Search results for: acute back pain

Authors: Febrian Tegar Wicaksana, Niqmatul Kurniati, Surya Nandika

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Indonesia is one of the countries that have great number of disaster occurrence and threat because it is located in not only between three tectonic plates such as Eurasia plates, Indo-Australia plates and Pacific plates, but also in the Ring of Fire path, like earthquake, Tsunami, volcanic eruption and many more. Recently, research shows that there are potential areas that will be devastated by Tsunami in southern coast of Java. Tsunami is a series of waves in a body of water caused by the displacement of a large volume of water, generally in an ocean. When the waves enter shallow water, they may rise to several feet or, in rare cases, tens of feet, striking the coast with devastating force. The parameter for reference such as magnitude, the depth of epicentre, distance between epicentres with land, the depth of every points, when reached the shore and the growth of waves. Interaction between parameters will bring the big variance of Tsunami wave. Based on that, we can formulate preparation that needed for disaster mitigation strategies. The mitigation strategies will take the important role in an effort to reduce the number of victims and damage in the area. It will reduce the number of victim and casualties. Reducing is directed to the most difficult mobilization casualties in the tsunami disaster area like old people, sick people and disabilities people. Until now, the method that used for rescuing people from Tsunami is basic horizontal evacuation. This evacuation system is not optimal because it needs so long time and it cannot be used by people with disabilities. The writers propose to create a vertical evacuation model with an escape bunker system. This bunker system is chosen because the downward vertical evacuation is considered more efficient and faster. Especially in coastal areas without any highlands surround it. The downward evacuation system is better than upward evacuation because it can avoid the risk of erosion at the ground around the structure which can affect the building. The structure of the bunker and the evacuation process while, and even after, disaster are the main priority to be considered. The power of bunker has quake’s resistance, the durability from water stream, variety of interaction to the ground, and waterproof design. When the situation is back to normal, victim and casualties can go into the safer place. The bunker will be located near the hospital and public places, and will have wide entrance supported by large slide in it so it will ease the disabilities people. The technology of the escape bunker system is expected to reduce the number of victims who have low mobility in the Tsunami.

Keywords: escape bunker, tsunami, vertical evacuation, mitigation, disaster management

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Authors: Hilal Turkoglu Sasmazel, Ozan Ozkan, Seda Surucu

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Tissue engineering is the field of treating defects caused by injuries, trauma or acute/chronic diseases by using artificial scaffolds that mimic the extracellular matrix (ECM), the natural biological support for the tissues and cells within the body. The main aspects of a successful artificial scaffold are (i) large surface area in order to provide multiple anchorage points for cells to attach, (ii) suitable porosity in order to achieve 3 dimensional growth of the cells within the scaffold as well as proper transport of nutrition, biosignals and waste and (iii) physical, chemical and biological compatibility of the material in order to obtain viability throughout the healing process. By hybrid scaffolds where two or more different materials were combined with advanced fabrication techniques into complex structures, it is possible to combine the advantages of individual materials into one single structure while eliminating the disadvantages of each. Adding this to the complex structure provided by advanced fabrication techniques enables obtaining the desired aspects of a successful artificial tissue scaffold. In this study, fibroblast compatibility of poly(ε-caprolactone) (PCL)/chitosan core-shell electrospun hybrid scaffolds with proper mechanical, chemical and physical properties successfully developed in our previous study was investigated. Standard 7-day cell culture was carried out with L929 fibroblast cell line. The viability of the cells cultured with the scaffolds was monitored with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) viability assay for every 48 h starting with 24 h after the initial seeding. In this assay, blank commercial tissue culture polystyrene (TCPS) Petri dishes, single electrospun PCL and single electrospun chitosan mats were used as control in order to compare and contrast the performance of the hybrid scaffolds. The adhesion, proliferation, spread and growth of the cells on/within the scaffolds were observed visually on the 3rd and the 7th days of the culture period with confocal laser scanning microscopy (CSLM) and scanning electron microscopy (SEM). The viability assay showed that the hybrid scaffolds caused no toxicity for fibroblast cells and provided a steady increase in cell viability, effectively doubling the cell density for every 48 h for the course of 7 days, as compared to TCPS, single electrospun PCL or chitosan mats. The cell viability on the hybrid scaffold was ~2 fold better compared to TCPS because of its 3D ECM-like structure compared to 2D flat surface of commercially cell compatible TCPS, and the performance was ~2 fold and ~10 fold better compared to single PCL and single chitosan mats, respectively, even though both fabricated similarly with electrospinning as non-woven fibrous structures, because single PCL and chitosan mats were either too hydrophobic or too hydrophilic to maintain cell attachment points. The viability results were verified with visual images obtained with CSLM and SEM, in which cells found to achieve characteristic spindle-like fibroblast shape and spread on the surface as well within the pores successfully at high densities.

Keywords: chitosan, core-shell, fibroblast, electrospinning, PCL

Procedia PDF Downloads 175

Authors: Pawel Kiper, Alfonc Baba, Mahmoud Alhelou, Giorgia Pregnolato, Michela Agostini, Andrea Turolla

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Impairment of cervical spine mobility is often related to pain triggered by musculoskeletal disorders or direct traumatic injuries of the spine. To date, these disorders are assessed with goniometers and inclinometers, which are the most popular devices used in clinical settings. Nevertheless, these technologies usually allow measurement of no more than two-dimensional range of motion (ROM) quotes in static conditions. Conversely, the wide use of motion tracking systems able to measure 3 to 6 degrees of freedom dynamically, while performing standard ROM assessment, are limited due to technical complexities in preparing the setup and high costs. Thus, motion tracking systems are primarily used in research. These systems are an integral part of virtual reality (VR) technologies, which can be used for measuring spine mobility. To our knowledge, the accuracy of VR measure has not yet been studied within virtual environments. Thus, the aim of this study was to test the reliability of a protocol for the assessment of sensorimotor function of the cervical spine in a population of healthy subjects and to compare whether using immersive or non-immersive VR for visualization affects the performance. Both VR assessments consisted of the same five exercises and random sequence determined which of the environments (i.e. immersive or non-immersive) was used as first assessment. Subjects were asked to perform head rotation (right and left), flexion, extension and lateral flexion (right and left side bending). Each movement was executed five times. Moreover, the participants were invited to perform head reaching movements i.e. head movements toward 8 targets placed along a circular perimeter each 45°, visualized one-by-one in random order. Finally, head repositioning movement was obtained by head movement toward the same 8 targets as for reaching and following reposition to the start point. Thus, each participant performed 46 tasks during assessment. Main measures were: ROM of rotation, flexion, extension, lateral flexion and complete kinematics of the cervical spine (i.e. number of completed targets, time of execution (seconds), spatial length (cm), angle distance (°), jerk). Thirty-five healthy participants (i.e. 14 males and 21 females, mean age 28.4±6.47) were recruited for the cervical spine assessment with immersive and non-immersive VR environments. Comparison analysis demonstrated that: head right rotation (p=0.027), extension (p=0.047), flexion (p=0.000), time (p=0.001), spatial length (p=0.004), jerk target (p=0.032), trajectory repositioning (p=0.003), and jerk target repositioning (p=0.007) were significantly better in immersive than non-immersive VR. A regression model showed that assessment in immersive VR was influenced by height, trajectory repositioning (p<0.05), and handedness (p<0.05), whereas in non-immersive VR performance was influenced by height, jerk target (p=0.002), head extension, jerk target repositioning (p=0.002), and by age, head flex/ext, trajectory repositioning, and weight (p=0.040). The results of this study showed higher accuracy of cervical spine assessment when executed in immersive VR. The assessment of ROM and kinematics of the cervical spine can be affected by independent and dependent variables in both immersive and non-immersive VR settings.

Keywords: virtual reality, cervical spine, motion analysis, range of motion, measurement validity

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Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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The history of gaseous fuel use in the motive power of vehicles dates back to the second half of the nineteenth century, and thus the beginnings of the automotive industry. The engines were powered by coal gas and became the prototype for internal combustion engines built so far. It can thus be considered that this construction gave rise to the automotive industry. As the socio-economic development advances, so does the number of motor vehicles. Although, due to technological progress in recent decades, the emissions generated by internal combustion engines of cars have been reduced, a sharp increase in the number of cars and the rapidly growing traffic are an important source of air pollution and a major cause of acoustic threat, in particular in large urban agglomerations. One of the solutions, in terms of reducing exhaust emissions and improving air quality, is a more extensive use of alternative fuels: CNG, LNG, electricity and hydrogen. In the case of electricity use for transport, it should be noted that the environmental outcome depends on the structure of electricity generation. The paper shows selected regulations affecting the use of alternative fuels for transport (including Directive 2014/94/EU) and its dynamics between 2000 and 2015 in Poland and selected EU countries. The paper also gives a focus on the impact of alternative fuels on the environment by comparing the volume of individual emissions (compared to the emissions from conventional fuels: petrol and diesel oil). Bearing in mind that the extent of various alternative fuel use is determined in first place by economic conditions, the article describes the price relationships between alternative and conventional fuels in Poland and selected EU countries. It is pointed out that although Poland has a wealth of experience in using methane alternative fuels for transport, one of the main barriers to their development in Poland is the extensive use of LPG. In addition, a poorly developed network of CNG stations in Poland, which does not allow easy transport, especially in the northern part of the country, is a serious problem to a further development of CNG use as fuel for transport. An interesting solution to this problem seems to be the use of home CNG filling stations: Home Refuelling Appliance (HRA, refuelling time 8-10 hours) and Home Refuelling Station (HRS, refuelling time 8-10 minutes). The team is working on HRA and HRS technologies. The article also highlights the impact of alternative fuel use on energy security by reducing reliance on imports of crude oil and petroleum products.

Keywords: alternative fuels, CNG (Compressed Natural Gas), CNG stations, LNG (Liquefied Natural Gas), NGVs (Natural Gas Vehicles), pollutant emissions

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Authors: Vanessa G. P. Severino, Eliangela Cristina Candida Costa, Nubia Alves Mariano Teixeira Pires Gomides, Lucilia Kato, Afif Felix Monteiro, Maria Anita Lemos Vasconcelos Ambrosio, Carlos Henrique Gomes Martins

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One of the biomes present in Brazil is known as Cerrado, which is a vast tropical savanna ecoregion, particularly in the states of Goiás, Mato Grosso do Sul, Mato Grosso, Tocantins and Minas Gerais. Many species of plants are characterized as endemic and they have therapeutic value for a large part of the population, especially to the rural communities. Given that, the southeastern region of the state of Goiás contains about 21 rural communities, which present a form of organization based on the use of natural resources available. One of these rural communities is named of Coqueiros, where the knowledge about the medicinal plants was very important to this research. Thus, this study focuses on the ethnobotanical survey of this community on the use of Kielmeyera coriacea to treat diseases. From the 37 members interviewed, 76% indicated this species for the treatment of intestinal infection, leukemia, anemia, gastritis, gum pain, toothache, cavity, arthritis, arthrosis, healing, vermifuge, rheumatism, antibiotic, skin problems, mycoses and all kinds of infections. The medicinal properties attributed during the interviews were framed in the body system (disease categories), adapted from ICD 10; thus, 20 indications of use were obtained, among five body systems. Therefore, the root of this species was select to chemical and biological (antioxidant and antimicrobial) studies. From the liquid-liquid extraction of ethanolic extract of root (EER), the hexane (FH), ethyl acetate (FAE), and hydro alcoholic (FHA) fractions were obtained. The chemical profile study of these fractions was performed by LC-MS, identifying major compounds such as δ-tocotrienol, prenylated acylphoroglucinol, 2-hydroxy-1-methoxyxanthone and quercitrin. EER, FH, FAE and FHA were submitted to biological tests. FHA presented the best antioxidant action (EC50 201.53 μg mL-1). EER inhibited the bacterial growth of Streptococcus pyogenes and Pseudomonas aeruginosa, microorganisms associated with rheumatism, at Minimum Inhibitory Concentration (MIC) of 6.25 μg mL-1. In addition, the FH-10 subfraction, obtained from FH fractionation, presented MIC of 1.56 μg mL-1 against S. pneumoniae; EER also inhibited the fungus Candida glabrata (MIC 7.81 μg mL- 1). The FAE-4.7.3 fraction, from the fractionation of FAE, presented MIC of 200 μg mL-1 against Lactobacillus casei, which is one of the causes of caries and oral infections. By the correlation of the chemical and biological data, it is possible to note that the FAE-4.7.3 and FH-10 are constituted 4-hydroxy-2,3-methylenedioxy xanthone, 3-hydroxy-1,2-dimethoxy xanthone, lupeol, prenylated acylphoroglucinol and quercitrin, which could be associated with the biological potential found. Therefore, this study provides an important basis for further investigations regarding the compounds present in the active fractions of K. coriacea, which will permit the establishment of a correlation between ethnobotanical survey and bioactivity.

Keywords: biological activity, ethnobotanical survey, Kielmeyera coriacea Mart., LC-MS profile

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Anna-Lisa Osvalder, Jonas Borell

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There are several reasons behind the use, non-use, or inadequate use of personal protective equipment (PPE) in the construction industry. Comfort and accurate size support proper use, while discomfort, misfit, and difficulties to understand how the PPEs should be handled inhibit correct usage. The need for several protective equipments simultaneously might also create problems. The purpose of this study was to analyse the correct usage, comfort, and fit of different types of PPEs used for construction work. Correct usage was analysed as guessability, i.e., human perceptions of how to don, adjust, use, and doff the equipment, and if used as intended. The PPEs tested individually or in combinations were a helmet, ear protectors, goggles, respiratory masks, gloves, protective cloths, and safety harnesses. First, an analytical evaluation was performed with ECW (enhanced cognitive walkthrough) and PUEA (predictive use error analysis) to search for usability problems and use errors during handling and use. Then usability tests were conducted to evaluate guessability, comfort, and fit with 10 test subjects of different heights and body constitutions. The tests included observations during donning, five different outdoor work tasks, and doffing. The think-aloud method, short interviews, and subjective estimations were performed. The analytical evaluation showed that some usability problems and use errors arise during donning and doffing, but with minor severity, mostly causing discomfort. A few use errors and usability problems arose for the safety harness, especially for novices, where some could lead to a high risk of severe incidents. The usability tests showed that discomfort arose for all test subjects when using a combination of PPEs, increasing over time. For instance, goggles, together with the face mask, caused pressure, chafing at the nose, and heat rash on the face. This combination also limited sight of vision. The helmet, in combination with the goggles and ear protectors, did not fit well and caused uncomfortable pressure at the temples. No major problems were found with the individual fit of the PPEs. The ear protectors, goggles, and face masks could be adjusted for different head sizes. The guessability for how to don and wear the combination of PPE was moderate, but it took some time to adjust them for a good fit. The guessability was poor for the safety harness; few clues in the design showed how it should be donned, adjusted, or worn on the skeletal bones. Discomfort occurred when the straps were tightened too much. All straps could not be adjusted for somebody's constitutions leading to non-optimal safety. To conclude, if several types of PPEs are used together, discomfort leading to pain is likely to occur over time, which can lead to misuse, non-use, or reduced performance. If people who are not regular users should wear a safety harness correctly, the design needs to be improved for easier interpretation, correct position of the straps, and increased possibilities for individual adjustments. The results from this study can be a base for re-design ideas for PPE, especially when they should be used in combinations.

Keywords: construction work, PPE, personal protective equipment, misuse, guessability, usability

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Authors: Boudjelal Amel

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Arisarum vulgare, a member of the Araceae family, is an herbaceous perennial widely distributed in the Mediterranean region. A. vulgare is recognized for its medicinal properties and holds significant traditional importance in Algeria for the treatment of various human ailments, including pain, infections, inflammation, digestive disorders, skin problems, eczema, cancer, wounds, burns and gynecological diseases. Despite its extensive traditional use, scientific exploration of A. vulgare remains limited. The study aims to investigate for the first time the therapeutic potential of A. vulgare ethanolic extract obtained by ultrasound-assisted extraction. The chemical composition of the extract was determined by LC-MS/MS analysis. For in vitro phytopharmacological evaluation, several assays, including DPPH, ABTS, FRAP and reducing power, were employed to evaluate the antioxidant activity. The antibacterial activity was assessed againt Escherichia coli, Salmonella typhimurium, Staphylococus aureus, Enterococcus feacium by disk diffusion and microdilution methods. The possible inhibitory activity of ethanolic extract was analyzed against the cholinesterases enzymes (AChE and BChE). The DNA protection activity of A. vulgare ethanolic extract was estimated using the agarose gel electrophoresis method. The capacities of the extract to protect plasmid DNA (pBR322) from the oxidizing effects of H2O2 and UV treatment were evaluated by their DNA-breaking forms. The in vivo wound healing potential of a traditional ointment containing 5% of A. vulgare ethanolic extract was also investigated. The LC-MS/MS profiling of the extract revealed the presence of various bioactive compounds, including naringenin, chlorogenic, vanillic, cafeic, coumaric acids, trans-cinnamic and trans ferrulic acids. The plant extract presented considerable antioxidant potential, being the most active for Reducing power (0,07326±0.001 mg/ml) and DPPH (0.14±0.004 mg/ml). The extract showed the highest inhibition zone diameter against Enterococcus feacium (36±0.1 mm). The ethanolic extract of A. vulgare suppressed the growth of Staphylococus aureus, Escherichia coli and Salmonella typhimurium according to the MIC values. The extract of the plant significantly inhibited both AChE and BChE enzymes. DNA protection activity of the A. vulgare extract was determined as 90.41% for form I and 51.92% for form II. The in vivo experiments showed that 5% ethanolic extract ointment accelerated the wound healing process. The topical application of the traditional formulation enhanced wound closure (95,36±0,6 %) and improved histological parameters in the treated group compared to the control groups. The promising biological properties of Arisarum vulgare revealed that the plant could be appraised as a potential origin of bioactive molecules having multifunctional medicinal uses.

Keywords: arisarum vulgare, LC-MS/MS, antioxidant activity, antimicrobial activity, cholinesterases enzymes inhibition, dna-damage activity, in vivo wound healing

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Authors: Anette Alén

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Intellectual property (IP) regimes have traditionally been designed to integrate various conflicting elements stemming from private entitlement and the public good. In IP laws and regulations, this design takes the form of specific uses of protected subject-matter without the right-holder’s consent, or exhaustion of exclusive rights upon market release, and the like. More recently, the pursuit of ‘balance’ has gained ground in the conceptualization of these conflicting elements both in terms of IP law and related policy. This can be seen, for example, in European Union (EU) copyright regime, where ‘balance’ has become a key element in argumentation, backed up by fundamental rights reasoning. This development also entails an ever-expanding dialogue between the IP regime and the constitutional safeguards for property, free speech, and privacy, among others. This study analyses the concept of ‘balance’ in EU copyright law: the research task is to examine the contents of the concept of ‘balance’ and the way it is operationalized and pursued, thereby producing new knowledge on the role and manifestations of ‘balance’ in recent copyright case law and regulatory instruments in the EU. The study discusses two particular pieces of legislation, the EU Digital Single Market (DSM) Copyright Directive (EU) 2019/790 and the finalized EU Artificial Intelligence (AI) Act, including some of the key preparatory materials, as well as EU Court of Justice (CJEU) case law pertaining to copyright in the digital era. The material is examined by means of document analysis, mapping the ways ‘balance’ is approached and conceptualized in the documents. Similarly, the interaction of fundamental rights as part of the balancing act is also analyzed. Doctrinal study of law is also employed in the analysis of legal sources. This study suggests that the pursuit of balance is, for its part, conducive to new battles, largely due to the advancement of digitalization and more recent developments in artificial intelligence. Indeed, the ‘balancing act’ rather presents itself as a way to bypass or even solidify some of the conflicting interests in a complex global digital economy. Indeed, such a conceptualization, especially when accompanied by non-critical or strategically driven fundamental rights argumentation, runs counter to the genuine acknowledgment of new types of conflicting interests in the copyright regime. Therefore, a more radical approach, including critical analysis of the normative basis and fundamental rights implications of the concept of ‘balance’, is required to readjust copyright law and regulations for the digital era. Notwithstanding the focus on executing the study in the context of the EU copyright regime, the results bear wider significance for the digital economy, especially due to the platform liability regime in the DSM Directive and with the AI Act including objectives of a ‘level playing field’ whereby compliance with EU copyright rules seems to be expected among system providers.

Keywords: balance, copyright, fundamental rights, platform liability, artificial intelligence

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Authors: Tjipta Lesmana

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Terrorist attacks quickly penetrated Indonesia following the downfall of Soeharto regime in May 1998. Reform era was officially proclaimed. Indonesia turned to 'heaven state' from 'authoritarian state'. For the first time since 1966, the country experienced a full-scale freedom of expression, including freedom of the press, and heavy acknowledgement of human rights practice. Some religious extremists previously run away to neighbor countries to escape from security apparatus secretly backed home. Quickly they consolidated the power to continue their long aspiration and dream to establish 'Shariah Indonesia', Indonesia based on Khilafah ideology. Bali bombings I which shocked world community occurred on 12 October 2002 in the famous tourist district of Kuta on the Indonesian island of Bali, killing 202 people (including 88 Australians, 38 Indonesians, and people from more than 20 other nationalities). In the capital, Jakarta, successive bombings were blasted in Marriott hotel, Australian Embassy, residence of the Philippine Ambassador and stock exchange office. A 'drunken Indonesia' is far from ready to combat nationwide sudden and massive terrorist attacks. Police Detachment 88 (Densus 88) Indonesian counter-terrorism squad, was quickly formed following 2002 Bali Bombing. Anti-terrorism Provisional Act was immediately erected, as well, due to urgent need to fight terrorism. Some Bali bombings criminals were deadly executed after sentenced by the court. But a series of terrorist suicide attacks and another Bali bombings (the second one) in Bali, again, shocked world community. Terrorism network is undoubtedly spreading nationwide. Suspicion is high that they had close connection with Al Qaeda’s groups. Even 'Afghanistan alumni' and 'Syria alumni' returned to Indonesia to back up the local mujahidins in their fights to topple Indonesia constitutional government and set up Islamic state (Khilafah). Supported by massive aids from friendly nations, especially Australia and United States, Indonesia launched large scale operations to crush terrorism consisted of various radical groups such as JAD, JAS, and JAADI. Huge energy, money, and souls were dedicated. Terrorism is, however, persistently entrenched. High ranking officials from Detachment 88 squad and military intelligence believe that terrorism is still one the most deadly enemy of Indonesia.

Keywords: counter-radicalization, de-radicalization, Khalifah, Union State, Al Qaedah, ISIS

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Authors: Patrícia Pires, Renata Vaz, Bárbara Teles, Marco Pato, Pedro Beckert

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Introduction: The management of lateral third clavicle fractures can be challenging due to difficulty in distinguishing subtle variations in the fracture pattern, which may be suggestive of potential fracture instability. They occur most often in men between 30 and 50 years of age, and in individuals over 70 years of age, its distribution is equal between both men and women. These fractures account for 10%–30% of all clavicle fractures and roughly 30%–45% of all clavicle nonunion fractures. Lateral third clavicle fractures may be treated conservatively or surgically, and there is no gold standard, although the risk of nonunion or pseudoarthrosis impacts the recommendation of surgical treatment when these fractures are unstable. There are many strategies for surgical treatment, including locking plates, hook plates fixation, coracoclavicular fixation using suture anchors, devices or screws, tension band fixation with suture or wire, transacromial Kirschner wire fixation and arthroscopically assisted techniques. Whenever taking the hardware into consideration, we must not disregard that obtaining adequate lateral fixation of small fragments is a difficult task, and plates are more associated to local irritation. The aim of the appropriate treatment is to ensure fracture healing and a rapid return to preinjury activities of daily living but, as explained, definitive treatment strategies have not been established and the variety of techniques avalilable add up to the discussion of this topic. Methods and Results: We present a clinical case of a 43-year-old man with the diagnosis of a lateral third clavicle fracture (Neer IIC) in the sequence of a fall on his right shoulder after a bicycle fall. He was operated three days after the injury, and through K-wire temporary fixation and indirect reduction using a ZipTight, he underwent osteosynthesis with an interfragmentary figure-of-eight tension band with polydioxanone suture (PDS). Two weeks later, there was a good aligment. He kept the sling until 6 weeks pos-op, avoiding efforts. At 7-weeks pos-op, there was still a good aligment, starting the physiotherapy exercises. After 10 months, he had no limitation in mobility or pain and returned to work with complete recovery in strength. Conclusion: Some distal clavicle fractures may be conservatively treated, but it is widely accepted that unstable fractures require surgical treatment to obtain superior clinical outcomes. In the clinical case presented, the authors chose an osteosuture technique due to the fracture pattern, its location. Since there isn´t a consensus on the prefered fixation method, it is important for surgeons to be skilled in various techniques and decide with their patient which approach is most appropriate for them, weighting the risk-benefit of each method. For instance, with the suture technique used, there is no wire migration or breakage, and it doesn´t require a reoperation for hardware removal; there is also less tissue exposure since it requires a smaller approach in comparison to the plate fixation and avoids cuff tears like the hook plate. The good clinical outcome on this case report serves the purpose of expanding the consideration of this method has a therapeutic option.

Keywords: lateral third, clavicle, suture, fixation

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Authors: Sricheta Chowdhury

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To require a woman to choose between her work and her personal life is the most acute form of discrimination that can be meted out against her. No woman should be given a choice to choose between her motherhood and her career at Bar, yet that is the most detrimental discrimination that has been happening in Indian Bar, which no one has questioned so far. The falling number of women in practice is a reality that isn’t garnering much attention given the sharp rise in women studying law but is not being able to continue in the profession. Moving from a colonial misogynist whim to a post-colonial “new-age construct of Indian woman” façade, the policymakers of the Indian Judiciary have done nothing so far to decolonize itself from its rudimentary understanding of ‘equality of gender’ when it comes to the legal profession. Therefore, when Indian jurisprudence was (and is) swooning to the sweeping effect of transformative constitutionalism in the understanding of equality as enshrined under the Indian Constitution, one cannot help but question why the legal profession remained out of brushing effect of achieving substantive equality. The Airline industry’s discriminatory policies were not spared from criticism, nor were the policies where women’s involvement in any establishment serving liquor (Anuj Garg case), but the judicial practice did not question the stereotypical bias of gender and unequal structural practices until recently. That necessitates the need to examine the existing Bar policies and the steps taken by the regulatory bodies in assessing the situations that are in favor or against the purpose of furthering women’s issues in present-day India. From a comparative feminist point of concern, South Africa’s pro-women Bar policies are attractive to assess their applicability and extent in terms of promoting inclusivity at the Bar. This article intends to tap on these two countries’ potential in carving a niche in giving women an equal platform to play a substantive role in designing governance policies through the Judiciary. The article analyses the current gender composition of the legal profession while endorsing the concept of substantive equality as a requisite in designing an appropriate appointment process of the judges. It studies the theoretical framework on gender equality, examines the international and regional instruments and analyses the scope of welfare policies that Indian legal and regulatory bodies can undertake towards a transformative initiative in re-modeling the Judiciary to a more diverse and inclusive institution. The methodology employs a comparative and analytical understanding of doctrinal resources. It makes quantitative use of secondary data and qualitative use of primary data collected for determining the present status of Indian women legal practitioners and judges. With respect to quantitative data, statistics on the representation of women as judges and chief justices and senior advocates from their official websites from 2018 till present have been utilized. In respect of qualitative data, results of the structured interviews conducted through open and close-ended questions with retired lady judges of the higher judiciary and senior advocates of the Supreme Court of India, contacted through snowball sampling, are utilized.

Keywords: gender, higher judiciary, legal profession, representation, substantive equality

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Authors: Yanyan Wang

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This paper on second language teaching and learning uses conversation analysis (CA) approach and focuses on how second language learners of Chinese do repair when making clarification requests. In order to demonstrate their behavior in interaction, a comparison was made to study the differences between native speakers of Chinese with non-native speakers of Chinese. The significance of the research is to make second language teachers and learners aware of repair and how to seek clarification. Utilizing the methodology of CA, the research involved two sets of naturally occurring recordings, one of native speaker students and the other of non-native speaker students. Both sets of recording were telephone talks between students and teachers. There were 50 native speaker students and 50 non-native speaker students. From multiple listening to the recordings, the parts with repairs for clarification were selected for analysis which included the moments in the talk when students had problems in understanding or hearing the speaker and had to seek clarification. For example, ‘Sorry, I do not understand ‘and ‘Can you repeat the question? ‘were the parts as repair to make clarification requests. In the data, there were 43 such cases from native speaker students and 88 cases from non-native speaker students. The non-native speaker students were more likely to use repair to seek clarification. Analysis on how the students make clarification requests during their conversation was carried out by investigating how the students initiated problems and how the teachers repaired the problems. In CA term, it is called other-initiated self-repair (OISR), which refers to student-initiated teacher-repair in this research. The findings show that, in initiating repair, native speaker students pay more attention to mutual understanding (inter-subjectivity) while non-native speaker students, due to their lack of language proficiency, pay more attention to their status of knowledge (epistemic) switch. There are three major differences: 1, native Chinese students more often initiate closed-class OISR (seeking specific information in the request) such as repeating a word or phrases from the previous turn while non-native students more frequently initiate open-class OISR (not specifying clarification) such as ‘sorry, I don’t understand ‘. 2, native speakers’ clarification requests are treated by the teacher as understanding of the content while non-native learners’ clarification requests are treated by teacher as language proficiency problem. 3, native speakers don’t see repair as knowledge issue and there is no third position in the repair sequences to close repair while non-native learners take repair sequence as a time to adjust their knowledge. There is clear closing third position token such as ‘oh ‘ to close repair sequence so that the topic can go back. In conclusion, this paper uses conversation analysis approach to compare differences between native Chinese speakers and non-native Chinese learners in their ways of conducting repair when making clarification requests. The findings are useful in future Chinese language teaching and learning, especially in teaching pragmatics such as requests.

Keywords: conversation analysis (CA), clarification request, second language (L2), teaching implication

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Authors: Surekha Barkur, Aseefhali Bankapur, Santhosh Chidangil

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Raman Tweezers technique has become prevalent in single cell studies. This technique combines Raman spectroscopy which gives information about molecular vibrations, with optical tweezers which use a tightly focused laser beam for trapping the single cells. Thus Raman Tweezers enabled researchers analyze single cells and explore different applications. The applications of Raman Tweezers include studying blood cells, monitoring blood-related disorders, silver nanoparticle-induced stress, etc. There is increased interest in the toxic effect of nanoparticles with an increase in the various applications of nanoparticles. The interaction of these nanoparticles with the cells may vary with their size. We have studied the effect of silver nanoparticles of sizes 10nm, 40nm, and 100nm on erythrocytes using Raman Tweezers technique. Our aim was to investigate the size dependence of the nanoparticle effect on RBCs. We used 785nm laser (Starbright Diode Laser, Torsana Laser Tech, Denmark) for both trapping and Raman spectroscopic studies. 100 x oil immersion objectives with high numerical aperture (NA 1.3) is used to focus the laser beam into a sample cell. The back-scattered light is collected using the same microscope objective and focused into the spectrometer (Horiba Jobin Vyon iHR320 with 1200grooves/mm grating blazed at 750nm). Liquid nitrogen cooled CCD (Symphony CCD-1024x256-OPEN-1LS) was used for signal detection. Blood was drawn from healthy volunteers in vacutainer tubes and centrifuged to separate the blood components. 1.5 ml of silver nanoparticles was washed twice with distilled water leaving 0.1 ml silver nanoparticles in the bottom of the vial. The concentration of silver nanoparticles is 0.02mg/ml so the 0.03mg of nanoparticles will be present in the 0.1 ml nanoparticles obtained. The 25 ul of RBCs were diluted in 2 ml of PBS solution and then treated with 50 ul (0.015mg) of nanoparticles and incubated in CO2 incubator. Raman spectroscopic measurements were done after 24 hours and 48 hours of incubation. All the spectra were recorded with 10mW laser power (785nm diode laser), 60s of accumulation time and 2 accumulations. Major changes were observed in the peaks 565 cm-1, 1211 cm-1, 1224 cm-1, 1371 cm-1, 1638 cm-1. A decrease in intensity of 565 cm-1, increase in 1211 cm-1 with a reduction in 1224 cm-1, increase in intensity of 1371 cm-1 also peak disappearing at 1635 cm-1 indicates deoxygenation of hemoglobin. Nanoparticles with higher size were showing maximum spectral changes. Lesser changes observed in case of 10nm nanoparticle-treated erythrocyte spectra.

Keywords: erythrocytes, nanoparticle-induced toxicity, Raman tweezers, silver nanoparticles

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Authors: Chiahsu Yang, Peiling Wu, Ted Ho

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From emphasizing economic development to stressing public happiness, the international community mainly hopes to be able to understand whether the quality of life for the public is becoming better. The Better Life Index (BLI) constructed by OECD uses living conditions and quality of life as starting points to cover 11 areas of life and to convey the state of the general public’s well-being. In light of the BLI framework, the Directorate General of Budget, Accounting and Statistics (DGBAS) of the Executive Yuan instituted the Gross National Happiness Index to understand the needs of the general public and to measure the progress of the aforementioned conditions in residents across the island. Whereas living conditions consist of income and wealth, jobs and earnings, and housing conditions, health status, work and life balance, education and skills, social connections, civic engagement and governance, environmental quality, personal security. The ICT area consists of health care, living environment, ICT-enabled communication, transportation, government, education, pleasure, purchasing, job & employment. In the wake of further science and technology development, rapid formation of information societies, and closer integration between lifestyles and information societies, the public’s well-being within information societies has indeed become a noteworthy topic. the Board of Science and Technology of the Executive Yuan use the OECD’s BLI as a reference in the establishment of the Taiwan-specific ICT-Enabled Better Life Index. Using this index, the government plans to examine whether the public’s quality of life is improving as well as measure the public’s satisfaction with current digital quality of life. This understanding will enable the government to gauge the degree of influence and impact that each dimension of digital services has on digital life happiness while also serving as an important reference for promoting digital service development. The content of the ICT Enabled Better Life Index. Information and communications technology (ICT) has been affecting people’s living styles, and further impact people’s quality of life (QoL). Even studies have shown that ICT access and usage have both positive and negative impact on life satisfaction and well-beings, many governments continue to invest in e-government programs to initiate their path to information society. This research is the few attempts to link the e-government benchmark to the subjective well-being perception, and further address the gap between user’s perception and existing hard data assessment, then propose a model to trace measurement results back to the original public policy in order for policy makers to justify their future proposals.

Keywords: information and communications technology, quality of life, satisfaction, well-being

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Authors: Majid Manawer Alenezi, Gavin Lawrence, Hans-Peter Kubis

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Imagery training could be an important treatment for muscle function improvements in patients who are facing limitations in exercise training by pain or other adverse symptoms. However, recent studies are mostly limited to small muscle groups and are often contradictory. Moreover, a possible bilateral transfer effect of imagery training has not been examined. We, therefore, investigated the effectiveness of unilateral imagery training in comparison with exercise training on hip abductor muscle strength and EMG. Additionally, both limbs were assessed to investigate bilateral transfer effects. Healthy individuals took part in an imagery or exercise training intervention for two weeks and were assesses pre and post training. Participants (n=30), after randomization into an imagery and an exercise group, trained 5 times a week under supervision with additional self-performed training on the weekends. The training consisted of performing, or to imagine, 5 maximal isometric hip abductor contractions (= one set), repeating the set 7 times. All measurements and trainings were performed laying on the side on a dynamometer table. The imagery script combined kinesthetic and visual imagery with internal perspective for producing imagined maximal hip abduction contractions. The exercise group performed the same number of tasks but performing the maximal hip abductor contractions. Maximal hip abduction strength and EMG amplitudes were measured of right and left limbs pre- and post-training period. Additionally, handgrip strength and right shoulder abduction (Strength and EMG) were measured. Using mixed model ANOVA (strength measures) and Wilcoxen-tests (EMGs), data revealed a significant increase in hip abductor strength production in the imagery group on the trained right limb (~6%). However, this was not reported for the exercise group. Additionally, the left hip abduction strength (not used for training) did not show a main effect in strength, however, there was a significant interaction of group and time revealing that the strength increased in the imagery group while it remained constant in the exercise group. EMG recordings supported the strength findings showing significant elevation of EMG amplitudes after imagery training on right and left side, while the exercise training group did not show any changes. Moreover, measures of handgrip strength and shoulder abduction showed no effects over time and no interactions in both groups. Experiments showed that imagery training is a suitable method for effectively increasing functional parameters of larger limb muscles (strength and EMG) which were enhanced on both sides (trained and untrained) confirming a bilateral transfer effect. Indeed, exercise training did not reveal any increases in the parameters above omitting functional improvements. The healthy individuals tested might not easily achieve benefits from exercise training within the time tested. However, it is evident that imagery training is effective in increasing the central motor command towards the muscles and that the effect seems to be segmental (no increase in handgrip strength and shoulder abduction parameters) and affects both sides (trained and untrained). In conclusion, imagery training was effective in functional improvements in limb muscles and produced a bilateral transfer on strength and EMG measures.

Keywords: imagery, exercise, physiotherapy, motor imagery

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Authors: Niina Meriläinen

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Digital platforms are arenas for dialogue, various kinds of political debates, information and news gathering, policymaking, and social change processes. Human rights serve as examples of social and political issues that are universally noted as principles and yet often violated on digital platforms as well as in the analog world. Digital platforms in this study are different Internet sites, blogs, discussion platforms, social media apps, and gaming. Various actors, from human rights activists and non-governmental organizations to individual people, governments, and corporations, use digital platforms along with analog arenas to discuss and defend human rights, while violators can find new victims and continue violating rights on the same platforms. Digital platforms create opportunities for various women and minorities to empower themselves and others and to be active in various arenas of society and policymaking. At the same time, digital platforms pose threats to human rights globally, especially to women, girls, and minorities. The results of this meta-study of n=120 academic case studies indicate that more research is needed to determine the framework of human rights and human rights on digital platforms. A broad discussion must be had on what human rights require in the digital realm and how ICTs may enhance or threaten our ability to respect, protect, and fulfill a wide variety of human rights while various digital platforms pose multiple threats to human rights. This relates to the willingness of political decision-makers to act upon various crimes committed on and with online platforms. More research is needed to determine the framework of digital human rights and human rights on digital platforms in relation to political communication and decision-making. It is important to develop a framework in which these are defined. It must be discussed who participates in this process: those whose rights are violated, companies that profit by selling our personal data, activists, governments, and some unknown actors. In the end, the question comes back to who has the power to define what we talk about, when, and where. This use of power plays a big role. Digital platforms illustrate the darker side of technological progress, which, on the one hand, has given various people the possibility to engage in society, empower themselves, and take ownership of their rights globally. At the same time, the platforms enable others to use the same platforms to find victims, abuse them, and exploit them. Bullying, harassment, and violence are rampant on various digital platforms, where minorities and people with limited support are victims. There is indeed a need for a discussion of normative values in the era of fake news, the power of influencers, Trumpism, and institutionalized disregard for human rights, gender equality, and the elimination of gender-based violence online. Attention and obligations must be placed on politicians and internet architecture, such as corporations, and their roles in human rights and their violations online.

Keywords: human rights, digital platforms, violations, internet, social media

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Authors: David Dolbow, Daniel Credeur, Mujtaba Rahimi, Dobrivoje Stokic, Jennifer Lemacks, Andrew Courtner

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Introduction: Obesity is at epidemic proportions in the spinal cord injury (SCI) population (66-75%), as individuals who suffer from paralysis undergo a dramatic decrease in muscle mass and a dramatic increase in adipose deposition. Obesity is a major public health concern which includes a doubling of the risk of heart disease, stroke and type II diabetes mellitus. It has been demonstrated that physical activity, and especially HIIT, can promote a healthy body composition and decrease the risk cardiometabolic disease in the able-bodied population. However, SCI typically limits voluntary exercise to the arms, but a high prevalence of shoulder pain in persons with chronic SCI (60-90%) can cause increased arm exercise to be problematic. Functional electrical stimulation (FES) cycling has proven to be a safe and effective way to exercise paralyzed leg muscles in clinical and home settings, saving the often overworked arms. Yet, HIIT-FES cycling had not been investigated prior to the current study. The purpose of this study was to investigate the body composition changes with combined HIIT-FES cycling and nutritional counseling on individuals with SCI. Design: A matched (level of injury, time since injury, body mass index) and controlled trail. Setting: University exercise performance laboratory. Subjects: Ten individuals with chronic SCI (C5-T9) ASIA impairment classification (A & B) were divided into the treatment group (n=5) for 30 minutes of HIIT-FES cycling 3 times per week for 8 weeks and nutritional counseling over the phone for 30 minutes once per week for 8 weeks and the control group (n=5) who received nutritional counseling only. Results: There was a statistically significant difference between the HIIT-FES group and the control group in mean body fat percentage change (-1.14 to +0.24) respectively, p = .030). There was also a statistically significant difference between the HIIT-FES and control groups in mean change in legs lean mass (+0.78 kg to -1.5 kg) respectively, p = 0.004. There was a nominal decrease in weight, BMI, total fat mass and a nominal increase in total lean mass for the HIIT-FES group over the control group. However, these changes were not found to be statistically significant. Additionally, there was a nominal decrease in the mean blood glucose levels for both groups 101.8 to 97.8 mg/dl for the HIIT-FES group and 94.6 to 93 mg/dl for the Nutrition only group, however, neither were found to be statistically significant. Conclusion: HIIT-FES cycling combined with nutritional counseling can provide healthful body composition changes including decreased body fat percentage in just 8 weeks. Future study recommendations include a greater number of participants, a primer electrical stimulation exercise program to better ready participants for HIIT-FES cycling and a greater volume of training above 30 minutes, 3 times per week for 8 weeks.

Keywords: body composition, functional electrical stimulation cycling, high-intensity interval training, spinal cord injury

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Authors: Shawndra Bowers, Allie Brandriet, Betsy Gilbertson

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This paper will highlight how Auburn Online’s instructional designers leveraged student and faculty data to update and improve online course design and instructional materials. When designing and revising online courses, it can be difficult for faculty to know what strategies are most likely to engage learners and improve educational outcomes in a specific discipline. It can also be difficult to identify which metrics are most useful for understanding and improving teaching, learning, and course design. At Auburn Online, the instructional designers use a suite of data based student’s performance, participation, satisfaction, and engagement, as well as faculty perceptions, to inform sound learning and design principles that guide growth-mindset consultations with faculty. The consultations allow the instructional designer, along with the faculty member, to co-create an actionable course improvement plan. Auburn Online gathers learning analytics from a variety of sources that any instructor or instructional design team may have access to at their own institutions. Participation and performance data, such as page: views, assignment submissions, and aggregate grade distributions, are collected from the learning management system. Engagement data is pulled from the video hosting platform, which includes unique viewers, views and downloads, the minutes delivered, and the average duration each video is viewed. Student satisfaction is also obtained through a short survey that is embedded at the end of each instructional module. This survey is included in each course every time it is taught. The survey data is then analyzed by an instructional designer for trends and pain points in order to identify areas that can be modified, such as course content and instructional strategies, to better support student learning. This analysis, along with the instructional designer’s recommendations, is presented in a comprehensive report to instructors in an hour-long consultation where instructional designers collaborate with the faculty member on how and when to implement improvements. Auburn Online has developed a triage strategy of priority 1 or 2 level changes that will be implemented in future course iterations. This data-informed decision-making process helps instructors focus on what will best work in their teaching environment while addressing which areas need additional attention. As a student-centered process, it has created improved learning environments for students and has been well received by faculty. It has also shown to be effective in addressing the need for improvement while removing the feeling the faculty’s teaching is being personally attacked. The process that Auburn Online uses is laid out, along with the three-tier maintenance and revision guide that will be used over a three-year implementation plan. This information can help others determine what components of the maintenance and revision plan they want to utilize, as well as guide them on how to create a similar approach. The data will be used to analyze, revise, and improve courses by providing recommendations and models of good practices through determining and disseminating best practices that demonstrate an impact on student success.

Keywords: data-driven, improvement, online courses, faculty development, analytics, course design

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Authors: Nicolas Peyret, Sylvain Courtois, Gaël Chevallier

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This article outlines the development of the Project Based Learning (PBL) at the level of a last year’s Bachelor’s Degree. This form of pedagogy has for objective to allow a better involving of the students from the beginning of the module. The theoretical contributions are introduced during the project to solving a technological problem. The module in question is the module of mechanical dimensioning method of Supméca a French engineering school. This school issues a Master’s Degree. While the teaching methods used in primary and secondary education are frequently renewed in France at the instigation of teachers and inspectors, higher education remains relatively traditional in its practices. Recently, some colleagues have felt the need to put the application back at the heart of their theoretical teaching. This need is induced by the difficulty of covering all the knowledge deductively before its application. It is therefore tempting to make the students 'learn by doing', even if it doesn’t cover some parts of the theoretical knowledge. The other argument that supports this type of learning is the lack of motivation the students have for the magisterial courses. The role-play allowed scenarios favoring interaction between students and teachers… However, this pedagogical form known as 'pedagogy by project' is difficult to apply in the first years of university studies because of the low level of autonomy and individual responsibility that the students have. The question of what the student actually learns from the initial program as well as the evaluation of the competences acquired by the students in this type of pedagogy also remains an open problem. Thus we propose to add to the pedagogy by project format a regressive part of interventionism by the teacher based on pedagogy by example. This pedagogical scenario is based on the cognitive load theory and Bruner's constructivist theory. It has been built by relying on the six points of the encouragement process defined by Bruner, with a concrete objective, to allow the students to go beyond the basic skills of dimensioning and allow them to acquire the more global skills of engineering. The implementation of project-based teaching coupled with pedagogy by example makes it possible to compensate for the lack of experience and autonomy of first-year students, while at the same time involving them strongly in the first few minutes of the module. In this project, students have been confronted with the real dimensioning problems and are able to understand the links and influences between parameter variations and dimensioning, an objective that we did not reach in classical teaching. It is this form of pedagogy which allows to accelerate the mastery of basic skills and so spend more time on the engineer skills namely the convergence of each dimensioning in order to obtain a validated mechanism. A self-evaluation of the project skills acquired by the students will also be presented.

Keywords: Bruner's constructivist theory, mechanisms dimensioning, pedagogy by example, problem based learning

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Authors: Christofas Stergianos, Jason Atkin, Herve Morvan

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As air traffic increases, more airports are interested in utilizing optimization methods. Many processes happen in parallel at an airport, and complex models are needed in order to have a reliable solution that can be implemented for ground movement operations. The ground movement for aircraft in an airport, allocating a path to each aircraft to follow in order to reach their destination (e.g. runway or gate), is one process that could be optimized. The Quickest Path Problem with Time Windows (QPPTW) algorithm has been developed to provide a conflict-free routing of vehicles and has been applied to routing aircraft around an airport. It was subsequently modified to increase the accuracy for airport applications. These modifications take into consideration specific characteristics of the problem, such as: the pushback process, which considers the extra time that is needed for pushing back an aircraft and turning its engines on; stand holding where any waiting should be allocated to the stand; and runway sequencing, where the sequence of the aircraft that take off is optimized and has to be respected. QPPTW involves searching for the quickest path by expanding the search in all directions, similarly to Dijkstra’s algorithm. Finding a way to direct the expansion can potentially assist the search and achieve a better performance. We have further modified the QPPTW algorithm to use a heuristic approach in order to guide the search. This new algorithm is based on the A-star search method but estimates the remaining time (instead of distance) in order to assess how far the target is. It is important to consider the remaining time that it is needed to reach the target, so that delays that are caused by other aircraft can be part of the optimization method. All of the other characteristics are still considered and time windows are still used in order to route multiple aircraft rather than a single aircraft. In this way the quickest path is found for each aircraft while taking into account the movements of the previously routed aircraft. After running experiments using a week of real aircraft data from Zurich Airport, the new algorithm (A-star QPPTW) was found to route aircraft much more quickly, being especially fast in routing the departing aircraft where pushback delays are significant. On average A-star QPPTW could route a full day (755 to 837 aircraft movements) 56% faster than the original algorithm. In total the routing of a full week of aircraft took only 12 seconds with the new algorithm, 15 seconds faster than the original algorithm. For real time application, the algorithm needs to be very fast, and this speed increase will allow us to add additional features and complexity, allowing further integration with other processes in airports and leading to more optimized and environmentally friendly airports.

Keywords: a-star search, airport operations, ground movement optimization, routing and scheduling

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Authors: Xavier Louis, Madhava Soma Sundaram

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The Palk Bay, a narrow strip of water, separates the state of Tamil Nadu in India from north Sri Lanka. The bay, which is 137 km in length and varies from 64 to 137 kilometers in width and is home to more than 580 fish species and chunks of shrimp’s resources, is divided by the International Maritime Boundary Line (IMBL). The bay, bordering it are five Tamil Nadu districts of India and three Sri Lankan districts and assumes importance as it is one of the areas presenting permanent and serious challenges to both India and Sri Lanka with respect to the fishing rights in the Bay. Fishermen from both sides were enjoying fishing with hormones for centuries. Katchchadeevu is a tiny Island located in the Bay, which was a part of India. After the Katchchadeevu agreement 1974 it became a part of Sri Lanka and a fishing conflict arose between the two countries' fishermen. Fuelling the dispute over Katchatheevu is the overfishing of Indian mechanized trawlers in Palk Bay and the damaging environmental and economic effects of trawling. Since 2008, more than 300 Indian fishermen have been killed by firing by Sri Lankan Navy, nearly 100 fishermen have gone missing and more than 3000 fishermen were arrested and later released after the trials for trespassing into Sri Lankan waters. Currently, more than 120 fishing boats and 29 fishermen are in Sri Lankan custody. This paper attempts to find out the causes of fishing conflict and who has the fishing rights in the mentioned waters, how the international treaties are complied with at the time of arrest and trials, how the arrested fishermen are treated by them and how they suffer from fishermen families without a breadwinner. A Semi-structured interview schedule tool was prepared by the researcher, which is suitable for measuring quantitative and qualitative aspects of the above-mentioned theme. One hundred arrested fishermen were interviewed and recorded their prison experiences in Sri Lanka. The research found that the majority of the fishermen believe that they have the right to fish in the historical water and that the Sri Lankan Naval personnel have brutally attacked the Indian fishermen at the time of the arrest. The majority of the fishermen accepted that they had limited fishing grounds. As a result, they entered Sri Lankan waters for their livelihood. The majority of the fishermen expected that they would also get their belongings back at the time of release, primarily the boats. Most of the arrested fishermen's families face financial crises in the absence of their breadwinners and this situation has created conditions for child labor among the affected families and some fishers migrate to different places for different occupations. The majority of the fishers have trauma about their victimization and face uncertainty in the future of their occupation. We can discuss more the causes and nature of the fishing conflict and the financial and psychological victimization of Indian fishermen in relation to the conflict.

Keywords: palk bay, historical water, fishing conflict, arrested fishermen, victimization

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Authors: Aline Woine, Moïra Mikolajczak, Virginie Dardier, Isabelle Roskam

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Background information: Becoming a parent is said to be the happiest event one can ever experience in one’s life. This popular (and almost absolute) truth–which no reasonable and decent human being would ever dare question on pain of being singled out as a bad parent–contrasts with the nuances that reality offers. Indeed, while many parents do thrive in their parenting role, some others falter and become progressively overwhelmed by their parenting role, ineluctably caught in a spiral of exhaustion. Parental burnout (henceforth PB) sets in when parental demands (stressors) exceed parental resources. While it is now generally acknowledged that PB affects the parent’s behavior in terms of neglect and violence toward their offspring, little is known about the impact that the syndrome might have on the children’s internalized (anxious and depressive symptoms, somatic complaints, etc.) and/or externalized (irritability, violence, aggressiveness, conduct disorder, oppositional disorder, etc.) behaviors. Furthermore, at the time of writing, to our best knowledge, no research has yet tested the reverse effect, namely, that of the child's internalized and/or externalized behaviors on the onset and/or maintenance of parental burnout symptoms. Goals and hypotheses: The present pioneering research proposes to fill an important gap in the existing literature related to PB by investigating the bidirectional effect between PB and the child’s internalized and/or externalized behaviors. Relying on a cross-lagged longitudinal study with three waves of data collection (4 months apart), our study tests a transactional model with bidirectional and recursive relations between observed variables and at the three waves, as well as autoregressive paths and cross-sectional correlations. Methods: As we write this, wave-two data are being collected via Qualtrics, and we expect a final sample of about 600 participants composed of French-speaking (snowball sample) and English-speaking (Prolific sample) parents. Structural equation modeling is employed using Stata version 17. In order to retain as much statistical power as possible, we use all available data and therefore apply the maximum likelihood with a missing value (mlmv) as the method of estimation to compute the parameter estimates. To limit (in so far is possible) the shared method variance bias in the evaluation of the child’s behavior, the study relies on a multi-informant evaluation approach. Expected results: We expect our three-wave longitudinal study to show that PB symptoms (measured at T1) raise the occurrence/intensity of the child’s externalized and/or internalized behaviors (measured at T2 and T3). We further expect the child’s occurrence/intensity of externalized and/or internalized behaviors (measured at T1) to augment the risk for PB (measured at T2 and T3). Conclusion: Should our hypotheses be confirmed, our results will make an important contribution to the understanding of both PB and children’s behavioral issues, thereby opening interesting theoretical and clinical avenues.

Keywords: exhaustion, structural equation modeling, cross-lagged longitudinal study, violence and neglect, child-parent relationship

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Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

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Authors: Ruchirek Ratchaburi, W. Kevin. Hicks, Christopher S. Malley, Lisa D. Emberson

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Air pollution problems in Thailand have improved over the last few decades, but in some areas, concentrations of coarse particulate matter (PM₁₀) are above health and regulatory guidelines. It is, therefore, useful to investigate how PM₁₀ varies across Thailand, what conditions cause this variation, and how could PM₁₀ concentrations be reduced. This research uses data collected by the Thailand Pollution Control Department (PCD) from 17 monitoring sites, located across 12 provinces, and obtained between 2011 and 2015 to assess PM₁₀ concentrations and the conditions that lead to different levels of pollution. This is achieved through exploration of air mass pathways using trajectory analysis, used in conjunction with the monitoring data, to understand the contribution of different months, an hour of the day and source regions to annual PM₁₀ concentrations in Thailand. A focus is placed on locations that exceed the national standard for the protection of human health. The analysis shows how this approach can be used to explore the influence of biomass burning on annual average PM₁₀ concentration and the difference in air pollution conditions between Northern and Southern Thailand. The results demonstrate the substantial contribution that open biomass burning from agriculture and forest fires in Thailand and neighboring countries make annual average PM₁₀ concentrations. The analysis of PM₁₀ measurements at monitoring sites in Northern Thailand show that in general, high concentrations tend to occur in March and that these particularly high monthly concentrations make a substantial contribution to the overall annual average concentration. In 2011, a > 75% reduction in the extent of biomass burning in Northern Thailand and in neighboring countries resulted in a substantial reduction not only in the magnitude and frequency of peak PM₁₀ concentrations but also in annual average PM₁₀ concentrations at sites across Northern Thailand. In Southern Thailand, the annual average PM₁₀ concentrations for individual years between 2011 and 2015 did not exceed the human health standard at any site. The highest peak concentrations in Southern Thailand were much lower than for Northern Thailand for all sites. The peak concentrations at sites in Southern Thailand generally occurred between June and October and were associated with air mass back trajectories that spent a substantial proportion of time over the sea, Indonesia, Malaysia, and Thailand prior to arrival at the monitoring sites. The results show that emissions reductions from biomass burning and forest fires require action on national and international scales, in both Thailand and neighboring countries, such action could contribute to ensuring compliance with Thailand air quality standards.

Keywords: annual average concentration, long-range transport, open biomass burning, particulate matter

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Radhika Jain

Abstract:

The nursing community in India face unique challenges ranging from lack of adequate career progression, low social status attached to the profession, poor nurse-to-patient ratio leading to heavy workload resulting in stress and burnout, lack of general recognition and the responsibility of often having to deal with the ire of the patients and their families. This study explores how a combination of Playback Theatre and Expressive Arts could be used as a very powerful tool to understand the concerns, and consequently as a self-care tool to bring about the sense of well-being and emotional awareness for the nurses. For the purpose of this study, Playback Theatre was used as an entry tool to understand the thoughts, feelings and concerns. Playback theatre is a unique improvisational form of theatre developed by Jonathan Fox and Jo Salas in 1975, in which audience share their own stories from their lives and the performers play them back through a range of improv techniques such as metaphor, poetry, music and movement. Playback Theatre helped in first warming them up to the idea of sharing and then gave them the confidence of a safe space to collectively go deeper into their emotional experiences. As the next step, structured sessions of Expressive Arts were conducted with the same set of nurses, for them to work on the issues and concerns they have (and which they shared during the Playback performance). These sessions were to enable longer engagements as many of the concerns expressed were related to perceptions and beliefs that have been ingrained over a period of time and hence it needs a longer engagement to be worked on in detail. The Expressive Art sessions helped in this regard. Expressive arts therapy combines psychology and the creative process to promote emotional growth and healing. The study was conducted at two places: one a geriatric centre and the other, a palliative care centre. The study revealed that concerns and challenges would not be identical across the nursing community or across similar types of health care organizations but would be specific to each organization or centre as the circumstances and set-up at each place would be different. At the geriatric centre, stress and burnout emerged as the main concerns while at the palliative care centre, the main concern that came up was around the difficulty the nurses faced in expressing emotions and in communicating their feelings. The objective analysis of the results of the study indicated how longer-term engagements using Expressive Arts as the modality helped the nurses have better awareness of their emotions and helped them develop tools of self-care tools while also tapping into their emotions to express and experience. The process of eliciting the main concerns from the nurses using a Playback Theatre performance and then following that with subsequent sessions of expressive arts helped the nurses in the way nurses approached their job and the reduced level of overwhelm that they felt.

Keywords: palliative care, nurses, self-care, expressive arts, playback theatre

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Authors: Balarabe Z. Ahmad, Anne-Lorène Vernay

Abstract:

The emergence of electricity in Nigeria was dated back to 1896. The power plants have the potential to generate 12,522 MW of electric power. Whereas current dispatch is about 4,000 MW, access to electrification is about 60%, with consumption at 0.14 MWh/capita. The government embarked on energy reforms to mitigate energy poverty. The reform targeted the provision of electricity access to 75% of the population by 2020 and 90% by 2030. Growth of total electricity demand by a factor of 5 by 2035 had been projected. This means that Nigeria will require almost 530 TWh of electricity which can be delivered through generators with a capacity of 65 GW. Analogously, the geographical location of Nigeria has placed it in an advantageous position as the source of solar energy; the availability of a high sunshine belt is obvious in the country. The implication is that the far North, where energy poverty is high, equally has about twice the solar radiation as against southern Nigeria. Hence, the chance of generating solar electricity is 66% possible at 11850 x 103 GWh per year, which is one hundred times the current electricity consumption rate in the country. Harvesting these huge potentials may be a mirage if the entrepreneurs in the solar panel business are left with the conventional business models that are not uncertainty resilient. Currently, business entities in RE in Nigeria are uncertain of; accessing the national grid, purchasing potentials of cooperating organizations, currency fluctuation and interest rate increases. Uncertainties such as the security of projects and government policy are issues entrepreneurs must navigate to remain sustainable in the solar panel industry in Nigeria. The aim of this paper is to identify how entrepreneurial firms consider uncertainties in developing workable business models for commercializing solar energy projects in Nigeria. In an attempt to develop a novel business model, the paper investigated how entrepreneurial firms assess and navigate uncertainties. The roles of key stakeholders in helping entrepreneurs to manage uncertainties in the Nigeria RE sector were probed in the ongoing study. The study explored empirical uncertainties that are peculiar to RE entrepreneurs in Nigeria. A mixed-mode of research was embraced using qualitative data from face-to-face interviews conducted on the Solar Energy Entrepreneurs and the experts drawn from key stakeholders. Content analysis of the interview was done using Atlas. It is a nine qualitative tool. The result suggested that all stakeholders are required to synergize in developing an uncertainty resilient business model. It was opined that the RE entrepreneurs need modifications in the business recommendations encapsulated in the energy policy in Nigeria to strengthen their capability in delivering solar energy solutions to the yawning Nigerians.

Keywords: uncertainties, entrepreneurial, business model, solar-panel

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Authors: Anush Patric, M. Jadeyegowda, M. N. Ramesh, M. Ravikumar, C. R. Ajay

Abstract:

Kodagu district which is situated in Central Western Ghats regions falls in one of the hottest of hot spots of biodiversity which is recognised by UNESCO. The district has one of the highest densities of community managed sacred forests in the world with rich floral and faunal diversity. It is a habitat for more than ten different types of Ethnic Indigenous tribal groups commonly called ‘Girijanas’ (Soligas, Yarvas, Jenukuruba, Bettakuruba etc.), who are having the rich knowledge of medicinal value of the plants that are commonly available in the forest. The tribal men of this region are the treasure house of the traditional plant knowledge and health care practices. An ethnobotanical survey was undertaken in tribal areas of the district to collect information about some of the indigenous medicinal plant knowledge of tribal people by semi-structured interviews, ranking exercises and field observations on their native habitat in order to evaluate the potential medicinal uses of local plants. The study revealed that, the ethnobotanical information of 83 plant species belonging to 45 families, of the total 83 species documented, most plants used in the treatment were trees (11 species), shrubs (41 species), herbs (22 species) and rarely climbers (9 species) which are used in the treatment of Hyperacidity, Respiratory disorders, Snake bite Abortifacient, Anthelmintic, Paralysis, Antiseptic, Fever, Chest pain, Stomachic, Jaundice, Piles, Asthma, Malaria, Renal disorders, Malaria and many other diseases. Maximum of 6 plant species each of Acanthaceae, Apiaceae and were used for drug preparation, followed by Asclepiadaceae, Liliaceae, Fabaceae, Verbenaceae, Caesalpinaceae, Bombaceae, Papilonaceae, Solanaceae, Rubiaceae, Myrtaceae, Amaranthaceae, Asteraceae, Ascelepidaceae, Cucurbitaceae, Apocyanaceae, and Solanaceae etc. In our present study, only medicinal plants and their local medicinal uses are recorded and presented. Information was obtained by local informants having the knowledge about medicinal plants. About 23 local tribes were interviewed. For each plant, necessary information like botanical name, family of plant species, local name and uses are given. Recent trend shows a decline in the number of traditional herbal healers in the tribal areas since the younger generation is not interested to continue this tradition. Hence, there is an urgent need to record and preserve all information on plants used by different ethnic/tribal communities for various purposes before it reaches to verge of extinction. In addition, several wild medicinal plants are declining in numbers due to deforestation and forest fires. There is need for phytochemical analysis and conservation measures to be taken for conserving medicinal plant species which is far better than allopathic medicines and these do not cause any side effects as they are the natural disease healers. So, conservation strategies have to be practiced in all levels and sectors by creating awareness about the value of such medicinal plants, and it is necessary to save the disappearing plants to strengthen the document and to conserve them for future generation.

Keywords: diseases, ethnic groups, folk medicine, Kodagu, medicinal plants

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Authors: Shahrukh Ahmad, Purnendu Bose

Abstract:

Algal-Bacterial photobioreactors (ABPBRs) have emerged as a promising technology for sustainable biomass production and wastewater treatment. Nutrient removal is seldom done in sewage treatment plants and large volumes of wastewater which still have nutrients are being discharged and that can lead to eutrophication. That is why ABPBR plays a vital role in wastewater treatment. However, improving the efficiency of ABPBR remains a significant challenge. This study aims to enhance ABPBR efficiency by focusing on two key aspects: nutrient removal and cost-effective optimization of the light source. By integrating nutrient removal and cost analysis for light source optimization, this study proposes practical strategies for improving ABPBR efficiency. To reduce organic carbon and convert ammonia to nitrates, domestic wastewater from a 130 MLD sewage treatment plant (STP) was aerated with a hydraulic retention time (HRT) of 2 days. The treated supernatant had an approximate nitrate and phosphate values of 16 ppm as N and 6 ppm as P, respectively. This supernatant was then fed into the ABPBR, and the removal of nutrients (nitrate as N and phosphate as P) was observed using different colored LED bulbs, namely white, blue, red, yellow, and green. The ABPBR operated with a 9-hour light and 3-hour dark cycle, using only one color of bulbs per cycle. The study found that the white LED bulb, with a photosynthetic photon flux density (PPFD) value of 82.61 µmol.m-2 .sec-1 , exhibited the highest removal efficiency. It achieved a removal rate of 91.56% for nitrate and 86.44% for phosphate, surpassing the other colored bulbs. Conversely, the green LED bulbs showed the lowest removal efficiencies, with 58.08% for nitrate and 47.48% for phosphate at an HRT of 5 days. The quantum PAR (Photosynthetic Active Radiation) meter measured the photosynthetic photon flux density for each colored bulb setting inside the photo chamber, confirming that white LED bulbs operated at a wider wavelength band than the others. Furthermore, a cost comparison was conducted for each colored bulb setting. The study revealed that the white LED bulb had the lowest average cost (Indian Rupee)/light intensity (µmol.m-2 .sec-1 ) value at 19.40, while the green LED bulbs had the highest average cost (INR)/light intensity (µmol.m-2 .sec-1 ) value at 115.11. Based on these comparative tests, it was concluded that the white LED bulbs were the most efficient and costeffective light source for an algal photobioreactor. They can be effectively utilized for nutrient removal from secondary treated wastewater which helps in improving the overall wastewater quality before it is discharged back into the environment.

Keywords: algal bacterial photobioreactor, domestic wastewater, nutrient removal, led bulbs

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