intend to find economical policies for water resource management. Water quality trading (WQT) is an approach that uses discharge permit market to reduce total environmental protection costs. This primarily requires assigning discharge limits known as total maximum daily loads (TMDLs). These are determined by monitoring organizations with respect to the receiving water quality and remediation capabilities. The purpose of this study is to compare two approaches of TMDL assignment for WQT policy in small catchment area of Haraz River, in north of Iran. At first, TMDLs are assigned uniformly for the whole point sources to keep the concentrations of BOD and dissolved oxygen (DO) at the standard level at checkpoint (terminus point). This was simply simulated and controlled by Qual2kw software. In the second scenario, TMDLs are assigned using multi objective particle swarm optimization (MOPSO) method in which the environmental violation at river basin and total treatment costs are minimized simultaneously. In both scenarios, the equity index and the WLA based on trading discharge permits (TDP) are calculated. The comparative results showed that using economically optimized TMDLs (2nd scenario) has slightly more cost savings rather than uniform TMDL approach (1st scenario). The former annually costs about 1 M$ while the latter is 1.15 M$. WQT can decrease these annual costs to 0.9 and 1.1 M$, respectively. In other word, these approaches may save 35 and 45% economically in comparison with command and control policy. It means that using multi objective decision support systems (DSS) may find more economical WLA, however its outcome is not necessarily significant in comparison with uniform TMDLs. This may be due to the similar impact factors of dischargers in small catchments. Conversely, using uniform TMDLs for WQT brings more equity that makes stakeholders not feel that much envious of difference between TMDL and WQT allocation. In addition, for this case, determination of TMDLs uniformly would be much easier for monitoring. Consequently, uniform TMDL for TDP market is recommended as a sustainable approach. However, economical TMDLs can be used for larger watersheds.

Keywords: waste load allocation (WLA), water quality trading (WQT), total maximum daily loads (TMDLs), Haraz River, multi objective particle swarm optimization (MOPSO), equity

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Authors: Omar Shafqat, Jaime Arias, Cristian Bogdan, Björn Palm

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Heating constitutes a major part of the overall energy consumption in Sweden. In 2013 heating and hot water accounted for about 55% of the total energy use in the housing sector. Historically, the end users have not been able to make a significant impact on their consumption on account of traditional control systems that do not facilitate interaction and control of the heating systems. However, in recent years internet connected home energy management systems have become increasingly available which allow users to visualize the indoor temperatures as well as control the heating system. However, the adoption of these systems is still in its nascent stages. This paper presents the outcome of a study carried out in a community of single-family houses in Stockholm. Heating in the area is provided through district heating, and the neighbourhood is connected through a local micro thermal grid, which is owned and operated by the local community. Heating in the houses is accomplished through a hydronic system equipped with radiators. The system installed offers the households to control the indoor temperature through a mobile application as well as through a physical thermostat. It was also possible to program the system to, for instance, lower the temperatures during night time and when the users were away. The users could also monitor the indoor temperatures through the application. It was additionally possible to create different zones in the house with their own individual programming. The historical heating data (in the form of billing data) was available for several previous years and has been used to perform quantitative analysis for the study after necessary normalization for weather variations. The experiment involved 30 households out of a community of 178 houses. The area was selected due to uniform construction profile in the area. It was observed that despite similar design and construction period there was a large variation in the heating energy consumption in the area which can for a large part be attributed to user behaviour. The paper also presents qualitative analysis done through survey questions as well as a focus group carried out with the participants. Overall, considerable energy savings were accomplished during the trial, however, there was a considerable variation between the participating households. The paper additionally presents recommendations to improve the impact of home energy management systems for heating in terms of improving user engagement and hence the energy impact.

Keywords: energy efficiency in buildings, energy behavior, heating control system, home energy management system

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Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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Authors: Dhruv Sharma, Lynne Blair, Stephen Clune

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Later life loneliness is a social issue that is increasing alongside an upward global population trend. As a society, one way that we have responded to this social challenge is through developing non-pharmacological interventions such as befriending services, activity clubs, meet-ups, etc. Through a systematic literature review, this paper suggests that currently there is an underrepresentation of radical innovation, and underutilization of digital technologies in developing loneliness interventions for older adults. This paper examines intervention studies that were published in English language, within peer reviewed journals between January 2005 and December 2014 across 4 electronic databases. In addition to academic databases, interventions found in grey literature in the form of websites, blogs, and Twitter were also included in the overall review. This approach yielded 129 interventions that were included in the study. A systematic approach allowed the minimization of any bias dictating the selection of interventions to study. A coding strategy based on a pattern analysis approach was devised to be able to compare and contrast the loneliness interventions. Firstly, interventions were categorized on the basis of their objective to identify whether they were preventative, supportive, or remedial in nature. Secondly, depending on their scope, they were categorized as one-to-one, community-based, or group based. It was also ascertained whether interventions represented an improvement, an incremental innovation, a major advance or a radical departure, in comparison to the most basic form of a loneliness intervention. Finally, interventions were also assessed on the basis of the extent to which they utilized digital technologies. Individual visualizations representing the four levels of coding were created for each intervention, followed by an aggregated visual to facilitate analysis. To keep the inquiry within scope and to present a coherent view of the findings, the analysis was primarily concerned the level of innovation, and the use of digital technologies. This analysis highlights a weak but positive correlation between the level of innovation and the use of digital technologies in designing and deploying loneliness interventions, and also emphasizes how certain existing interventions could be tweaked to enable their migration from representing incremental innovation to radical innovation for example. This analysis also points out the value of including grey literature, especially from Twitter, in systematic literature reviews to get a contemporary view of latest work in the area under investigation.

Keywords: ageing, loneliness, innovation, digital

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Authors: Saidur R. Chowdhury, Mamme K. Addai, Ernest K. Yanful

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The research was performed to assess the potential of nickel smelter slag, an industrial waste, as an adsorbent in the removal of metals from aqueous solution. An investigation was carried out for Arsenic (As), Copper (Cu), lead (Pb) and Cadmium (Cd) adsorption from aqueous solution. Smelter slag was obtain from Ni ore at the Vale Inco Ni smelter in Sudbury, Ontario, Canada. The batch experimental studies were conducted to evaluate the removal efficiencies of smelter slag. The slag was characterized by surface analytical techniques. The slag contained different iron oxides and iron silicate bearing compounds. In this study, the effect of pH, contact time, particle size, competition by other ions, slag dose and distribution coefficient were evaluated to measure the optimum adsorption conditions of the slag as an adsorbent for As, Cu, Pb and Cd. The results showed 95-99% removal of As, Cu, Pb, and almost 50-60% removal of Cd, while batch experimental studies were conducted at 5-10 mg/L of initial concentration of metals, 10 g/L of slag doses, 10 hours of contact time and 170 rpm of shaking speed and 25oC condition. The maximum removal of Arsenic (As), Copper (Cu), lead (Pb) was achieved at pH 5 while the maximum removal of Cd was found after pH 7. The column experiment was also conducted to evaluate adsorption depth and service time for metal removal. This study also determined adsorption capacity, adsorption rate and mass transfer rate. The maximum adsorption capacity was found to be 3.84 mg/g for As, 4 mg/g for Pb, and 3.86 mg/g for Cu. The adsorption capacity of nickel slag for the four test metals were in decreasing order of Pb > Cu > As > Cd. Modelling of experimental data with Visual MINTEQ revealed that saturation indices of < 0 were recorded in all cases suggesting that the metals at this pH were under- saturated and thus in their aqueous forms. This confirms the absence of precipitation in the removal of these metals at the pHs. The experimental results also showed that Fe and Ni leaching from the slag during the adsorption process was found to be very minimal, ranging from 0.01 to 0.022 mg/L indicating the potential adsorbent in the treatment industry. The study also revealed that waste product (Ni smelter slag) can be used about five times more before disposal in a landfill or as a stabilization material. It also highlighted the recycled slags as a potential reactive adsorbent in the field of remediation engineering. It also explored the benefits of using renewable waste products for the water treatment industry.

Keywords: adsorption, industrial waste, recycling, slag, treatment

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Authors: Margot Whitfield, Andrea Ducent, Marie Catherine Rombaut, Katia Iassinovskaia, Deborah Fels

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Learning how to create inclusive media, such as closed captioning (CC) and audio description (AD), in North America is restricted to the private sector, proprietary company-based training. We are delivering (through synchronous and asynchronous online learning) the first Canadian post-secondary, practice-based continuing education course package in inclusive media for broadcast production and processes. Despite the prevalence of CC and AD taught within the field of translation studies in Europe, North America has no comparable field of study. This novel approach to audio visual translation (AVT) education develops evidence-based methodology innovations, stemming from user study research with blind/low vision and Deaf/hard of hearing audiences for television and theatre, undertaken at Ryerson University. Knowledge outcomes from the courses include a) Understanding how CC/AD fit within disability/regulatory frameworks in Canada. b) Knowledge of how CC/AD could be employed in the initial stages of production development within broadcasting. c) Writing and/or speaking techniques designed for media. d) Hands-on practice in captioning re-speaking techniques and open source technologies, or in AD techniques. e) Understanding of audio production technologies and editing techniques. The case study of the curriculum development and deployment, involving first-time online course delivery from academic and practitioner-based instructors in introductory Captioning and Audio Description courses (CDIM 101 and 102), will compare two different instructors' approaches to learning design, including the ratio of synchronous and asynchronous classroom time and technological engagement tools on meeting software platform such as breakout rooms and polling. Student reception of these two different approaches will be analysed using qualitative thematic and quantitative survey analysis. Thus far, anecdotal conversations with students suggests that they prefer synchronous compared with asynchronous learning within our hands-on online course delivery method.

Keywords: inclusive media theory, broadcasting practices, AVT post secondary education, respeaking, audio description, learning design, virtual education

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Authors: Sicheng Liu

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Zhang Ming is a never-A-listed writer-director in China who is famous for his poetic art-house filmmaking in mainland China, and his complex to spectacles of tiny places in south China. Entirely, Zhang’s works concentrate on the interconnection amongst settlement images, desirable fictional storytelling, and the dilemma of alienated interpersonal relationships. Zhang uses his pendulous camerawork to reconstruct the spectacles of his hometown and detached places in northern China, such as hometown Wushan county, lower-tier cities or remote areas that close to nature, where the old spectacles are experiencing great transformation and vanishment. Under his camera, the cities' geo-cultural and geopolitical implications which are not only a symbolic meaning that these places are not only settlements for residents to live but also representations to the abstraction of time-lapse, dimensional disorientation and revealment to people’s innerness. Zhang Ming is good at creating the essay-like expression, poetic atmosphere and vague metaphors in films, so as to show the sensitivity, aimlessness and slight anxiety of Chinese wenren (intellectuals), whose unique and objective experiences to a few aspects inside or outside their the living circumstance, typically for example, transformation of the environment, obscure expression to inner desire and aspirations, personal loneliness because of being isolated, slight anxiety to the uncertainty of life, and other mental dilemma brought by maladjustment. Also, Zhang’s works impressed the audience as slow cinemas, via creating stillness, complicity and fluidity of images and sound, by decompressing liner time passing and wandering within the enclosed loopback-space with his camera, so as to produce poeticized depiction and mysterious dimensions in films. This paper aims to summarize these mentioned features of Zhang’s films, by analyzing filmic texts and film-making styles, in order to prove an outcome that as a wenren-turned-filmmaker, Zhang Ming is good at use metaphor to create an artistic situation to depict the poetry in films and portray characteristics. In addition to this, Zhang Ming’s style relatively reflects some aesthetic features of Chinese wenren cinema.

Keywords: Chinese wenren cinema, intellectuals’ awareness, slow cinema,  slowness and dampness, people and environment

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Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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Authors: Xu Feifei

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The prevalence of COVID-19 currently is the biggest challenge to improving people's quality of life. Its impact on the health-related quality of life (HRQoL) is highly uncertain and has not been summarized so far. The aim of the present systematic review was to assess and provide an up-to-date analysis of the impact of the COVID-19 pandemic on the HRQoL of participants who have been infected, have not been infected but isolated, frontline, with different diseases, and the general population. Therefore, an electronic search of the literature in PubMed databases was performed from 2019 to July 2022 (without date restriction). PRISMA guideline methodology was employed, and data regarding the HRQoL were extracted from eligible studies. Articles were included if they met the following inclusion criteria: (a) reports on the data collection of the health state utility values (HSUVs) related to COVID-19 from 2019 to 2021; (b) English language and peer-reviewed journals; and (c) original HSUV data; (d) using EQ-5D tool to quantify the HRQoL. To identify studies that reported the effects on COVID-19, data on the proportion of overall HSUVs of participants who had the outcome were collected and analyzed using a one-group meta-analysis. As a result, thirty-two studies fulfilled the inclusion criteria and, therefore, were included in the systematic review. A total of 45295 participants and provided 219 means of HSUVs during COVID-19 were included in this systematic review. The range of utility is from 0.224 to 1. The study included participants from Europe (n=16), North America (n=4), Asia (n=10), South America (n=1), and Africa (n=1). Twelve articles showed that the HRQoL of the participants who have been infected with COVID-19 (range of overall HSUVs from 0.6125 to 0.863). Two studies reported the population of frontline workers (the range of overall HSUVs from 0.82 to 0.93). Seven of the articles researched the participants who had not been infected with COVID-19 but suffered from morbidities during the pandemic (range of overall HSUVs from 0.5 to 0.96). Thirteen studies showed that the HRQoL of the respondents who have not been infected with COVID-19 and without any morbidities (range of overall HSUVs from 0.64 to 0.964). Moreover, eighteen articles reported the outcomes of overall HSUVs during the COVID-19 pandemic in different population groups. The estimate of overall HSUVs of direct COVID-19 experience population (n=1333) was 0.751 (95% CI 0.670 - 0.832, I2 = 98.64%); the estimate of frontline population (n=610) was 0.906 ((95% CI 0.854 – 0.957, I2 = 98.61%); participants with different disease (n=132) were 0.768 (95% CI 0.515 - 1.021, I2= 99.26%); general population without infection history (n=29,892) was 0.825 (95% CI 0.766 - 0.885, I2 =99.69%). Conclusively, taking into account these results, this systematic review might confirm that COVID-19 has a negative impact on the HRQoL of the infected population and illness population. It provides practical value for cost-effectiveness model analysis of health states related to COVID-19.

Keywords: COVID-19, health-related quality of life, meta-analysis, systematic review, utility value

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Authors: Athena Pedro, Zandile Batweni, Laura Bradfield, Michael Dare, Ashley Nyman

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The rapid growth and development of an infant in the first 1000 days of life means that this time period provides the greatest opportunity for a positive developmental impact on a child’s life socially, emotionally, cognitively and physically. Current research is being focused on children in the first 1000 days, but there is a lack of research and understanding of mothers and their experiences during this crucial time period. Thus, it is imperative that more research is done to help better understand the experiences of mothers during the first 1000 days of their child’s life, as well as gain more insight into mothers’ knowledge regarding this time period. The first 1000 days of life, from conception to two years, is a critical period, and the child’s attachment to his or her mother or primary caregiver during this period is crucial for a multitude of future outcomes. The aim of this study was to explore mothers’ understanding and experience of the first 1000 days of their child’s life, specifically looking at attachment in the context of Bowlby and Ainsworths’ attachment theory. Using a qualitative methodological framework, data were collected through semi-structured individual interviews with 12 first-time mothers from low-income communities in Cape Town. Thematic analysis of the data revealed that mothers articulated the importance of attachment within the first 1000 days of life and shared experiences of how they bond and form attachment with their babies. Furthermore, these mothers expressed their belief in the long-term effects of early attachment of responsive positive parenting as well as the lasting effects of poor attachment and non-responsive parenting. This study has implications for new mothers and healthcare staff working with mothers of new-born babies, as well as for future contextual research. By gaining insight into the mothers’ experiences, policies and intervention efforts can be formulated in order to assist mothers during this time, which ultimately promote the healthy development of the nation’s children and future adult generation. If researchers are also able to understand the extent of mothers’ general knowledge regarding the first 1000 days and attachment, then there will be a better understanding of where there may be gaps in knowledge and thus, recommendations for effective and relevant intervention efforts may be provided. These interventions may increase knowledge and awareness of new mothers and health care workers at clinics and other service providers, creating a high impact on positive outcome. Thus, improving the developmental trajectory for many young babies allows them the opportunity to pursue optimal development by reaching their full potential.

Keywords: attachment, experience, first 1000 days, knowledge, mothers

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Moustafa Osman Mohammed

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The modeling of a spatial-economic database is crucial in recitation economic network structure to social development. Sustainability within the spatial-economic model gives attention to green businesses to comply with Earth’s Systems. The natural exchange patterns of ecosystems have consistent and periodic cycles to preserve energy and materials flow in systems ecology. When network topology influences formal and informal communication to function in systems ecology, ecosystems are postulated to valence the basic level of spatial sustainable outcome (i.e., project compatibility success). These referred instrumentalities impact various aspects of the second level of spatial sustainable outcomes (i.e., participant social security satisfaction). The sustainability outcomes are modeling composite structure based on a network analysis model to calculate the prosperity of panel databases for efficiency value, from 2005 to 2025. The database is modeling spatial structure to represent state-of-the-art value-orientation impact and corresponding complexity of sustainability issues (e.g., build a consistent database necessary to approach spatial structure; construct the spatial-economic-ecological model; develop a set of sustainability indicators associated with the model; allow quantification of social, economic and environmental impact; use the value-orientation as a set of important sustainability policy measures), and demonstrate spatial structure reliability. The structure of spatial-ecological model is established for management schemes from the perspective pollutants of multiple sources through the input–output criteria. These criteria evaluate the spillover effect to conduct Monte Carlo simulations and sensitivity analysis in a unique spatial structure. The balance within “equilibrium patterns,” such as collective biosphere features, has a composite index of many distributed feedback flows. The following have a dynamic structure related to physical and chemical properties for gradual prolong to incremental patterns. While these spatial structures argue from ecological modeling of resource savings, static loads are not decisive from an artistic/architectural perspective. The model attempts to unify analytic and analogical spatial structure for the development of urban environments in a relational database setting, using optimization software to integrate spatial structure where the process is based on the engineering topology of systems ecology.

Keywords: ecological modeling, spatial structure, orientation impact, composite index, industrial ecology

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Authors: Ayala Amir

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The paper presents interdisciplinary research which draws on the literary study and the cultural study of photography to explore a literary genre defined by nostalgia – the photographed book for children. This genre, which was popular in the second half of the 20th century, presents the romantic, nostalgic image of childhood created in the visual arts in the 18th century (as suggested by Ann Higonnet). At the same time, it capitalizes on the nostalgia inherent in the event of photography as formulated by Jennifer Green-Lewis: photography frames a moment in the present while transforming it into a past longed for in the future. Unlike Freudian melancholy, nostalgia is an effect that enables representation by acknowledging the loss and containing it in the very experience of the object. The representation and preservation of the lost object (nature, childhood, innocence) are in the center of the genre of children's photography books – a modern version of ancient pastoral. In it, the unique synergia of word and image results in a nostalgic image of childhood in an era already conquered by modernization. The nostalgic effect works both in the representation of space – an Edenic image of nature already shadowed by its demise, and of time – an image of childhood imbued by what Gill Bartholnyes calls the "looking backward aesthetics" – under the sign of loss. Little critical attention has been devoted to this genre with the exception of the work of Bettina Kümmerling-Meibauer, who noted the nostalgic effect of the well-known series of photography books by Astrid Lindgren and Anna Riwkin-Brick. This research aims to elaborate Kümmerling-Meibauer's approach using the theories of the study of photography, word-image studies, as well as current studies of childhood. The theoretical perspectives are implemented in the case study of photography books created in one of the most innovative social structures in our time – the Israeli Kibbutz. This communal way of life designed a society where children will experience their childhood in a parentless rural environment that will save them from the fate of the Oedipal fall. It is suggested that in documenting these children in a fictional format, photographers and writers, images and words cooperated in creating nostalgic works situated on the border between nature and culture, imagination and reality, utopia and its realization in history.

Keywords: nostalgia, photography , childhood, children's books, kibutz

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Authors: Teemu Saressalo

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This article examines the evolution of the Israel Defence Forces’ information operation activities during an eight-year timespan from the 2006 war with Hezbollah to more recent operations such as Pillar of Defence and Protective Edge. To this end, the case study will show a change in the Israel Defence Forces’ activities in the information domain. In the 2006 war with Hezbollah in Lebanon, Israel inflicted enormous damage on the Lebanese infrastructure, leaving more than 1,200 people dead and 4,400 injured. Casualties among Hezbollah, Israel’s main adversary, were estimated to range from 250 to 700 fighters. Damage to the Lebanese infrastructure was estimated at over USD 2.5bn, with almost 2,000 houses and buildings damaged and destroyed. Even this amount of destruction did not force Hezbollah to yield and while both sides were claiming victory in the war, Israel paid a heavier price in political backlashes and loss of reputation, mainly due to failures in the media and the way in which the war was portrayed and perceived in Israel and abroad. Much of this can be credited to Hezbollah’s efficient use of the media, and Israel’s failure to do so. Israel managed the next conflict it was engaged in completely differently – it had learnt its lessons and built up new ways to counter its adversary’s propaganda and media operations. In Operation Cast Lead at the turn of 2009, Hamas, Israel’s adversary and Gaza’s dominating faction, was not able to utilize the media in the same way that Hezbollah had. By creating a virtual and physical barrier around the Gaza Strip, Israel almost totally denied its adversary access to the worldwide media, and by restricting the movement of journalists in the area, Israel could let its voice be heard above all. The operation Cast Lead began with a deception operation, which caught Hamas totally off guard. The 21-day campaign left the Gaza Strip devastated, but did not cause as much protest in Israel during the operation as the 2006 war did, mainly due to almost total Israeli dominance in the information dimension. The most important outcome from the Israeli perspective was the fact that Operation Cast Lead was assessed to be a success and the operation enjoyed domestic support along with support from many western nations, which had condemned Israeli actions in the 2006 war. Later conflicts have shown the same tendency towards virtually total dominance in the information domain, which has had an impact on target audiences across the world. Thus, it is clear that well-planned and conducted information operations are able to shape public opinion and influence decision-makers, although Israel might have been outpaced by its rivals.

Keywords: Hamas, Hezbollah, information operations, Israel Defence Forces

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Authors: Sushil Kumar Singh, Kumar Rahul, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: Rheumatic mitral stenosis continues to be a major public health problem in developing countries. When the left atrium (LA) is unable to fill the left ventricle (LV) at normal LA pressures due to impaired relaxation and impaired compliance, diastolic dysfunction occurs. The assessment of left ventricular (LV) diastolic function and filling pressures is of clinical importance to identify underlying cardiac disease, its treatment, and to assess prognosis. 2D echocardiography can detect diastolic dysfunction with excellent sensitivity and minimal risk when compared to the gold standard of invasive pressure-volume measurements. Material and Method: This was a one-year study consisting of twenty-nine patients of isolated rheumatic severe mitral stenosis. Data was analyzed preoperative and post operative (at one month follow-up). Transthoracic 2D echocardiographic parameters of the diastolic function are transmitral flow, pulmonary venous flow, mitral annular tissue doppler, and color M-mode doppler. In our study, mitral valve orifice area, ejection fraction, deceleration time, E/A-wave, E/E’-wave, myocardial performance index of left ventricle (Tei index ), and Mitral inflow propagation velocity were included for echocardiographic evaluation. The statistical analysis was performed on SPSS Version 15.0 statistical analysis software. Result: Twenty-nine patients underwent successful closed mitral commissurotomy for isolated mitral stenosis. The outcome measures were observed pre-operatively and at one-month follow-up. The majority of patients were in NYHA grade III (69.0%) in the preoperative period, which improved to NYHA grade I (48.3%) after closed mitral commissurotomy. Post-surgery mitral valve area increased from 0.77 ± 0.13 to 2.32 ± 0.26 cm, ejection fraction increased from 61.38 ± 4.61 to 64.79 ± 3.22. There was a decrease in deceleration time from 231.55 ± 49.31 to 168.28 ± 14.30 ms, E/A ratio from 1.70 ± 0.54 from 0.89 ± 0.39, E/E’ ratio from 14.59 ± 3.34 to 8.86 ± 3.03. In addition, there was improvement in TIE index from 0.50 ± 0.03 to 0.39 ± 0.06 and mitral inflow propagation velocity from 47.28 ± 3.71 to 57.86 ± 3.19 cm/sec. In peri-operative and follow-up, there was no incidence of severe mitral regurgitation (MR). There was no thromboembolic incident and no mortality.

Keywords: closed mitral valvotomy, mitral stenosis, open mitral commissurotomy, balloon mitral valvotomy

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Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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Authors: Xiaohong Li, Wenfan Yan

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Background: While it is widely considered that the university library plays a critical role in fulfilling the institution's mission and providing students’ learning experience beyond the classrooms, how the technology-enhanced library reform changed college students’ learning experience hasn’t been thoroughly investigated. The purpose of this study is to explore how technology-enhanced library reform affects students’ learning experience and career readiness and further identify the factors and effective conditions that enable the quality learning outcome of Chinese college students. Methodologies: This study selected the qualitative comparative analysis (QCA) method to explore the effects of technology-enhanced university library reform on college students’ learning experience and career readiness. QCA is unique in explaining the complex relationship between multiple factors from a holistic perspective. Compared with the traditional quantitative and qualitative analysis, QCA not only adds some quantitative logic but also inherits the characteristics of qualitative research focusing on the heterogeneity and complexity of samples. Shenyang Normal University (SNU) selected a sample of the typical comprehensive university in China that focuses on students’ learning and application of professional knowledge and trains professionals to different levels of expertise. A total of 22 current university students and 30 graduates who joined the Library Readers Association of SNU from 2011 to 2019 were selected for semi-structured interviews. Based on the data collected from these participating students, qualitative comparative analysis (QCA), including univariate necessity analysis and the multi-configuration analysis, was conducted. Findings and Discussion: QCA analysis results indicated that the influence of technology-enhanced university library restructures and reorganization on student learning experience and career readiness is the result of multiple factors. Technology-enhanced library equipment and other hardware restructured to meet the college students learning needs and have played an important role in improving the student learning experience and learning persistence. More importantly, the soft characteristics of technology-enhanced library reform, such as library service innovation space and culture space, have a positive impact on student’s career readiness and development. Technology-enhanced university library reform is not only the change in the building's appearance and facilities but also in library service quality and capability. The study also provides suggestions for policy, practice, and future research.

Keywords: career readiness, college student learning experience, qualitative comparative analysis (QCA), technology-enhanced library reform

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Authors: Saifalarab A. Mohmmed, Morgana E. Vianna, Jonathan C. Knowles

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The issue of apical periodontitis has received considerable critical attention. Bacteria is integrated into communities, attached to surfaces and consequently form biofilm. The biofilm structure provides bacteria with a series protection skills against, antimicrobial agents and enhances pathogenicity (e.g. apical periodontitis). Sodium hypochlorite (NaOCl) has become the irrigant of choice for elimination of bacteria from the root canal system based on its antimicrobial findings. The aim of the study was to investigate the effect of different agitation techniques on the efficacy of 2.5% NaOCl to eliminate the biofilm from the surface of the lateral canal using the residual biofilm, and removal rate of biofilm as outcome measures. The effect of canal complexity (lateral canal) on the efficacy of the irrigation procedure was also assessed. Forty root canal models (n = 10 per group) were manufactured using 3D printing and resin materials. Each model consisted of two halves of an 18 mm length root canal with apical size 30 and taper 0.06, and a lateral canal of 3 mm length, 0.3 mm diameter located at 3 mm from the apical terminus. E. faecalis biofilms were grown on the apical 3 mm and lateral canal of the models for 10 days in Brain Heart Infusion broth. Biofilms were stained using crystal violet for visualisation. The model halves were reassembled, attached to an apparatus and tested under a fluorescence microscope. Syringe and needle irrigation protocol was performed using 9 mL of 2.5% NaOCl irrigant for 60 seconds. The irrigant was either left stagnant in the canal or activated for 30 seconds using manual (gutta-percha), sonic and ultrasonic methods. Images were then captured every second using an external camera. The percentages of residual biofilm were measured using image analysis software. The data were analysed using generalised linear mixed models. The greatest removal was associated with the ultrasonic group (66.76%) followed by sonic (45.49%), manual (43.97%), and passive irrigation group (control) (38.67%) respectively. No marked reduction in the efficiency of NaOCl to remove biofilm was found between the simple and complex anatomy models (p = 0.098). The removal efficacy of NaOCl on the biofilm was limited to the 1 mm level of the lateral canal. The agitation of NaOCl results in better penetration of the irrigant into the lateral canals. Ultrasonic agitation of NaOCl improved the removal of bacterial biofilm.

Keywords: 3D printing, biofilm, root canal irrigation, sodium hypochlorite

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Authors: Angelika Dierolf, K. Rischer, A. Gonzalez-Roldan, P. Montoya, F. Anton, M. Van der Meulen

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Placebo analgesia is a powerful cognitive endogenous pain modulation mechanism with high relevance in pain treatment. Older people would benefit, especially from non-pharmacologic pain interventions, since this age group is disproportionately affected by acute and chronic pain, while pharmacological treatments are less suitable due to polypharmacy and age-related changes in drug metabolism. Although aging is known to affect neurobiological and physiological aspects of pain perception, as for example, changes in pain threshold and pain tolerance, its effects on cognitive pain modulation strategies, including placebo analgesia, have hardly been investigated so far. In the present study, we are assessing placebo analgesia in 35 older adults (60 years and older) and 35 younger adults (between 18 and 35 years). Acute pain was induced with short transdermal electrical pulses to the inner forearm, using a concentric stimulating electrode. Stimulation intensities were individually adjusted to the participant’s threshold. Next to the stimulation site, we applied sham transcutaneous electrical nerve stimulation (TENS). Participants were informed that sometimes the TENS device would be switched on (placebo condition), and sometimes it would be switched off (control condition). In reality, it was always switched off. Participants received alternating blocks of painful stimuli in the placebo and control condition and were asked to rate the intensity and unpleasantness of each stimulus on a visual analog scale (VAS). Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results show a reduced placebo effect in older compared to younger adults in both behavioral and neurophysiological data. Older people experienced less subjective pain reduction under sham TENS treatment compared to younger adults, as evidenced by the VAS ratings. The N1 and P2 event-related potential components were generally reduced in the older group. While younger adults showed a reduced N1 and P2 under sham TENS treatment, this reduction was considerably smaller in older people. This reduced placebo effect in the older group suggests that cognitive pain modulation is altered in aging and may at least partly explain why older adults experience more pain. Our results highlight the need for a better understanding of the efficacy of non-pharmacological pain treatments in older adults and how these can be optimized to meet the specific requirements of this population.

Keywords: placebo analgesia, aging, acute pain, TENS, EEG

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Authors: Yagya Murti Aryal, Bipin Adhikari, Pradeep Gyawali

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The Lesser Himalaya zone of Nepal consists of thrusting and folding belts, which play an important role in the sustainable management of groundwater in the Himalayan regions. The study area is located in the Dolakha and Ramechhap Districts of Bagmati Province, Nepal. Geologically, these districts are situated in the Lesser Himalayas and partly encompass the Higher Himalayan rock sequence, which includes low-grade to high-grade metamorphic rocks. Following the Gorkha Earthquake in 2015, numerous springs dried up, and many others are currently experiencing depletion due to the distortion of the natural groundwater flow. The primary objective of this study is to identify potential groundwater areas and determine suitable sites for artificial groundwater recharge. Two distinct statistical approaches were used to develop models: The Frequency Ratio (FR) and Shannon Entropy (SE) methods. The study utilized both primary and secondary datasets and incorporated significant role and controlling factors derived from field works and literature reviews. Field data collection involved spring inventory, soil analysis, lithology assessment, and hydro-geomorphology study. Additionally, slope, aspect, drainage density, and lineament density were extracted from a Digital Elevation Model (DEM) using GIS and transformed into thematic layers. For training and validation, 114 springs were divided into a 70/30 ratio, with an equal number of non-spring pixels. After assigning weights to each class based on the two proposed models, a groundwater potential map was generated using GIS, classifying the area into five levels: very low, low, moderate, high, and very high. The model's outcome reveals that over 41% of the area falls into the low and very low potential categories, while only 30% of the area demonstrates a high probability of groundwater potential. To evaluate model performance, accuracy was assessed using the Area under the Curve (AUC). The success rate AUC values for the FR and SE methods were determined to be 78.73% and 77.09%, respectively. Additionally, the prediction rate AUC values for the FR and SE methods were calculated as 76.31% and 74.08%. The results indicate that the FR model exhibits greater prediction capability compared to the SE model in this case study.

Keywords: groundwater potential mapping, frequency ratio, Shannon’s Entropy, Lesser Himalaya Zone, sustainable groundwater management

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Authors: Devon Simpson

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Recycled Manure Solids (RMS), attained via centrifugation from Canadian dairy farms, were synthesized into a non-polluting fertilizer by bonding micronutrients (Fe, Zn, and Mn) to cellulose fibers and then assessed for the effectiveness of nutrient recovery in tomatoes. Manure management technology is critical for improving the sustainability of agroecosystems and has the capacity to offer a truly circular economy. The ability to add value to manure byproducts offers an opportunity for economic benefits while generating tenable solutions to livestock waste. The dairy industry is under increasing pressure from new environmental protections such as government restrictions on manure applications, limitations on herd size as well as increased product demand from a growing population. Current systems use RMS as bedding, so there is a lack of data pertaining to RMS use as a fertilizer. This is because of nutrient distribution, where most nutrients are retained in the liquid effluent of the solid-liquid separation. A literature review on the physical and chemical properties of dairy manure further revealed more data for raw manure than centrifuged solids. This research offers an innovative perspective and a new avenue of exploration in the use of RMS. Manure solids in this study were obtained directly from dairy farms in Salmon Arm and Abbotsford, British Columbia, and underwent physical, chemical, and biological characterizations pre- and post-synthesis processing. Samples were sent to A&L labs Canada for analysis. Once characterized and bonded to micronutrients, the effect of synthesized RMS on nutrient recovery in tomatoes was studied in a greenhouse environment. The agricultural research package ‘agricolae’ for R was used for experimental design and data analysis. The growth trials consisted of a randomized complete block design (RCBD) that allowed for analysis of variance (ANOVA). The primary outcome was to measure nutrient uptake, and this was done using an Inductively Coupled Plasma Mass Spectrometer (IC-PMS) to analyze the micronutrient content of both the tissue and fruit of the tomatoes. It was found that treatments containing bonded dairy manure solids had an increased micronutrient concentration. Treatments with bonded dairy manure solids also saw an increase in yield, and a brix analysis showed higher sugar content than the untreated control and a grower standard.

Keywords: aoecosystems, dairy manure, micronutrient fertilizer, manure management, nutrient recovery, nutrient recycling, recycled manure solids, regenerative agricugrlture, sustainable farming

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Authors: Surabhi Gautam, Uma Kumar, Rima Dada

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A sustained acute-phase response in Rheumatoid Arthritis (RA) is associated with increased joint damage and inflammation leading to progressive disability. It is induced continuously by consecutive stimuli of proinflammatory cytokines, following a wide range of pathophysiological reactions, leading to increased synthesis of acute phase proteins like C - reactive protein (CRP) and dysregulation in levels of immunomodulatory soluble Human Leukocyte Antigen-G (HLA-G) molecule. This study was designed to explore the effect of yoga and meditation based lifestyle intervention (YMLI) on inflammatory markers in RA patients. Blood samples of 50 patients were collected at baseline (day 0) and after 30 days of YMLI. Patients underwent a pretested YMLI under the supervision of a certified yoga instructor for 30 days including different Asanas (physical postures), Pranayama (breathing exercises), and Dhayna (meditation). Levels of CRP, IL-6, IL-17A, soluble HLA-G and erythrocyte sedimentation rate (ESR) were measured at day 0 and 30 interval. Parameters of disease activity, disability quotient, pain acuity and quality of life were also assessed by disease activity score (DAS28), health assessment questionnaire (HAQ), visual analogue scale (VAS), and World Health Organization Quality of Life (WHOQOL-BREF) respectively. There was reduction in mean levels of CRP (p < 0.05), IL-6 (interleukin-6) (p < 0.05), IL-17A (interleukin-17A) (p < 0.05) and ESR (p < 0.05) and elevation in soluble HLA-G (p < 0.05) at 30 days compared to baseline level (day 0). There was reduction seen in DAS28-ESR (p < 0.05), VAS (p < 0.05) and HAQ (p < 0.05) after 30 days with respect to the base line levels (day 0) and significant increase in WHOQOL-BREF scale (p < 0.05) in all 4 domains of physical health, psychological health, social relationships, and environmental health. The present study has demonstrated that yoga practices are associated with regression of inflammatory processes by reducing inflammatory parameters and regulating the levels of soluble HLA-G significantly in active RA patients. Short term YMLI has significantly improved pain perception, disability quotient, disease activity and quality of life. Thus this simple life style intervention can reduce disease severity and dose of drugs used in the treatment of RA.

Keywords: inflammation, quality of life, rheumatoid arthritis, yoga and meditation

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Authors: Atheer Al-Nuaimi, Harry Evdorides

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Every day many people die or get disabled or injured on roads around the world, which necessitates more specific treatments for transportation safety issues. International road assessment program (iRAP) model is one of the comprehensive road safety models which accounting for many factors that affect road safety in a cost-effective way in low and middle income countries. In iRAP model road safety has been divided into five star ratings from 1 star (the lowest level) to 5 star (the highest level). These star ratings are based on star rating score which is calculated by iRAP methodology depending on road attributes, traffic volumes and operating speeds. The outcome of iRAP methodology are the treatments that can be used to improve road safety and reduce fatalities and serious injuries (FSI) numbers. These countermeasures can be used separately as a single countermeasure or mix as multiple countermeasures for a location. There is general agreement that the adequacy of a countermeasure is liable to consistent losses when it is utilized as a part of mix with different countermeasures. That is, accident diminishment appraisals of individual countermeasures cannot be easily added together. The iRAP model philosophy makes utilization of a multiple countermeasure adjustment factors to predict diminishments in the effectiveness of road safety countermeasures when more than one countermeasure is chosen. A multiple countermeasure correction factors are figured for every 100-meter segment and for every accident type. However, restrictions of this methodology incorporate a presumable over-estimation in the predicted crash reduction. This study aims to adjust this correction factor by developing new models to calculate the effect of using multiple countermeasures on the number of fatalities for a location or an entire road. Regression models have been used to establish relationships between crash frequencies and the factors that affect their rates. Multiple linear regression, negative binomial regression, and Poisson regression techniques were used to develop models that can address the effectiveness of using multiple countermeasures. Analyses are conducted using The R Project for Statistical Computing showed that a model developed by negative binomial regression technique could give more reliable results of the predicted number of fatalities after the implementation of road safety multiple countermeasures than the results from iRAP model. The results also showed that the negative binomial regression approach gives more precise results in comparison with multiple linear and Poisson regression techniques because of the overdispersion and standard error issues.

Keywords: international road assessment program, negative binomial, road multiple countermeasures, road safety

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Authors: Dalia Antiniene, Rosita Lekaviciene

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The qualitative methodology based study is designed to reveal a connection between emotional intelligence (EI) and locus of control (LC) within the population of Lithuanian youth. In the context of emotional problems, the locus of control reflects how one estimates the causes of his/her emotions: internals (internal locus of control) associate their emotions with their manner of thinking, whereas externals (external locus of control) consider emotions to be evoked by external circumstances. On the other hand, there is little empirical data about this connection, and the results in disposition are often contradictory. In the conducted study 1430 young people, aged 17 to 27, from various regions of Lithuania were surveyed. The subjects were selected by quota sampling, maintaining natural proportions of the general Lithuanian youth population. To assess emotional intelligence the EI-DARL test (i.e. self-report questionnaire consisting of 75 items) was implemented. The emotional intelligence test, created applying exploratory factor analysis, reveals four main dimensions of EI: understanding of one’s own emotions, regulation of one’s own emotions, understanding other’s emotions, and regulation of other’s emotions (subscale reliability coefficients fluctuate between 0,84 and 0,91). An original 16-item internality/externality scale was used to examine the locus of control (internal consistency of the Externality subscale - 0,75; Internality subscale - 0,65). The study has determined that the youth understands and regulates other people’s emotions better than their own. Using the K-mean cluster analysis method, it was established that there are three groups of subjects according to their EI level – people with low, medium and high EI. After comparing means of subjects’ favorability of statements on the Internality/Externality scale, a predominance of internal locus of control in the young population was established. The multiple regression models has shown that a rather strong statistically significant correlation exists between total EI, EI subscales and LC. People who tend to attribute responsibility for the outcome of their actions to their own abilities and efforts have higher EI and, conversely, the tendency to attribute responsibility to external forces is related more with lower EI. While pursuing their goals, young people with high internality have a predisposition to analyze perceived emotions and, therefore, gain emotional experience: they learn to control their natural reactions and to act adequately in a situation at hand. Thus the study unfolds, that a person’s locus of control and emotional intelligence are related phenomena and allows us to draw a conclusion, that a person’s internality/externality is a reliable predictor of total EI and its components.

Keywords: emotional intelligence, externality, internality, locus of control

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Authors: Hayder H. Kareem, Shunqi Pan

Abstract:

The geological environment where the groundwater is collected represents the most important element that affects the behaviour of groundwater aquifer. As groundwater is a worldwide vital resource, it requires knowing the parameters that affect this source accurately so that the conceptualized mathematical models would be acceptable to the broadest ranges. Therefore, groundwater models have recently become an effective and efficient tool to investigate groundwater aquifer behaviours. Groundwater aquifer may contain aquitards, aquicludes, or interfaces within its geological formations. Aquitards and aquicludes have geological formations that forced the modellers to include those formations within the conceptualized groundwater models, while interfaces are commonly neglected from the conceptualization process because the modellers believe that the interface has no effect on aquifer behaviour. The current research highlights the impact of an interface existing in a real unconfined groundwater aquifer called Dibdibba, located in Al-Najaf City, Iraq where it has a river called the Euphrates River that passes through the eastern part of this city. Dibdibba groundwater aquifer consists of two types of soil layers separated by an interface soil layer. A groundwater model is built for Al-Najaf City to explore the impact of this interface. Calibration process is done using PEST 'Parameter ESTimation' approach and the best Dibdibba groundwater model is obtained. When the soil interface is conceptualized, results show that the groundwater tables are significantly affected by that interface through appearing dry areas of 56.24 km² and 6.16 km² in the upper and lower layers of the aquifer, respectively. The Euphrates River will also leak water into the groundwater aquifer of 7359 m³/day. While these results are changed when the soil interface is neglected where the dry area became 0.16 km², the Euphrates River leakage became 6334 m³/day. In addition, the conceptualized models (with and without interface) reveal different responses for the change in the recharge rates applied on the aquifer through the uncertainty analysis test. The aquifer of Dibdibba in Al-Najaf City shows a slight deficit in the amount of water supplied by the current pumping scheme and also notices that the Euphrates River suffers from stresses applied to the aquifer. Ultimately, this study shows a crucial need to represent the interface soil layer in model conceptualization to be the intended and future predicted behaviours more reliable for consideration purposes.

Keywords: Al-Najaf City, groundwater aquifer behaviour, groundwater modelling, interface soil layer, Visual MODFLOW

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