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Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur

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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.

Keywords: etomidate, intraocular pressure, thiopentone, traumatic

Procedia PDF Downloads 106

Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

Procedia PDF Downloads 210

Authors: Mylene T. Caytap-Milan

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This study was materialized with the purpose of determining the anxieties of students towards spoken English, sources of the specified anxiety, coping mechanisms to counter the apprehensions, and teacher management to reduce the anxiety within the classroom. Being qualitative in nature, interview as the data gathering tool was utilized with an audio-recorder. Participants of the study included thirteen teachers and students of speech classes in a state university in Region I, Philippines. Data elicited were transcribed in verbatim, confirmed by the participants, coded and categorized, and themed accordingly. A triangulation method was applied to establish the stronger validity of the data. Findings confirmed teachers’ and students’ awareness of the existence of Anxiety in speaking English (ASE). Based on the data gathered from the teachers, the following themes on students’ ASE were identified: (1) No Brain and Mouth Coordination, (2) Center of Attention, and (3) Acting Out Loud. However, the following themes were formulated based on the responses made by the students themselves: (1) The Common Feeling, (2) The Incompetent Me, and (3) The Limelight. With regard the sources of students’ ASE according to teachers are the following: (1) It Began at Home, (2) It Continued in School, (3) It’s not for me at all. On the other hand, the sources of students’ ASE according to students themselves are: (1) It Comes from Within, (2) It wasn’t Nursed Well, and (3) They’re Looking for Errors. In terms of coping with ASE, students identified the following mechanisms, which were themed into: (1) Acceptance, (2) Application, and (3) Apathy. Moreover, to reduce the ASE phenomenon within the classroom, the teachers demonstrate the following roles according to themes: (1) The Compass, (2) The Counselor, (3) The Referee, (4) The Polyglot, and (5) The English Nazi. Based on the findings, the following conclusions were drawn: (1) ASE can both serve positive and negative influences to the English speaking skills of students, (2) ASE can be reduced with teachers’ provision of more English speaking opportunities and with students’ initiative of personal training, (3) ASE can be reduced when English is introduced and practiced by children at an early age, and (4) ASE is inevitable in the affective domain thus teachers are encouraged to apply psychological positivism in the classroom. Studies related to the present undertaking may refer to the succeeding recommendations: (1) experiment on activities that will reduce anxiety ASE, (2) involve a psychologist for more critical but reliable results and recommendations, and (3) conduct the study among high school and primary students.

Keywords: coping mechanisms, sources, speaking anxiety, teacher management

Procedia PDF Downloads 97

Authors: Franco Van De Velde, Debora Esposito, Maria E. Pirovani, Mary A. Lila

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The physiology of various inflammatory diseases is a complex process mediated by inflammatory and immune cells such as macrophages and monocytes. Chronic inflammation, as observed in many cardiovascular and autoimmune disorders, occurs when the low-grade inflammatory response fails to resolve with time. Because of the complexity of the chronic inflammatory disease, major efforts have focused on identifying novel anti-inflammatory agents and dietary regimes that prevent the pro-inflammatory process at the early stage of gene expression of key pro-inflammatory mediators and cytokines. The ability of the extracts of three blackberry cultivars (‘Jumbo’, ‘Black Satin’ and ‘Dirksen’), and one strawberry cultivar (‘Camarosa’) to inhibit four well-known genetic biomarkers of inflammation: inducible nitric oxide synthase (iNOS), cyclooxynase-2 (Cox-2), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in an in vitro lipopolysaccharide-stimulated murine RAW 264.7 macrophage model were investigated. Moreover, the effect of latter extracts on the intracellular reactive oxygen species (ROS) and nitric oxide (NO) production was assessed. Assay was conducted with 50 µg/mL crude extract concentration, an amount that is easily achievable in the gastrointestinal tract after berries consumption. The mRNA expression levels of Cox-2 and IL-6 were reduced consistently (more than 30%) by extracts of ‘Jumbo’ and ‘Black Satin’ blackberries. Strawberry extracts showed high reduction in mRNA expression levels of IL-6 (more than 65%) and exhibited moderate reduction in mRNA expression of Cox-2 (more than 35%). The latter behavior mirrors the intracellular ROS production of the LPS stimulated RAW 264.7 macrophages after the treatment with blackberry ‘Black Satin’ and ‘Jumbo’, and strawberry ‘Camarosa’ extracts, suggesting that phytochemicals from these fruits may play a role in the health maintenance by reducing oxidative stress. On the other hand, effective inhibition in the gene expression of IL-1β and iNOS was not observed by any of blackberry and strawberry extracts. However, suppression in the NO production in the activated macrophages among 5–25% was observed by ‘Jumbo’ and ‘Black Satin’ blackberry extracts and ‘Camarosa’ strawberry extracts, suggesting a higher NO suppression property by phytochemicals of these fruits. All these results suggest the potential beneficial effects of studied berries as functional foods with antioxidant and anti-inflammatory roles. Moreover, the underlying role of phytochemicals from these fruits in the protection of inflammatory process will deserve to be further explored.

Keywords: cyclooxygenase-2, functional foods, interleukin-6, reactive oxygen species

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Authors: Rewati Raman, Uttam K. Roy

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One of the main adversaries of city planning in present times is the ever-expanding problem of urbanization and the antagonistic issues accompanying it. The prevalent challenges in urbanization such as population growth, urban sprawl, poverty, inequality, pollution, congestion, etc. call for reforms in the urban fabric as well as in planning theory and practice. One of the various paradigms of city planning, land use planning, has been the major instruments for spatial planning of cities and regions in India. Zoning regulation based land use planning in the form of land use and development control plans (LUDCP) and development control regulations (DCR) have been considered mainstream guiding principles in land use planning for decades. In spite of many advantages of such zoning based regulations, over a period of time, it has been critiqued by scholars for its own limitations of isolation and lack of vitality, inconvenience in business in terms of proximity to residence and low operating cost, unsuitable environment for small investments, higher travel distance for facilities, amenities and thereby higher expenditure, safety issues etc. Mixed land use has been advocated as a tool to avoid such limitations in city planning by researchers. In addition, mixed land use can offer many advantages like housing variety and density, the creation of an economic blend of compatible land use, compact development, stronger neighborhood character, walkability, and generation of jobs, etc. Alternatively, the mixed land use beyond a suitable balance of use can also bring disadvantages like traffic congestion, encroachments, very high-density housing leading to a slum like condition, parking spill out, non-residential uses operating on residential premises paying less tax, chaos hampering residential privacy, pressure on existing infrastructure facilities, etc. This research aims at studying and outlining the various challenges and potentials of mixed land use zoning, through modeling tools, as a competent instrument for city planning in lieu of the present urban scenario. The methodology of research adopted in this paper involves the study of a mixed land use neighborhood in India, identification of indicators and parameters related to its extent and spatial pattern and the subsequent use of system dynamics as a modeling tool for simulation. The findings from this analysis helped in identifying the various advantages and challenges associated with the dynamic nature of a mixed use urban settlement. The results also confirmed the hypothesis that mixed use neighborhoods are catalysts for employment generation, socioeconomic gains while improving vibrancy, health, safety, and security. It is also seen that certain challenges related to chaos, lack of privacy and pollution prevail in mixed use neighborhoods, which can be mitigated by varying the percentage of mixing as per need, ensuring compatibility of adjoining use, institutional interventions in the form of policies, neighborhood micro-climatic interventions, etc. Therefore this paper gives a consolidated and holistic framework and quantified outcome pertaining to the extent and spatial pattern of mixed land use that should be adopted to ensure sustainable urban planning.

Keywords: mixed land use, sustainable development, system dynamics analysis, urban dynamics modelling

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Authors: Andrea M. Rivas-Castillo, Marlenne Gómez-Ramirez, Isela Rodríguez-Pozos, Norma G. Rojas-Avelizapa

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Spent catalysts are considered as hazardous residues of major concern, mainly due to the simultaneous presence of several metals in elevated concentrations. Although hydrometallurgical, pyrometallurgical and chelating agent methods are available to remove and recover some metals contained in spent catalysts; these procedures generate potentially hazardous wastes and the emission of harmful gases. Thus, biotechnological treatments are currently gaining importance to avoid the negative impacts of chemical technologies. To this end, diverse microorganisms have been used to assess the removal of metals from spent catalysts, comprising bacteria, archaea and fungi, whose resistance and metal uptake capabilities differ depending on the microorganism tested. Acidophilic sulfur oxidizing bacteria have been used to investigate the biotreatment and extraction of valuable metals from spent catalysts, namely Acidithiobacillus thiooxidans and Acidithiobacillus ferroxidans, as they present the ability to produce leaching agents such as sulfuric acid and sulfur oxidation intermediates. In the present work, the ability of A. thiooxidans DSM 26636 for the bioleaching of metals contained in five different spent catalysts was assessed by growing the culture in modified Starkey mineral medium (with elemental sulfur at 1%, w/v), and 1% (w/v) pulp density of each residue for up to 21 days at 30 °C and 150 rpm. Sulfur-oxidizing activity was periodically evaluated by determining sulfate concentration in the supernatants according to the NMX-k-436-1977 method. The production of sulfuric acid was assessed in the supernatants as well, by a titration procedure using NaOH 0.5 M with bromothymol blue as acid-base indicator, and by measuring pH using a digital potentiometer. On the other hand, Inductively Coupled Plasma - Optical Emission Spectrometry was used to analyze metal removal from the five different spent catalysts by A. thiooxidans DSM 26636. Results obtained show that, as could be expected, sulfuric acid production is directly related to the diminish of pH, and also to highest metal removal efficiencies. It was observed that Al and Fe are recurrently removed from refinery spent catalysts regardless of their origin and previous usage, although these removals may vary from 9.5 ± 2.2 to 439 ± 3.9 mg/kg for Al, and from 7.13 ± 0.31 to 368.4 ± 47.8 mg/kg for Fe, depending on the spent catalyst proven. Besides, bioleaching of metals like Mg, Ni, and Si was also obtained from automotive spent catalysts, which removals were of up to 66 ± 2.2, 6.2±0.07, and 100±2.4, respectively. Hence, the data presented here exhibit the potential of A. thiooxidans DSM 26636 for the simultaneous bioleaching of metals contained in spent catalysts from diverse provenance.

Keywords: bioleaching, metal removal, spent catalysts, Acidithiobacillus thiooxidans

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Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

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Authors: S. Sandri, G. M. Contessa, C. Poggi

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An experimental nuclear fusion device could be seen as a step toward the development of the future nuclear fusion power plant. If compared with other possible solutions to the energy problem, nuclear fusion has advantages that ensure sustainability and security. In particular considering the radioactivity and the radioactive waste produced, in a nuclear fusion plant the component materials could be selected in order to limit the decay period, making it possible the recycling in a new reactor after about 100 years from the beginning of the decommissioning. To achieve this and other pertinent goals many experimental machines have been developed and operated worldwide in the last decades, underlining that radiation protection and workers exposure are critical aspects of these facilities due to the high flux, high energy neutrons produced in the fusion reactions. Direct radiation, material activation, tritium diffusion and other related issues pose a real challenge to the demonstration that these devices are safer than the nuclear fission facilities. In Italy, a limited number of fusion facilities have been constructed and operated since 30 years ago, mainly at the ENEA Frascati Center, and the radiation protection approach, addressed by the national licensing requirements, shows that it is not always easy to respect the constraints for the workers' exposure to ionizing radiation. In the current analysis, the main radiation protection issues encountered in the Italian Fusion facilities are considered and discussed, and the technical and legal requirements are described. The licensing process for these kinds of devices is outlined and compared with that of other European countries. The following aspects are considered throughout the current study: i) description of the installation, plant and systems, ii) suitability of the area, buildings, and structures, iii) radioprotection structures and organization, iv) exposure of personnel, v) accident analysis and relevant radiological consequences, vi) radioactive wastes assessment and management. In conclusion, the analysis points out the needing of a special attention to the radiological exposure of the workers in order to demonstrate at least the same level of safety as that reached at the nuclear fission facilities.

Keywords: fusion facilities, high energy neutrons, licensing process, radiation protection

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Authors: Felippe Clemente, Evaldo Henrique da Silva

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The need to adopt some type of industrial policy and innovation in Brazil is a recurring theme in the discussion of public interventions aimed at boosting economic growth. For many years, the country has adopted various policies to change its productive structure in order to increase the participation of sectors that would have the greatest potential to generate innovation and economic growth. Only in the 2000s, tax incentives as a policy to support industrial and technological innovation are being adopted in Brazil as a phenomenon associated with rates of productivity growth and economic development. In this context, in late 2004 and 2005, Brazil reformulated its institutional apparatus for innovation in order to approach the OECD conventions and the Frascati Manual. The Innovation Law (2004) and the 'Lei do Bem' (2005) reduced some institutional barriers to innovation, provided incentives for university-business cooperation, and modified access to tax incentives for innovation. Chapter III of the 'Lei do Bem' (no. 11,196/05) is currently the most comprehensive fiscal incentive to stimulate innovation. It complies with the requirements, which stipulates that the Union should encourage innovation in the company or industry by granting tax incentives. With its introduction, the bureaucratic procedure was simplified by not requiring pre-approval of projects or participation in bidding documents. However, preliminary analysis suggests that this instrument has not yet been able to stimulate the sector diversification of these investments in Brazil, since its benefits are mostly captured by sectors that already developed this activity, thus showing problems with moral hazard. It is necessary, then, to analyze the 'Lei do Bem' to know if there is indeed the need for some change, investigating what changes should be implanted in the Brazilian innovation policy. This work, therefore, shows itself as a first effort to analyze a current national problem, evaluating the effectiveness of the 'Lei do Bem' and suggesting public policies that help and direct the State to the elaboration of legislative laws capable of encouraging agents to follow what they describes. As a preliminary result, it is known that 130 firms used fiscal incentives for innovation in 2006, 320 in 2007 and 552 in 2008. Although this number is on the rise, it is still small, if it is considered that there are around 6 thousand firms that perform Research and Development (R&D) activities in Brazil. Moreover, another obstacle to the 'Lei do Bem' is the percentages of tax incentives provided to companies. These percentages reveal a significant sectoral correlation between R&D expenditures of large companies and R&D expenses of companies that accessed the 'Lei do Bem', reaching a correlation of 95.8% in 2008. With these results, it becomes relevant to investigate the law's ability to stimulate private investments in R&D.

Keywords: brazilian innovation system, moral hazard, R&D, Lei do Bem

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Authors: Pratima Poudel, Austin Himes, Heidi Renninger, Eric McConnel

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Populus spp. (poplar) are the fastest-growing trees in North America, making them ideal for a range of applications as they can achieve high yields on short rotations and regenerate by coppice. Furthermore, poplar undergoes biochemical conversion to fuels without complexity, making it one of the most promising, purpose-grown, woody perennial energy sources. Employing wood-based biomass for bioenergy offers numerous benefits, including reducing greenhouse gas (GHG) emissions compared to non-renewable traditional fuels, the preservation of robust forest ecosystems, and creating economic prospects for rural communities.In order to gain a better understanding of the potential use of poplar as a biomass feedstock for biofuel in the southeastern US, the conducted a techno-economic assessment (TEA). This assessment is an analytical approach that integrates technical and economic factors of a production system to evaluate its economic viability. the TEA specifically focused on a short rotation coppice system employing a single-pass cut-and-chip harvesting method for poplar. It encompassed all the costs associated with establishing dedicated poplar plantations, including land rent, site preparation, planting, fertilizers, and herbicides. Additionally, we performed a sensitivity analysis to evaluate how different costs can affect the economic performance of the poplar cropping system. This analysis aimed to determine the minimum average delivered selling price for one metric ton of biomass necessary to achieve a desired rate of return over the cropping period. To inform the TEA, data on the establishment, crop care activities, and crop yields were derived from a field study conducted at the Mississippi Agricultural and Forestry Experiment Station's Bearden Dairy Research Center in Oktibbeha County and Pontotoc Ridge-Flatwood Branch Experiment Station in Pontotoc County.

Keywords: biomass, populus species, sensitivity analysis, technoeconomic analysis

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Authors: Rostyslav Horbay, Nick Korolis, Vahid Anvari, Rostyslav Stoika

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Introduction: Giant cancer cells (GCC) are common in all types of cancer, especially after poor therapy. Some specific features of such cells include ~10-fold enlargement, drug resistance, and the ability to propagate similar daughter cells. We used murine NK/Ly lymphoma, an aggressive and fast growing lymphoma model that has already shown drastic changes in GCC comparing to parental cells (chromatin condensation, nuclear fragmentation, tighter OXPHOS/cellular respiration coupling, multidrug resistance). Materials and methods: In this study, we compared morpho-functional changes of GCC that predominantly show either a cytostatic or a cytotoxic effect after treatment with drugs. We studied the effect of a combined cytostatic/cytotoxic drug treatment to determine the correlation of drug efficiency and GCC formation. Doses of G1/S-specific drug paclitaxel/PTX (G2/M-specific, 50 mg/mouse), vinblastine/VBL (50 mg/mouse), and DNA-targeting agents doxorubicin/DOX (125 ng/mouse) and cisplatin/CP (225 ng/mouse) on C57 black mice. Several tests were chosen to estimate morphological and physiological state (propidium iodide, Rhodamine-123, DAPI, JC-1, Janus Green, Giemsa staining and other), which included cell integrity, nuclear fragmentation and chromatin condensation, mitochondrial activity, and others. A single and double factor ANOVA analysis were performed to determine correlation between the criteria of applied drugs and cytomorphological changes. Results: In all cases of treatment, several morphological changes were observed (intracellular vacuolization, membrane blebbing, and interconnected mitochondrial network). A lower gain in ascites (49.97% comparing to control group) and longest lifespan (22+9 days) after tumor injection was obtained with single VBL and single DOX injections. Such ascites contained the highest number of GCC (83.7%+9.2%), lowest cell count number (72.7+31.0 mln/ml), and a strong correlation coefficient between increased mitochondrial activity and percentage of giant NK/Ly cells. A high number of viable GCC (82.1+9.2%) was observed compared to the parental forms (15.4+11.9%) indicating that GCC are more drug resistant than the parental cells. All this indicates that the giant cell formation and its ability to obtain drug resistance is an expanding field in cancer research.

Keywords: ANOVA, cisplatin, doxorubicin, drug resistance, giant cancer cells, NK/Ly lymphoma, paclitaxel, vinblastine

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Authors: Mary Edokpa Fadal, Frances Agweda

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Considering the volatile and evolving nature of the political environment in the developing countries, it is important that the subject of effective leadership practices that focus on transformational and systematic political development and values be reviewed. If the attitude towards partisan politics and the played politics by political parties is relatively deviated from expected adherence to acceptance, safe, efficient and practical standard, the political parties will continue to struggle endlessly in an effort to maintain a system that works. The analysis is situated in the context of political parties and partisan political behavior in contemporary societies and developing nations. Recent research of empirical evidence shows that most of the political parties are more or less, not too active in playing their instrumental role in the political system, such as unifying, simplifying and stabilizing the political process. This is however traced to the problem of ethnic politics that have been dominated by tribalism. The rising clamor for political development needs re-structuring and correcting the abnormalities in the center of the polity to address the flaws in our political system. The paper argues that political parties and political actors are some of the vital instrument of attaining societal goals of democratic principles for peace and durability. Issues of ethnic and partisan politics are also discussed, as it relates to question pertaining to political ideologies. It is in the findings that this paper examines some of the issues that have been seen revolving the true practice of political parties and its activities towards the democratic trend of a society, that help to resolve questions surrounding the issues of politics and governance in developing countries. These issues are seen as an aberration that have characterized politics and political behavior especially in the aspect of transparency and fulfilling its purpose of existence. The paper argues that the transition of the developing nature of states largely depends on the political structures and party politics and the nature of constitutionalism following the democratic awakening. The paper concludes that politics and political behavior are all human factors that play a vital role in the development of contemporary societies. They drive the wheel of nations towards its goal attainment. This paper relies on documentary, primary sources of data collection and empirical analysis.

Keywords: development, ethnicity, partisan politics, political behavior, political parties

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Authors: Nidhi Gupta, Omita Nanda, Rakhi Grover, Kanchan Saxena

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Hybrid perovskite is new class of material which has gained much attention due to their different crystal structure and interesting optical and electrical properties. Easy fabrication, high absorption coefficient, and photoluminescence properties make them a strong candidate for various applications such as sensors, photovoltaics, photodetectors, etc. In perovskites, ions arrange themselves in a special type of crystal structure with chemical formula ABX3, where A is organic species like CH3NH3+, B is metal ion (e.g., Pb, Sn, etc.) and X is halide (Cl-, Br-, I-). In crystal structure, A is present at corner position, B at center of the crystal lattice and halide ions at the face centers. High stability and sensitivity of nanostructured perovskite make them suitable for chemical sensors. Researchers have studied sensing properties of perovskites for number of analytes such as 2,4,6-trinitrophenol, ethanol and other hazardous chemical compounds. Ammonia being highly toxic agent makes it a reason of concern for the environment. Thus the detection of ammonia is extremely important. Our present investigation deals with organic inorganic hybrid perovskite based ammonia sensor. Various methods like sol-gel, solid state synthesis, thermal vapor deposition etc can be used to synthesize Different hybrid perovskites. In the present work, a novel hybrid perovskite has been synthesized by a single step method. Ethylenediammnedihalide and lead halide were used as precursor. Formation of hybrid perovskite was confirmed by FT-IR and XRD. Morphological characterization of the synthesized material was performed using scanning electron microscopy (SEM). SEM analysis revealed the formation of one dimensional nanowire perovskite with mean diameter of 200 nm. Measurements for sensing properties of halide perovskite for ammonia vapor were carried out. Perovskite thin films showed a color change from yellow to orange on exposure of ammonia vapor. Electro-optical measurements show that sensor based on lead halide perovskite has high sensitivity towards ammonia with effective selectivity and reversibility. Sensor exhibited rapid response time of less than 20 seconds.

Keywords: hybrid perovskite, ammonia, sensor, nanostructure, thin film

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Authors: Xining Wang

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After-school educational service has been proven that it could benefit children’s academic performance, socio-emotional skills, and physical health level. However, there is little research demonstrating parents’ perspectives on the choice of after-school educational service from a level of cross-cultural backgrounds. China and Ireland are typical representatives of collectivist countries (e.g., estimated individualism score is 20) and individualist countries (e.g., estimated individualism score is 70) according to Hofstede's cultural dimensions theory. Living in countries with distinguished cultural backgrounds, there is an evident discrepancy in parents’ attitudes towards domestic after-school education and parents’ motivations for choosing after-school educational services. Through conducting a semi-structured interview with 15 parents from China and 15 parents from Ireland, using thematic analysis software (ATLAS) to extract the key information, and applying a comparative approach to process data analysis; results present polarization of Chinese and Irish parents' perspectives and motivations on after-school educational service. For example, Chinese parents tend to view after-school education as a complement to school education. It is a service they purchased for their children to acquire extra knowledge and skills so that they could adapt to the highly competitive educational setting. Given the fact that children’s education is a priority for Chinese families, most parents believe that their children would succeed in the future through massive learning. This attitude reflects that Chinese parents are more likely to apply authoritarian parenting methods and having a strong expectations for their children. Conversely, Irish parents' choice of after-school educational service is a consideration that primarily based on their own situation, secondly, for their family. For instance, with the expansion of the labor market, there is a change in household structure. Irish mothers are more likely to seek working opportunities instead of looking after the family. Irish parents view that after-school educational service is an essential need for themselves and a beneficial component for their family due to the external pressure (e.g., the growing work intensity and extended working hours, increasing numbers of separated families, as well as parents’ pursuit of higher education and promotion). These factors are fundamental agents that encourage Irish parents to choose after-school educational services. To conclude, the findings could provide readers with a better understanding of parents’ disparate and contrasting perspectives on after-school educational services from a multi-culture level.

Keywords: after-school, China, family studies, Ireland, parents

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Authors: Nigatu Tadesse, Li Juan, Liuhong Ming

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Gastric cancer (GC) is the fifth most common and fourth deadly cancer in the world with limited treatment options at late advanced stage in which surgical therapy is not recommended with chemotherapy remain as the mainstay of treatment. However, the occurrence of chemoresistance as well as intera-tumoral and inter-tumoral heterogeneity of response to targeted and immunotherapy underlined a clear unmet treatment need in gastroenterology. Several molecular and cellular alterations ascribed for chemo resistance in GC including cancer stem cells (CSC) and tumor microenvironment (TME) remodeling. Cancer cells including CSC bears higher metabolic demand and major changes in TME involves alterations of gut microbiota interacting with nutrients metabolism. Metabolic upregulation in lipids, carbohydrates, amino acids, fatty acids biosynthesis pathways identified as a common hall mark in GC. Metabolic addiction to methionine metabolism occurs in many cancer cells to promote the biosynthesis of S-Adenosylmethionine (SAM), a universal methyl donor molecule for high rate of transmethylation in GC and promote cell proliferation. Targeting methionine metabolism found to promotes chemo-sensitivity with treatment non-heterogeneity. Methionine restriction (MR) promoted the arrest of cell cycle at S/G2 phase and enhanced downregulation of GC cells resistance to apoptosis (including ferroptosis), which suggests the potential of synergy with chemotherapies acting at S-phase of the cell cycle as well as inducing cell apoptosis. Accumulated evidences showed both the biogenesis as well as intracellular metabolism of exogenous methionine could be safe and effective target for therapy either alone or in combination with chemotherapies. This review article provides an over view of the upregulation in methionine biosynthesis pathway and the molecular signaling through the PI3K/Akt/mTOR-c-MYC axis to promote metabolic reprograming through activating the expression of L-type aminoacid-1 (LAT1) transporter and overexpression of Methionine adenosyltransferase 2A(MAT2A) for intercellular metabolic conversion of exogenous methionine to SAM in GC, and the potential of targeting with novel therapeutic agents such as methioninase (METase), Methionine adenosyltransferase 2A (MAT2A), c-MYC, methyl like transferase 16 (METTL16) inhibitors that are currently under clinical trial development stages and future perspectives.

Keywords: gastric cancer, methionine metabolism, pi3k/akt/mtorc1-c-myc axis, gut microbiota, MAT2A, c-MYC, METTL16, methioninase

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Authors: Tamphasana Wairokpam

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Inflammatory myopathies (IMs) have long been recognised as a heterogenous family of myopathies with acute, subacute, and sometimes chronic presentation and are potentially treatable. Necrotizing autoimmune myopathies (NAM) are a relatively new subset of myopathies. Patients generally present with subacute onset of proximal myopathy and significantly elevated creatinine kinase (CK) levels. It is being increasingly recognised that there are limitations to the independent diagnostic utility of muscle biopsy. Immunohistochemistry tests may reveal important information in these cases. The traditional classification of IMs failed to recognise NAM as a separate entity and did not adequately emphasize the diversity of IMs. This review and case report on NAM aims to highlight the heterogeneity of this entity and focus on the distinct clinical presentation, biopsy findings, specific auto-antibodies implicated, and available treatment options with prognosis. This article is a meta-analysis of literatures on NAM and a case report illustrating the clinical course, investigation and biopsy findings, antibodies implicated, and management of a patient with NAM. The main databases used for the search were Pubmed, Google Scholar, and Cochrane Library. Altogether, 67 publications have been taken as references. Two biomarkers, anti-signal recognition protein (SRP) and anti- hydroxyl methylglutaryl-coenzyme A reductase (HMGCR) Abs, have been found to have an association with NAM in about 2/3rd of cases. Interestingly, anti-SRP associated NAM appears to be more aggressive in its clinical course when compared to its anti-HMGCR associated counterpart. Biopsy shows muscle fibre necrosis without inflammation. There are reports of statin-induced NAM where progression of myopathy has been seen even after discontinuation of statins, pointing towards an underlying immune mechanism. Diagnosisng NAM is essential as it requires more aggressive immunotherapy than other types of IMs. Most cases are refractory to corticosteroid monotherapy. Immunosuppressive therapy with other immunotherapeutic agents such as IVIg, rituximab, mycophenolate mofetil, azathioprine has been explored and found to have a role in the treatment of NAM. In conclusion,given the heterogeneity of NAM, it appears that NAM is not just a single entity but consists of many different forms, despite the similarities in presentation and its classification remains an evolving field. A thorough understanding of underlying mechanism and the clinical correlation with antibodies associated with NAM is essential for efficacious management and disease prognostication.

Keywords: inflammatory myopathies, necrotising autoimmune myopathies, anti-SRP antibody, anti-HMGCR antibody, statin induced myopathy

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Authors: Chetna Mohabeer, Luis Reyes, Lokmane Abdelouahed, Bechara Taouk

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In the transition to sustainability and the increasing use of renewable energy, hydrogen will play a key role as an energy carrier. Biomass has the potential to accelerate the realization of hydrogen as a major fuel of the future. Pyro-gasification allows the conversion of organic matter mainly into synthesis gas, or “syngas”, majorly constituted by CO, H2, CH4, and CO2. A second, condensable fraction of biomass pyro-gasification products are “tars”. Under certain conditions, tars may decompose into hydrogen and other light hydrocarbons. These conditions include two types of cracking: homogeneous cracking, where tars decompose under the effect of temperature ( > 1000 °C), and heterogeneous cracking, where catalysts such as olivine, dolomite or biochar are used. The latter process favors cracking of tars at temperatures close to pyro-gasification temperatures (~ 850 °C). Pyro-gasification of biomass coupled with water-gas shift is the most widely practiced process route for biomass to hydrogen today. In this work, an innovating solution will be proposed for this conversion route, in that all the pyro-gasification products, not only methane, will undergo processes that aim to optimize hydrogen production. First, a heterogeneous cracking step was included in the reaction scheme, using biochar (remaining solid from the pyro-gasification reaction) as catalyst and CO2 and H2O as gasifying agents. This process was followed by a catalytic steam methane reforming (SMR) step. For this, a Ni-based catalyst was tested under different reaction conditions to optimize H2 yield. Finally, a water-gas shift (WGS) reaction step with a Fe-based catalyst was added to optimize the H2 yield from CO. The reactor used for cracking was a fluidized bed reactor, and the one used for SMR and WGS was a fixed bed reactor. The gaseous products were analyzed continuously using a µ-GC (Fusion PN 074-594-P1F). With biochar as bed material, it was seen that more H2 was obtained with steam as a gasifying agent (32 mol. % vs. 15 mol. % with CO2 at 900 °C). CO and CH4 productions were also higher with steam than with CO2. Steam as gasifying agent and biochar as bed material were hence deemed efficient parameters for the first step. Among all parameters tested, CH4 conversions approaching 100 % were obtained from SMR reactions using Ni/γ-Al2O3 as a catalyst, 800 °C, and a steam/methane ratio of 5. This gave rise to about 45 mol % H2. Experiments about WGS reaction are currently being conducted. At the end of this phase, the four reactions are performed consecutively, and the results analyzed. The final aim is the development of a global kinetic model of the whole system in a multi-stage fluidized bed reactor that can be transferred on ASPEN PlusTM.

Keywords: multi-staged fluidized bed reactor, pyro-gasification, steam methane reforming, water-gas shift

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Authors: Isadora Bugarin, Taygoara F. de Oliveira

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Multiphase flows have currently been placed as a key solution for technological advances in energy and thermal sciences. The comprehension of droplet motion and behavior on non-isothermal flows is, however, rather limited. The present work consists of an investigation of a 2D droplet migration on natural convection inside a square enclosure with differentially heated walls. The investigation in question concerns the effects on drop motion of imposing different combinations of Prandtl and Rayleigh numbers while defining the drop on distinct initial positions. The finite differences method was used to compute the Navier-Stokes and energy equations for a laminar flow, considering the Boussinesq approximation. Also, a high order level set method was applied to simulate the two-phase flow. A previous analysis developed by the authors had shown that for fixed values of Rayleigh and Prandtl, the variation of the droplet initial position at the beginning of the simulation delivered different patterns of motion, in which for Ra≥10⁴ the droplet presents two very specific behaviors: it can travel through a helical path towards the center or define cyclic circular paths resulting in closed paths when reaching the stationary regime. Now, when varying the Prandtl number for different Rayleigh regimes, it was observed that this particular parameter also affects the migration of the droplet, altering the motion patterns as its value is increased. On higher Prandtl values, the drop performs wider paths with larger amplitudes, traveling closer to the walls and taking longer time periods to finally reach the stationary regime. It is important to highlight that drastic drop behavior changes on the stationary regime were not yet observed, but the path traveled from the begging of the simulation until the stationary regime was significantly altered, resulting in distinct turning over frequencies. The flow’s unsteady Nusselt number is also registered for each case studied, enabling a discussion on the overall effects on heat transfer variations.

Keywords: droplet migration, level set method, multiphase flow, natural convection in enclosure, Prandtl number

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Authors: Saad Algharib, Jay Lee

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Urbanization is a complex phenomenon that occurs during the city’s development from one form to another. In other words, it is the process when the activities in the land use/land cover change from rural to urban. Since the oil exploration, Kuwait City has been growing rapidly due to its urbanization and population growth by both natural growth and inward immigration. The main objective of this study is to detect changes in urban land use/land cover and to examine the changing spatial patterns of urban growth in and around Kuwait City between 1989 and 2001. In addition, this study also evaluates the spatial patterns of the changes detected and how they can be related to the spatial configuration of the city. Recently, the use of remote sensing and geographic information systems became very useful and important tools in urban studies because of the integration of them can allow and provide the analysts and planners to detect, monitor and analyze the urban growth in a region effectively. Moreover, both planners and users can predict the trends of the growth in urban areas in the future with remotely sensed and GIS data because they can be effectively updated with required precision levels. In order to identify the new urban areas between 1989 and 2001, the study uses satellite images of the study area and remote sensing technology for classifying these images. Unsupervised classification method was applied to classify images to land use and land cover data layers. After finishing the unsupervised classification method, GIS overlay function was applied to the classified images for detecting the locations and patterns of the new urban areas that developed during the study period. GIS was also utilized to evaluate the distribution of the spatial patterns. For example, Moran’s index was applied for all data inputs to examine the urban growth distribution. Furthermore, this study assesses if the spatial patterns and process of these changes take place in a random fashion or with certain identifiable trends. During the study period, the result of this study indicates that the urban growth has occurred and expanded 10% from 32.4% in 1989 to 42.4% in 2001. Also, the results revealed that the largest increase of the urban area occurred between the major highways after the forth ring road from the center of Kuwait City. Moreover, the spatial distribution of urban growth occurred in cluster manners.

Keywords: geographic information systems, remote sensing, urbanization, urban growth

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Authors: S. Mamoucha, J. Rahul, N. Christodoulakis

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Introduction: Nature has been the source of medicinal agents since the dawn of the human existence on Earth. Currently, millions of people, in the developing world, rely on medicinal plants for primary health care, income generation and lifespan improvement. In Greece, more than 5500 plant taxa are reported while about 250 of them are considered to be of great pharmaceutical importance. Among the plants used for medical purposes, Vitex agnus-castus L. (Verbenaceae) is known since ancient times. It is a small tree or shrub, widely distributed in the Mediterranean basin up to the Central Asia. It is also known as chaste tree or monks pepper. Theophrastus mentioned the shrub several times, as ‘agnos’ in his ‘Enquiry into Plants’. Dioscorides mentioned the use of V. agnus-castus for the stimulation of lactation in nursing mothers and the treatment of several female disorders. The plant has important medicinal properties and a long tradition in folk medicine as an antimicrobial, diuretic, digestive and insecticidal agent. Materials and methods: Leaves were cleaned, detached, fixed, sectioned and investigated with light and Scanning Electron Microscopy (SEM). Histochemical tests were executed as well. Specific histochemical reagents (osmium tetroxide, H2SO4, vanillin/HCl, antimony trichloride, Wagner’ s reagent, Dittmar’ s reagent, potassium bichromate, nitroso reaction, ferric chloride and di methoxy benzaldehyde) were used for the sub cellular localization of secondary metabolites. Results: Light microscopical investigations of the elongated leaves of V. agnus-castus revealed three layers of palisade parenchyma, just below the single layered adaxial epidermis. The spongy parenchyma is rather loose. Adaxial epidermal cells are larger in magnitude, compared to those of the abaxial epidermis. Four different types of capitate, secreting trichomes, were localized among the abaxial epidermal cells. Stomata were observed at the abaxial epidermis as well. SEM revealed the interesting arrangement of trichomes. Histochemical treatment on fresh and plastic embedded tissue sections revealed the nature and the sites of secondary metabolites accumulation (flavonoids, steroids, terpenes). Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: Vitex agnus-castus, leaf anatomy, histochemical reagents, secondary metabolites

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Authors: Agim Kukelii, Gevorg Sargsyan

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This study, focusing on the base regional area (county level), estimates the effect of natural disaster damages on aggregate personal income, aggregate wages, wages per worker, aggregate employment, and aggregate income transfer. The study further estimates the dynamics of personal income, employment, and wages under natural disaster shocks. Southeast Texas, located at the center of Golf Coast, is hit by meteorological and hydrological caused natural disasters yearly. On average, there are more than four natural disasters per year that cane an estimated damage average of 2.2% of real personal income. The study uses the panel data method to estimate the average effect of natural disasters on the area’s economy (personal income, wages, employment, and income transfer). It also uses Panel Vector Autoregressive (PVAR) model to study the dynamics of macroeconomic variables under natural disaster shocks. The study finds that the average effect of natural disasters is positive for personal income and income transfer and is negative for wages and employment. The PVAR and the impulse response function estimates reveal that natural disaster shocks cause a decrease in personal income, employment, and wages. However, the economy’s variables bounce back after three years. The novelty of this study rests on several aspects. First, this is the first study to investigate the effects of natural disasters on macroeconomic variables at a regional level. Second, the study uses direct measures of natural disaster damages. Third, the study estimates that the time that the local economy takes to absorb the natural disaster damages shocks is three years. This is a relatively good reaction to the local economy, therefore, adding to the “resiliency” hypothesis. The study has several implications for policymakers, businesses, and households. First, this study serves to increase the awareness of local stakeholders that natural disaster damages do worsen, macroeconomic variables, such as personal income, employment, and wages beyond the immediate damages to residential and commercial properties, physical infrastructure, and discomfort in daily lives. Second, the study estimates that these effects linger on the economy on average for three years, which would require policymakers to factor in the time area need to be on focus.

Keywords: natural disaster damages, macroeconomics effects, PVAR, panel data

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Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

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Authors: Hannele Laaksonen, Seija Nyqvist, Kari Nurmes

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Objectives: In the year 2011 the City of Vaasa started to develop know-how in the technology and the introduction of services for aging people in cooperation with the Polytechnic Novia University of Applied Sciences and VAMK, University of Applied Sciences. The project´s targets included: to help elderly people to maintain their ability to function, to provide them social and physical activities, to prevent their social exclusion, to decrease their feelings of loneliness and insecurity and to develop their technical know-how. Methods: The project was built based on open source code, tailor-made service system and user interface for the elderly living at home and their families, based on the users´ expectations and experiences of services. Activation-TV®-project vas carried out 1.4.2011-31.3.2014. A pilot group of eight elderly persons, who were living at home, were selected to the project. All necessary technical means as well as guidance and teaching equipment were provided to the pilot group. The students of University of Applied Sciences (VAMK, Novia) and employees of Center of Ageing were made all programs to the Activation-TV®. The project group were interviewed after and before intervention. The data were evaluated both qualitatively and quantitatively. Results: The built service includes a video library, a group room for interactive programs and a personal room for bilateral meetings and direct shipment. The program is bilingual and produced in both national languages. The Activation TV® reduced elderly peoples´ (n=8) feelings of emptiness, added mental well-being and quality of life with social contacts. Relatives felt, that they were able to get in to older peoples´ everyday life with Activation TV®. Discussion: The built application was tailored to the model that has not been developed elsewhere in Finland. This model can be copied from one server to another and thus transferred to other municipalities but the program requires its own personnel system management and maintenance as well as program production cooperation between the different actors. This service can be used for the elderly who are living at home without dementia.

Keywords: mental well-being, quality of life, elderly people, Finland

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Authors: Dmitriy V. Chulkov

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Escalation of commitment is defined as continuation of a project after receiving negative information about it. While literature in management and psychology identified various factors contributing to escalation behavior, this phenomenon has received little analysis in economics, potentially due to the apparent irrationality of escalation. In this study, we present an economic model of escalation with asymmetric information in a principal-agent setup where the agents are responsible for a project selection decision and discover the outcome of the project before the principal. Our theoretical model complements the existing literature on several accounts. First, we link the incentive to escalate commitment to a project with the turnover decision by the manager. When a manager learns the outcome of the project and stops it that reveals that a mistake was made. There is an incentive to continue failing projects and avoid admitting the mistake. This incentive is enhanced when the agent may voluntarily resign from the firm before the outcome of the failing project is revealed, and thus not bear the full extent of reputation damage due to project failure. As long as some successful managers leave the firm for extraneous reasons, outside firms find it difficult to link failing projects with certainty to managers that left a firm. Second, we demonstrate that non-CEO managers have reputation concerns separate from those of the CEO, and thus may escalate commitment to projects they oversee, when such escalation can attenuate damage to reputation from impending project failure. Such incentive for escalation will be present for non-CEO managers if the CEO delegates responsibility for a project to a non-CEO executive. If reputation matters for promotion to the CEO, the incentive for a rising executive to escalate in order to protect reputation is distinct from that of a CEO. Third, our theoretical model is supported by empirical analysis of changes in the firm’s operations measured by the presence of discontinued operations at the time of turnover among the top four members of the top management team. Discontinued operations are indicative of termination of failing projects at a firm. The empirical results demonstrate that in a large dataset of over three thousand publicly traded U.S. firms for a period from 1993 to 2014 turnover by top executives significantly increases the likelihood that the firm discontinues operations. Furthermore, the type of turnover matters as this effect is strongest when at least one non-CEO member of the top management team leaves the firm and when the CEO departure is due to a voluntary resignation and not to a retirement or illness. Empirical results are consistent with the predictions of the theoretical model and suggest that escalation of commitment is primarily observed in decisions by non-CEO members of the top management team.

Keywords: discontinued operations, escalation of commitment, executive turnover, top management teams

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Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

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We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

Procedia PDF Downloads 150

Authors: Petar Dobrev

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There is no agreed-upon definition of firm quality. While profitability and stock performance often qualify as popular proxies of quality, in this project, we aim to identify quality without relying on a firm’s financial statements or stock returns as selection criteria. Instead, we use firm-level data on management practices across small to medium-sized U.S. manufacturing firms from the World Management Survey (WMS) to measure firm quality. Each firm in the WMS dataset is assigned a mean management score from 0 to 5, with higher scores identifying better-managed firms. This management score serves as our proxy for firm quality and is the sole criteria we use to separate firms into portfolios comprised of high-quality and low-quality firms. We define high-quality (low-quality) firms as those firms with a management score of one standard deviation above (below) the mean. To study whether this proxy for firm quality can identify better-performing firms, we link this data to Compustat and The Center for Research in Security Prices (CRSP) to obtain firm-level data on financial performance and monthly stock returns, respectively. We find that from 1999 to 2019 (our sample data period), firms in the high-quality portfolio are consistently more profitable — higher operating profitability and return on equity compared to low-quality firms. In addition, high-quality firms also exhibit a lower risk of bankruptcy — a higher Altman Z-score. Next, we test whether the stocks of the firms in the high-quality portfolio earn superior risk-adjusted excess returns. We regress the monthly excess returns on each portfolio on the Fama-French 3-factor, 4-factor, and 5-factor models, the betting-against-beta factor, and the quality-minus-junk factor. We find no statistically significant differences in excess returns between both portfolios, suggesting that stocks of high-quality (well managed) firms do not earn superior risk-adjusted returns compared to low-quality (poorly managed) firms. In short, our proxy for firm quality, the WMS management score, can identify firms with superior financial performance (higher profitability and reduced risk of bankruptcy). However, our management proxy cannot identify stocks that earn superior risk-adjusted returns, suggesting no statistically significant relationship between managerial quality and stock performance.

Keywords: excess stock returns, management, profitability, quality

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Authors: Lianne M. Q. Lee, Mohammed Sharaf Shaiban

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The importance of bank liquidity management took center stage as policy makers promoted a more resilient global banking system after the market turmoil of 2007. The growing recognition of Islamic banks’ function of intermediating funds in the economy warrants the need to investigate its balance sheet structure which is distinct from its conventional counterparts. Given that asymmetric risk, transformation is inevitable; Islamic banks need to identify the liquidity risk within their distinctive balance sheet structure. Thus, there is a strong need to quantify and assess the liquidity position to ensure proper functioning of a financial institution. It is vital to measure bank liquidity because liquid banks face less liquidity risk. We examine this issue by using two alternative quantitative measures of liquidity creation “cat fat” and “cat nonfat” constructed by Berger and Bouwman (2009). “Cat fat” measures all on balance sheet items including off balance sheet, whilst the latter measures only on balance sheet items. Liquidity creation is measured over the period 2007-2014 in 14 countries where Islamic and conventional commercial banks coexist. Also, separately by bank size class as empirical studies have shown that liquidity creation varies by bank size. An interesting and important finding shows that all size class of Islamic banks, on average have increased creation of aggregate liquidity in real dollar terms over the years for both liquidity creation measures especially for large banks indicating that Islamic banks actually generates more liquidity to the economy compared to its conventional counterparts, including from off-balance sheet items. The liquidity creation for off-balance sheets by conventional banks may have been affected by the global financial crisis when derivatives markets were severely hit. The results also suggest that Islamic banks have the higher volume of assets and deposits and that borrowing/issues of bonds are less in Islamic banks compared to conventional banks because most products are interest-based. As Islamic banks appear to create more liquidity than conventional banks under both measures, it translates that the development of Islamic banking is significant over the decades since its inception. This finding is encouraging as, despite Islamic banking’s overall size, it represents growth opportunities for these countries.

Keywords: financial institution, liquidity creation, liquidity risk, policy and regulation

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Authors: Esra Ceren Kara, Ufuk Seri̇n

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The Byzantine Empire, which persisted from the 4th to 15th centuries, covered a significant period in history and bequeathed a significant cultural heritage throughout its territories, including Turkey. However, despite its historical and cultural importance, the approach of the political authorities, which emphasizes the Seljuk and Ottoman heritage, to Byzantium in Turkey is reluctant and problematic. Byzantine history and culture have long been neglected and attained negative connotations. This has led to a lack of awareness and understanding of Byzantine heritage among the public and inadequate conservation efforts. This research aims to address this problem by proposing a reinterpretation and presentation of Byzantine heritage in Turkey that emphasizes its cultural value and presents it to the public as a part of a common cultural heritage in order to accomplish effective conservation, raise awareness and provide a better understanding of the Byzantium. In this article, the ways to interpret, present and integrate the Medieval Byzantine heritage into today’s world are analyzed through the selected case study of Trebizond (Trabzon) with a holistic approach by putting emphasis on the Byzantine religious edifices, churches, chapels and monasteries. Although the vestiges of this period are still intact and in use today, their past is unknown to many of their users. This situation is even more evident in the case of the converted churches, which are now used as mosques or mosque-museums. In the city center of Trebizond, 9 out of 12 religious edifices that are still in use were built during the Medieval Byzantine period and converted into mosques under Ottoman and Turkish rule. Currently, these monuments serve as mosques and mosque-museums. However, with the exception of Hagia Sophia and Girls Monastery, their Byzantine past is obscure to many locals. Thus, the promotion of local awareness and conservation of the Medieval Byzantine heritage in the city is required. With this premise, this research will investigate the values and opportunities offered by the Byzantine cultural heritage in Trebizond and the threats to its conservation, and it will offer proposals for a more effective interpretation and presentation so as to foster local awareness and integration of the Medieval Byzantine heritage.

Keywords: Byzantium/Byzantine, Trebizond, cultural heritage, interpretation and presentation, conservation, religious architecture, converted churches interpretation and presentation

Procedia PDF Downloads 51

Authors: Song Hung Chi, Lee Chun Benn

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Follow by the “A Research on Types of Settlement Housing Alterations of Chinese New Village in Malaysia- A Study in Ampang New Village, Selangor” preliminary informed that the main factors for expansion and enlargement suitably due to the needs of user's life and restoration purpose. The alterations behavior generally derived at the rear position of main house with different types of derivatives, the averages expansion area are not exceeding of 100㎡, while building materials used were wooden, wooden structure, and zinc which are non-permanent building materials. Therefore, a subsequent studies taken in this paper, further to analyze the drawing with summarize method, to explore the derived forms and the constituted rules of housing alterations in Ampang Village, as a more complete presentation of housing alterations in New Village. Firstly, classified the existing housing alterations into three types by using summarize method, which are Type 1, Additional of Prototype House; Type 2, Expansion of Prototype House; and Type 3, Diffusion of Additional. The results shows that the derivative mode of alterations can be divided into the use of "continuous wall" or "non-continuous wall," this will affects the structural systems and roof styles of alterations, and formed the different layers of interior space with "stages" and "continuity". On the aspects of spatial distribution, sacrificial area as a prescriptive function of space, it was mostly remains in the original location which in the center of living area after alterations. It is an important characteristic in a New Village house, reflecting the traditional Ethics of Hakka Chinese communities in the settlement. In addition, wooden as the main building materials of constituted rules for the prototype house, although there were appeared other building materials, such as cement, brick, glass, metal and zinc after alterations, but still mostly as "wooden house" pattern. Result show because of the economy of village does not significantly improve, and also forming the similarity types in alterations and constructions of the additional building with the existing. It did not significantly improve on the quality of living, but only increased the area of usage space.

Keywords: Ampang new village, derived forms, constituted rules, alterations

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Authors: Mingxia Zhu, Matthew Tingchi Liu

Abstract:

AI grows gradually in the market with its efficiency and accuracy, influencing people’s perceptions, attitude, and even consequential behaviors. Current study extends prior research by focusing on AI’s impact on consumers’ morality. First, study 1 tested individuals’ believes about AI and human’s moral perceptions and people’s attribution of moral worth to AI and human. Moral perception refers to a computational system an entity maintains to detect and identify moral violations, while moral worth here denotes whether individual regard an entity as worthy of moral treatment. To identify the effect of AI on consumers’ morality, two studies were employed. Study 1 is a within-subjects survey, while study 2 is an experimental study. In the study 1, one hundred and forty participants were recruited through online survey company in China (M_age = 27.31 years, SD = 7.12 years; 65% female). The participants were asked to assign moral perception and moral worth to AI and human. A paired samples t-test reveals that people generally regard that human has higher moral perception (M_Human = 6.03, SD = .86) than AI (M_AI = 2.79, SD = 1.19; t(139) = 27.07, p < .001; Cohen’s d = 1.41). In addition, another paired samples t-test results showed that people attributed higher moral worth to the human personnel (M_Human = 6.39, SD = .56) compared with AIs (M_AI = 5.43, SD = .85; t(139) = 12.96, p < .001; d = .88). In the next study, two hundred valid samples were recruited from survey company in China (M_age = 27.87 years, SD = 6.68 years; 55% female) and the participants were randomly assigned to two conditions (AI vs. human). After viewing the stimuli of human versus AI, participants are informed that one insurance company would determine the price purely based on their declaration. Therefore, their open-ended answers were coded into ethical, honest behavior and unethical, dishonest behavior according to the design of prior literature. A Chi-square analysis revealed that 64% of the participants would immorally lie towards AI insurance inspector while 42% of participants reported deliberately lower mileage facing with human inspector (χ^2 (1) = 9.71, p = .002). Similarly, the logistic regression results suggested that people would significantly more likely to report fraudulent answer when facing with AI (β = .89, odds ratio = 2.45, Wald = 9.56, p = .002). It is demonstrated that people would be more likely to behave unethically in front of non-human agents, such as AI agent, rather than human. The research findings shed light on new practical ethical issues in human-AI interaction and address the important role of human employees during the process of service delivery in the new era of AI.

Keywords: AI agent, consumer morality, ethical behavior, human-AI interaction

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