Search results for: long term investment

Authors: Ş. Çiftcioğlu, E. Efe

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In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: cancer treatment, children, complication, nutrition, nursing approaches

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Authors: Supattra Pranee

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The purposes of this research are to study the current business of health spa and to study the customers’ level of expectation as well as level of satisfaction of the health spa business in Ranong, Thailand. This paper drew upon data collected from health spa customers by using questionnaire. In addition, an in-depth interview was utilized to collect data from health spa entrepreneurs. The findings revealed that the health spa business is growing very fast and the coming ASEAN Economic Community (AEC) will ameliorate the business growth and increase the customer base. There is a need to improve staff’s ability to communicate in English. However, the economic size of Ranong province is still small which has resulted in the hesitation of investors to increase their investment in this business. The findings also revealed four categories of level of expectation and satisfaction as follows: (1) Service: overall, customers had a high expectation with a mean of 3.80 and 0.873 SD and a high level of satisfaction with a mean of 3.66 and 0.704 SD. (2) Staff: overall, customers had a high expectation with a mean of 3.95 and 0.865 SD and a high level of satisfaction with a mean of 3.84 and 0.783 SD. (3) Product, Equipment, and Tools: overall, customers had a high expectation with a mean of 4.02 and 0.913 SD and a high level of satisfaction with a mean of 3.88 and 0.772 SD. (4) Place, Atmosphere, and Environment: overall, customers had a high expectation with a mean of 3.95 and 0.906 SD and a high level of satisfaction with a mean of 3.86 and 0.785 SD.

Keywords: expectation, health spa business, satisfaction, ranong province

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Authors: Mohammad Azam

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The purpose of this study is to investigate risk and real excess portfolio returns using inflation adjusted risk-free rates, a measuring technique that focuses on the momentum augmented Fama-French six-factor model and use monthly data from 1994 to 2022. With the exception of profitability, the data show that market, size, value, momentum, and investment factors are all strongly associated to excess portfolio stock returns using ordinary lease square regression technique. According to the Gibbons, Ross, and Shanken test, the momentum augmented Fama-French six-factor model outperforms the market. This technique discovery may be utilised by academics and professionals to acquire an in-depth knowledge of the Pakistan Stock Exchange across a broad stock pattern for investing decisions and portfolio construction.

Keywords: real excess portfolio returns, momentum augmented fama & french five-factor model, GRS-test, pakistan stock exchange

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Authors: Priscila Ribeiro dos Santos, Luiz Antonio Daniel

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Inadequate access to clean water and sanitation has become one of the most widespread problems affecting people throughout the developing world, leading to an unceasing need for low-cost and sustainable wastewater treatment systems. The UASB technology has been widely employed as a suitable and economical option for the treatment of sewage in developing countries, which involves low initial investment, low energy requirements, low operation and maintenance costs, high loading capacity, short hydraulic retention times, long solids retention times and low sludge production. Whereas dissolved air flotation process is a good option for the post-treatment of anaerobic effluents, being capable of producing high quality effluents in terms of total suspended solids, chemical oxygen demand, phosphorus, and even pathogens. This work presents an evaluation and monitoring, over a period of 6 months, of one compact full-scale system with this configuration, UASB reactors followed by dissolved air flotation units (DAF), operating in Brazil. It was verified as a successful treatment system, and an issue of relevance since dissolved air flotation process treating UASB reactor effluents is not widely encompassed in the literature. The study covered the removal and behavior of several variables, such as turbidity, total suspend solids (TSS), chemical oxygen demand (COD), Escherichia coli, total coliforms and Clostridium perfringens. The physicochemical variables were analyzed according to the protocols established by the Standard Methods for Examination of Water and Wastewater. For microbiological variables, such as Escherichia coli and total coliforms, it was used the “pour plate” technique with Chromocult Coliform Agar (Merk Cat. No.1.10426) serving as the culture medium, while the microorganism Clostridium perfringens was analyzed through the filtering membrane technique, with the Ágar m-CP (Oxoid Ltda, England) serving as the culture medium. Approximately 74% of total COD was removed in the UASB reactor, and the complementary removal done during the flotation process resulted in 88% of COD removal from the raw sewage, thus the initial concentration of COD of 729 mg.L-1 decreased to 87 mg.L-1. Whereas, in terms of particulate COD, the overall removal efficiency for the whole system was about 94%, decreasing from 375 mg.L-1 in raw sewage to 29 mg.L-1 in final effluent. The UASB reactor removed on average 77% of the TSS from raw sewage. While the dissolved air flotation process did not work as expected, removing only 30% of TSS from the anaerobic effluent. The final effluent presented an average concentration of 38 mg.L-1 of TSS. The turbidity was significantly reduced, leading to an overall efficiency removal of 80% and a final turbidity of 28 NTU.The treated effluent still presented a high concentration of fecal pollution indicators (E. coli, total coliforms, and Clostridium perfringens), showing that the system did not present a good performance in removing pathogens. Clostridium perfringens was the organism which suffered the higher removal by the treatment system. The results can be considered satisfactory for the physicochemical variables, taking into account the simplicity of the system, besides that, it is necessary a post-treatment to improve the microbiological quality of the final effluent.

Keywords: dissolved air flotation, municipal sewage, UASB reactor, treatment

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Authors: Jun Young Chong, Seung Whan Kim

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Introduction: The use of personal protective equipment for respiratory infection control in cardiopulmonary resuscitation (CPR) is a physical burden to healthcare providers. It matters how long CPR quality according to recommended guidelines can be maintained under these circumstances. It was investigated whether chest compression time was appropriate for a 2-minute shift and how long it was maintained in accordance with the guidelines under such conditions. Methods: This prospective crossover simulation study was performed at a single center from September 2020 to October 2020. Five indicators of CPR quality were measured during the first and second sessions of the study period. All participants wore a Level D powered air-purifying respirator (PAPR), and the experiment was conducted using a Resusci Anne manikin, which can measure the quality of chest compressions. Each participant conducted two sessions. In session one, 2-minutes of chest compressions followed by a 2-minute rest was repeated twice; in session two, 1-minute of chest compressions followed by a 1-minute rest was repeated four times. Results: All 34 participants completed the study. The deep and sufficient compression rate was 65.9 ± 13.1 mm in the 1-minute shift group and 61.5 ± 30.5 mm in the 2-minute shift group. The mean depth was 52.8 ±4.3 mm in the 1-minute shift group and 51.0 ± 6.1 mm in the 2-minute shift group. In these two values, there was a statistically significant difference between the two sessions. There was no statistically significant difference in the other CPR quality values. Conclusions: It was suggested that the different standard of current 2-minute to 1-minute cycles due to a significant reduction in the quality of chest compression in cases of CPR with PAPR.

Keywords: cardiopulmonary resuscitation, chest compression, personal protective equipment, powered air-purifying respirator

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Authors: Shivani, Seema Sharma, Shveta Singh, Akriti Chandra

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Business activities contribute to various environmental issues such as deforestation, waste generation, and pollution. Therefore, integration of environmental concerns within manufacturing operations is vital for the long-term survival of businesses. In this context, green entrepreneurial orientation (GEO) is recognized as a firm-level internal strategy to mitigate ecological damage through initiating green business practices. However, despite the surge in research on GEO in recent years, ambiguity remains on the genesis of GEO and the mechanism through which GEO impacts various organizational outcomes. This prompts an examination of the ongoing scholarly discourse about GEO and its domain knowledge structure within the entrepreneurship literature using bibliometric analysis and the Theories, Contexts, Characteristics, and Methodologies (TCCM) framework. The authors analyzed a dataset comprising 73 scientific documents sourced from the Scopus and Web of Science database from 2005 to 2024 to provide insights into the publication trends, prominent journals, authors, articles, countries' collaboration, and keyword analysis in GEO research. The findings indicate that the number of relevant papers and citations has increased consistently, with authors from China being the main contributors. The articles are mainly published in Business Strategy and the Environment and Sustainability. Dynamic capability view is the dominant framework applied in the GEO domain, with large manufacturing firms and SMEs constituting the majority of the sample. Further, various antecedents of GEO have been identified at an organizational level to which managers can focus their attention. The studies have used various contextual factors to explain when GEO translates into superior organizational outcomes. The Method analysis reveals that PLS-SEM is the commonly used approach for analyzing the primary data collected through surveys. Moreover, the content analysis indicates four emerging research frontiers identified as unidimensional vs. multidimensional perspectives of GEO, typologies of green innovation, environmental management in the hospitality industry, and tech-savvy sustainability in the agriculture sector. This study is one of the earliest to apply quantitative methods to synthesize the extant literature on GEO. This research holds relevance for management practice due to the escalating levels of carbon emissions, energy consumption, and waste discharges observed in recent years, resulting in increased apprehension about climate change.

Keywords: green entrepreneurship, sustainability, SLR, TCCM

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Authors: Genevieve R. Kan, Jolyon Ford

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Background: Caesarean section has become the routine route of delivery for breech fetuses, but breech cesarean deliveries are hypothesized to have poorer immediate neonatal outcomes when compared to cephalic deliveries. In accordance with this, in many Australian hospitals, the pediatric team is routinely required to attend every elective breech cesarean section in case urgent resuscitation is required. Our study aimed to determine whether term elective breech deliveries indeed had worse immediate neonatal outcomes at delivery, which will justify the necessity of pediatric staff presence at every elective breech cesarean delivery and influence the workload for the pediatric team. Objective: Elective breech cesarean deliveries were compared to elective cephalic cesarean deliveries at 37 weeks gestation or above to evaluate the immediate neonatal outcomes (Apgar scores <7 at 5 minutes, and Special Care Nursery admissions on Day 1 of life) of each group. Design: A retrospective cohort study Method: This study examined 2035 elective breech and cephalic singleton cesarean deliveries at term over 5 years from July 2017 to July 2022 at Frankston Hospital, a metropolitan hospital in Melbourne, Australia. There were 260 breech deliveries and 1775 cephalic deliveries. De-identified patient data were collected retrospectively from the hospital’s electronically integrated pregnancy and birth records to assess demographics and neonatal outcomes. Results: Apgar scores <7 at 5 minutes of life were worse in the breech group compared to the cephalic group (3.4% vs 1.6%). Special Care Nursery admissions on Day 1 of life were also higher for the breech cohort compared to the cephalic cohort (9.6% vs 8.7%). Conclusions: Our results support the expected findings that breech deliveries are associated with worse immediate neonatal outcomes. It, therefore, suggests that routine attendance at elective breech cesarean deliveries by the pediatric team is indeed required to assist with potentially higher needs for neonatal resuscitation and special care nursery admission.

Keywords: breech, cesarean section, Apgar scores, special care nursery admission

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Authors: Beatriz González-rodrigo, Diego Hidalgo-leiva, Omar Flores, Claudia Germoso, Maribel Jiménez-martínez, Laura Navas-sánchez, Belén Orta, Nicola Tarque, Orlando Hernández- Rubio, Miguel Marchamalo, Juan Gregorio Rejas, Belén Benito-oterino

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Cities facing seismic hazard necessitate detailed risk assessments for effective urban planning and vulnerability identification, ensuring the safety and sustainability of urban infrastructure. Comprehensive studies involving seismic hazard, vulnerability, and exposure evaluations are pivotal for estimating potential losses and guiding proactive measures against seismic events. However, broad-scale traditional risk studies limit consideration of specific local threats and identify vulnerable housing within a structural typology. Achieving precise results at neighbourhood levels demands higher resolution seismic hazard exposure, and vulnerability studies. This research aims to bolster sustainability and safety against seismic disasters in three Central American and Caribbean capitals. It integrates geospatial techniques and artificial intelligence into seismic risk studies, proposing cost-effective methods for exposure data collection and damage prediction. The methodology relies on prior seismic threat studies in pilot zones, utilizing existing exposure and vulnerability data in the region. Emphasizing detailed building attributes enables the consideration of behaviour modifiers affecting seismic response. The approach aims to generate detailed risk scenarios, facilitating prioritization of preventive actions pre-, during, and post-seismic events, enhancing decision-making certainty. Detailed risk scenarios necessitate substantial investment in fieldwork, training, research, and methodology development. Regional cooperation becomes crucial given similar seismic threats, urban planning, and construction systems among involved countries. The outcomes hold significance for emergency planning and national and regional construction regulations. The success of this methodology depends on cooperation, investment, and innovative approaches, offering insights and lessons applicable to regions facing moderate seismic threats with vulnerable constructions. Thus, this framework aims to fortify resilience in seismic-prone areas and serves as a reference for global urban planning and disaster management strategies. In conclusion, this research proposes a comprehensive framework for seismic risk assessment in high-risk urban areas, emphasizing detailed studies at finer resolutions for precise vulnerability evaluations. The approach integrates regional cooperation, geospatial technologies, and adaptive fragility curve adjustments to enhance risk assessment accuracy, guiding effective mitigation strategies and emergency management plans.

Keywords: assessment, behaviour modifiers, emergency management, mitigation strategies, resilience, vulnerability

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Authors: Melissa Hachem, Maxime Loizeau, Nadine Saleh, Isabelle Momas, Lynda Bensefa-Colas

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Professional drivers are exposed inside their vehicles to high levels of air pollutants due to the considerable time they spend close to motor vehicle emissions. Little is known about ultrafine particles (UFP) or black carbon (BC) adverse respiratory health effects compared to the regulated pollutants. We aimed to study the short-term associations between UFP and BC concentrations inside vehicles and (1) the onset of mucosal irritation and (2) the acute changes in lung function of Parisian taxi drivers during a working day. An epidemiological study was carried out on 50 taxi drivers in Paris. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively. On the same day, the frequency and the severity of nose, eye, and throat irritations were self-reported by each participant and a spirometry test was performed before and after the work shift. Multivariate analysis was used to evaluate the associations between in-taxis UFP and BC concentrations and mucosal irritation and lung function, after adjustment for potential confounders. In-taxis UFP concentrations ranged from 17.9 to 37.9 × 103 particles/cm³ and BC concentrations from 2.2 to 3.9 μg/m³, during a mean of 9 ± 2 working hours. Significant dose-response relationships were observed between in-taxis UFP concentrations and both nasal irritation and lung function. The increase of in-taxis UFP (for an interquartile range of 20 × 103 particles/cm3) was associated to an increase in nasal irritation (adjusted OR = 6.27 [95% CI: 1.02 to 38.62]) and to a reduction in forced expiratory flow at 25–75% by −7.44% [95% CI: −12.63 to −2.24], forced expiratory volume in one second by −4.46% [95% CI: −6.99 to −1.93] and forced vital capacity by −3.31% [95% CI: −5.82 to −0.80]. Such associations were not found with BC. Incident throat and eye irritations were not related to in-vehicle particles exposure; however, they were associated with outdoor air quality (estimated by the Atmo index) and in-vehicle humidity, respectively. This study is the first to show a significant association, within a short-period of time, between in-vehicle UFP exposure and acute respiratory effects in professional drivers.

Keywords: black carbon, lung function, mucosal irritation, taxi drivers, ultrafine particles

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Authors: Ghada Ben Brahim, Aicha El Rabia, Mohamed Hedi Inoubli

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Climate change has exacerbated disparities in the distribution of water resources in Tunisia, resulting in significant degradation in quantity and quality over the past five decades. The Mio-Plio-Quaternary aquifer, the primary water source in the Zarzis region, is subject to climatic, geographical, and geological challenges, as well as human stress. The region is experiencing uneven distribution and growing threats from groundwater salinity and saltwater intrusion. Addressing this challenge is critical for the arid region’s socioeconomic development, and effective water resource management is required to combat climate change and reduce water deficits. This study uses a multidisciplinary approach to determine the groundwater potential of this aquifer, involving geophysics and hydrogeology data analysis. We used advanced techniques such as 3D Euler deconvolution and power spectrum analysis to generate detailed anomaly maps and estimate the depths of density sources, identifying significant Bouguer anomalies trending E-W, NW-SE, and NE-SW. Various techniques, such as wavelength filtering, upward continuation, and horizontal and vertical derivatives, were used to improve the gravity data, resulting in consistent results for anomaly shapes and amplitudes. The Euler deconvolution method revealed two prominent surface faults, trending NE-SW and NW-SE, that have a significant impact on the distribution of sedimentary facies and water quality within the Mio-Plio-Quaternary aquifer. Additionally, depth maxima greater than 1400 m to the North indicate the presence of a Cretaceous paleo-fault. Geoelectrical models and resistivity pseudo-sections were used to interpret the distribution of electrical facies in the Mio-Plio-Quaternary aquifer, highlighting lateral variation and depositional environment type. AI optimises the analysis and interpretation of exploration data, which is important to long-term management and water security. Machine learning algorithms and deep learning models analyse large datasets to provide precise interpretations of subsurface conditions, such as aquifer salinisation. However, AI has limitations, such as the requirement for large datasets, the risk of overfitting, and integration issues with traditional geological methods.

Keywords: mio-plio-quaternary aquifer, Southeastern Tunisia, geophysical methods, hydrogeological analysis, artificial intelligence

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Authors: Khan Md. Abdus Subhan, Rabeya Bushra

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The management of Intellectual Property (IP) in museums can be complex and challenging, as it requires balancing access and control. On the one hand, museums must ensure that they have balanced permissions to display works in their collections and make them accessible to the public. On the other hand, they must also protect the rights of creators and owners of works and ensure that they are not infringing on IP rights. Intellectual property has become an increasingly important aspect of museum operations in the digital age. Museums hold a vast array of cultural assets in their collections, many of which have significant value as IP assets. The balanced management of IP in museums can help generate additional revenue and promote cultural heritage while also protecting the rights of the museum and its collections. Digital technologies have greatly impacted the way museums manage IP, providing new opportunities for revenue generation through e-commerce and licensing while also presenting new challenges related to IP protection and management. Museums must take a comprehensive approach to IP management, leveraging digital technologies, protecting IP rights, and engaging in licensing and e-commerce activities to maximize income and the economy of countries through the strong management of cultural institutions. Overall, the balanced management of IP in museums is crucial for ensuring the sustainability of museum operations and for preserving cultural heritage for future generations. By taking a balanced approach to identifying museum IP assets, museums can generate revenues and secure their financial sustainability to ensure the long-term preservation of their cultural heritage. We can divide IP assets in museums into two kinds: collection IP and museum-generated IP. Certain museums become confused and lose sight of their mission when trying to leverage collections-based IP. This was the case at the German State Museum in Berlin when the museum made 100 replicas from the Nefertiti bust and wrote under the replicas all rights reserved to the Berlin Museum and issued a certificate to prevent any person or Institution from reproducing any replica from this bust. The implications of IP in museums are far-reaching and can have significant impacts on the preservation of cultural heritage, the dissemination of information, and the development of educational programs. As such, it is important for museums to have a comprehensive understanding of IP laws and regulations and to properly manage IP to avoid legal liability, damage to reputation, and loss of revenue. The research aims to highlight the importance and role of intellectual property in museums and provide some illustrative examples of this.

Keywords: zakat, economic development, Muslim world, poverty alleviation.

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Authors: Kristof Grätz

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Background: Coping with crisis situations (e.g., the identity crisis in adolescence) is omnipresent in today's socialization and should be encouraged as a child. For this reason, students should be given the opportunity to create, endure and manage these crisis situations in a sporting context within the project “Herausforderung.” They should prove themselves by working on a self-assigned task, accompanied by ‚coaches’ in a place outside of their hometown. The aim of the project is to observe this process from a resource-oriented perspective. Health promotion, as called for by the WHO in the Ottawa Charter since 1986, includes strengthening psychosocial resources. These include cognitive, emotional, and social potentials that contribute to improving the quality of life, provide favourable conditions for coping with health burdens and enable people to influence their physical performance and well-being self-confidently and actively. A systematic strengthening of psychosocial resources leads to an improvement in mental health and contributes decisively to the regular implementation and long-term maintenance of this health behavior. Previous studies have already shown significant increases in self-concept following experiential educational measures [Fengler, 2007; Eberle & Fengler, 2018] and positive effects of experience-based school trips on the social competence of students [Reuker, 2009]. Method: The research project examines the influence of the project “Herausforderung” on psychosocial resources such as self-efficacy, self-concept, social support, and group cohesion. The students participating in the project will be tested in a pre-post design in the context of the challenge. This test includes specific questions to capture the different psychosocial resources. For the measurement, modifications of existing scales with good item selectivity and reliability are used to a large extent, so that acceptable item and scale values can be expected. If necessary, the scales were adapted or shortened to the specific context in order to ensure a balanced relationship between reliability and test economy. Specifically, these are already tested scales such as FRKJ 8-16, FSKN, GEQ, and F-SozU. The aim is to achieve a sample size of n ≥ 100. Conclusion: The project will be reviewed with regard to its effectiveness, and implications for a resource-enhancing application in sports settings will be given. Conclusions are drawn as to which extent to specific experiential educational content in physical education can have a health-promoting effect on the participants.

Keywords: children, education, health promotion, psychosocial resources

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Danni Cheng

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Background: Preclinical and epidemiological studies have reported potential protective effects of low-density lipoprotein cholesterol (LDL-C) lowering drugs on head and neck squamous cell cancer (HNSCC) survival, but the causality was not consistent. Genetic variants associated with LDL-C lowering drug targets can predict the effects of their therapeutic inhibition on disease outcomes. Objective: We aimed to evaluate the causal association of genetically proxied cholesterol-lowering drug targets and circulating lipid traits with cancer survival in HNSCC patients stratified by human papillomavirus (HPV) status using two-sample Mendelian randomization (MR) analyses. Method: Single-nucleotide polymorphisms (SNPs) in gene region of LDL-C lowering drug targets (HMGCR, NPC1L1, CETP, PCSK9, and LDLR) associated with LDL-C levels in genome-wide association study (GWAS) from the Global Lipids Genetics Consortium (GLGC) were used to proxy LDL-C lowering drug action. SNPs proxy circulating lipids (LDL-C, HDL-C, total cholesterol, triglycerides, apoprotein A and apoprotein B) were also derived from the GLGC data. Genetic associations of these SNPs and cancer survivals were derived from 1,120 HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and 2,570 non-HPV-driven HNSCC patients in VOYAGER program. We estimated the causal associations of LDL-C lowering drugs and circulating lipids with HNSCC survival using the inverse-variance weighted method. Results: Genetically proxied HMGCR inhibition was significantly associated with worse overall survival (OS) in non-HPV-drive HNSCC patients (inverse variance-weighted hazard ratio (HR IVW), 2.64[95%CI,1.28-5.43]; P = 0.01) but better OS in HPV-positive OPSCC patients (HR IVW,0.11[95%CI,0.02-0.56]; P = 0.01). Estimates for NPC1L1 were strongly associated with worse OS in both total HNSCC (HR IVW,4.17[95%CI,1.06-16.36]; P = 0.04) and non-HPV-driven HNSCC patients (HR IVW,7.33[95%CI,1.63-32.97]; P = 0.01). A similar result was found that genetically proxied PSCK9 inhibitors were significantly associated with poor OS in non-HPV-driven HNSCC (HR IVW,1.56[95%CI,1.02 to 2.39]). Conclusion: Genetically proxied long-term HMGCR inhibition was significantly associated with decreased OS in non-HPV-driven HNSCC and increased OS in HPV-positive OPSCC. While genetically proxied NPC1L1 and PCSK9 had associations with worse OS in total and non-HPV-driven HNSCC patients. Further research is needed to understand whether these drugs have consistent associations with head and neck tumor outcomes.

Keywords: Mendelian randomization analysis, head and neck cancer, cancer survival, cholesterol, statin

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Authors: Jamie L. Stangel

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Increased popularity and visibility of college athletics have contributed to an environment in which institutions -most of which lack self-sufficient athletics department budgets- reallocate monies from the university general fund and seek additional funding sources to keep up with increasing levels of spending on athletics. Given the prevalence of debates on student debt levels, coach salaries, and athlete pay, empirical evidence on whether this spending yields an expected return on investment is necessary. This study considered the relationship between the independent variable of the winning percentage of the men’s basketball team at a mid-major university, moderated by NCAA tournament appearance, number of applicants, number of enrollments, average SAT score of students, and donor giving to the university general and athletic funds. The results indicate that, other than a small correlation between athletic success and number of applicants, only when NCAA tournament appearance is used as a moderating variable, these purported benefits are not supported, suggesting the need for a reevaluation of athletic department spending and perceptions on tangible and intangible benefits for universities.

Keywords: athletic success, enrollment, NCAA, private giving

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Authors: Okoro Ikechukwu Ralph, Fuat Kara

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The discoveries of hydrocarbon reserves has clearly drifted offshore, and in deeper waters - areas where the industry still has limited knowledge; and that were hitherto, regarded as being out of reach. This shift presents significant and increased challenges in technology requirements needed to guarantee safety of personnel, environment and equipment; ensure high reliability of installed equipment; and provide high level of confidence in security of investment and company reputation. Nowhere are these challenges more apparent than on subsea well integrity and production performance. The past two decades has witnessed enormous rise in deep and ultra-deep water offshore field developments for the recovery of hydrocarbons. Subsea installed equipment at the seabed has been the technology of choice for these developments. This paper discusses the role of Subsea Control module (SCM) as a vital factor for deep-water well integrity and production performance. A case study for Deep-water well integrity and production performance is analysed.

Keywords: offshore reliability, production performance, subsea control module, well integrity

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Authors: Francesco Scarpati

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Because of their long history, ranging from ancient times to the present day, European cities feature many historical layers, whose single identities are represented by traces surviving in the urban design. However, urban transformations, in particular, the ones that have been produced by the property speculation phenomena of the 20th century, often compromised the readability of these traces, resulting in a loss of the historical identities of the single layers. The purpose of this research is, therefore, a reflection on the theme of the reenactment of the historical memory in the stratified European contexts and on how contemporary architecture can help to reveal past signs of the cities. The research work starts from an analysis of a series of emblematic examples that have already provided an original solution to the described problem, going from the architectural detail scale to the urban and landscape scale. The results of these analyses are then applied to the case study of the city of Naples, as an emblematic example of a stratified city, with an ancient Greek origin; a city where it is possible to read most of the traces of its transformations. Particular consideration is given to the trace of the medieval walls of the city, which a long time ago clearly divided the city itself from the outer fields, and that is no longer readable at the current time. Finally, solutions and methods of intervention are proposed to ensure that the trace of the walls, read as a boundary, can be revealed through the contemporary project.

Keywords: contemporary project, historic memory, historic urban contexts, medieval walls, naples, stratified cities, urban traces

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Authors: Yongjun Zeng, Shan Huang, Guanjun Huang, Changzhi Long

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The chalkiness, starch fine structure, and physiochemical properties of rice starch were analyzed, and their correlations were investigated under different nighttime temperatures during the early grain-filling stage. Compared to MT, medium temperature (MT) and low (LNT) and high (HNT) nighttime temperatures resulted in an increased chalky grain rate (CGR) and chalkiness degree (CD). LNT mainly affected the chalkiness by increasing peak1 (short branch chains of amylopectin), the branching degree, and the proportion of small starch granules but decreasing peak2 (long branch chains of amylopectin) and peak 3 (amylose branches). This altered the pasting properties, such as by increasing the peak viscosity and final viscosity. However, HNT mainly affected the chalkiness by increasing peak 2 and the crystalline degree but decreasing peak 1 and peak 3. Regarding the thermal properties, HNT also elevated peak and conclusion temperatures. The CGR and CD were significantly and positively correlated with the proportions of small and medium starch granules, peak1, branching degree, gelatinization enthalpy, setback viscosity, and pasting time but markedly and negatively correlated with the proportion of large starch granules, amylose content, peak 3, peak viscosity, and breakdown viscosity. These findings suggest that LNT and HNT disrupted the starch structure, resulting in increased chalkiness. However, their mechanisms of action differ.

Keywords: chalkiness, starch fine structure, different nighttime temperatures, early grain-filling stage

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Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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Authors: Lahcen Daoudi, Fatima Zahra Omdi, Abldelali Gourfi

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In Morocco, as in most Mediterranean countries, water scarcity is a common situation because of low and unevenly distributed rainfall. The expansions of irrigated lands, as well as the growth of urban and industrial areas and tourist resorts, contribute to an increase of water demand. Therefore in the 1960s Morocco embarked on an ambitious program to increase the number of dams to boost water retention capacity. However, the decrease in the capacity of these reservoirs caused by sedimentation is a major problem; it is estimated at 75 million m3/year. Dams and reservoirs became unusable for their intended purposes due to sedimentation in large rivers that result from soil erosion. Soil erosion presents an important driving force in the process affecting the landscape. It has become one of the most serious environmental problems that raised much interest throughout the world. Monitoring soil erosion risk is an important part of soil conservation practices. The estimation of soil loss risk is the first step for a successful control of water erosion. The aim of this study is to estimate the soil loss risk and its spatial distribution in the different fields of Morocco and to prioritize areas for soil conservation interventions. The approach followed is the Revised Universal Soil Loss Equation (RUSLE) using remote sensing and GIS, which is the most popular empirically based model used globally for erosion prediction and control. This model has been tested in many agricultural watersheds in the world, particularly for large-scale basins due to the simplicity of the model formulation and easy availability of the dataset. The spatial distribution of the annual soil loss was elaborated by the combination of several factors: rainfall erosivity, soil erodability, topography, and land cover. The average annual soil loss estimated in several basins watershed of Morocco varies from 0 to 50t/ha/year. Watersheds characterized by high-erosion-vulnerability are located in the North (Rif Mountains) and more particularly in the Central part of Morocco (High Atlas Mountains). This variation of vulnerability is highly correlated to slope variation which indicates that the topography factor is the main agent of soil erosion within these basin catchments. These results could be helpful for the planning of natural resources management and for implementing sustainable long-term management strategies which are necessary for soil conservation and for increasing over the projected economic life of the dam implemented.

Keywords: soil loss, RUSLE, GIS-remote sensing, watershed, Morocco

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Authors: Athina Thanou, Eirini Eleni Tsiropoulou, Symeon Papavassiliou

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The problem of museum visitor experience and congestion management – in various forms - has come increasingly under the spotlight over the last few years, since overcrowding can significantly decrease the quality of visitors’ experience. Evidence suggests that on busy days the amount of time a visitor spends inside a crowded house museum can fall by up to 60% compared to a quiet mid-week day. In this paper we consider the aforementioned problem, by treating museums as evolving social systems that induce constraints. However, in a cultural heritage space, as opposed to the majority of social environments, the momentum of the experience is primarily controlled by the visitor himself. Visitors typically behave selfishly regarding the maximization of their own Quality of Experience (QoE) - commonly expressed through a utility function that takes several parameters into consideration, with crowd density and waiting/visiting time being among the key ones. In such a setting, congestion occurs when either the utility of one visitor decreases due to the behavior of other persons, or when costs of undertaking an activity rise due to the presence of other persons. We initially investigate how visitors’ behavioral risk attitudes, as captured and represented by prospect theory, affect their decisions in resource sharing settings, where visitors’ decisions and experiences are strongly interdependent. Different from the majority of existing studies and literature, we highlight that visitors are not risk neutral utility maximizers, but they demonstrate risk-aware behavior according to their personal risk characteristics. In our work, exhibits are organized into two groups: a) “safe exhibits” that correspond to less congested ones, where the visitors receive guaranteed satisfaction in accordance with the visiting time invested, and b) common pool of resources (CPR) exhibits, which are the most popular exhibits with possibly increased congestion and uncertain outcome in terms of visitor satisfaction. A key difference is that the visitor satisfaction due to CPR strongly depends not only on the invested time decision of a specific visitor, but also on that of the rest of the visitors. In the latter case, the over-investment in time, or equivalently the increased congestion potentially leads to “exhibit failure”, interpreted as the visitors gain no satisfaction from their observation of this exhibit due to high congestion. We present a framework where each visitor in a distributed manner determines his time investment in safe or CPR exhibits to optimize his QoE. Based on this framework, we analyze and evaluate how visitors, acting as prospect-theoretic decision-makers, respond and react to the various pricing policies imposed by the museum curators. Based on detailed evaluation results and experiments, we present interesting observations, regarding the impact of several parameters and characteristics such as visitor heterogeneity and use of alternative pricing policies, on scalability, user satisfaction, museum capacity, resource fragility, and operation point stability. Furthermore, we study and present the effectiveness of alternative pricing mechanisms, when used as implicit tools, to deal with the congestion management problem in the museums, and potentially decrease the exhibit failure probability (fragility), while considering the visitor risk preferences.

Keywords: museum resource and visitor management, congestion management, propsect theory, cyber physical social systems

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Authors: Mikhail Zimin, Svetlana Zimina, Maxim Zimin

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Without question, the basic method of prevention of human and material losses is the provision for adequate strength of constructions. At the same time, seismic load has a stochastic character. So, at all times, there is little danger of earthquake forces exceeding the selected design load. This risk is very low, but the consequences of such events may be extremely serious. Very dangerous are also occasional mistakes in seismic zoning, soil conditions changing before temblors, and failure to take into account hazardous natural phenomena caused by earthquakes. Besides, it is known that temblors detrimentally affect the environmental situation in regions where they occur, resulting in panic and worsening various disease courses. It may lead to mistakes of personnel of hazardous production facilities like the production and distribution of gas and oil, which may provoke severe accidents. In addition, gas and oil pipelines often have long mileage and cross many perilous zones by contrast with buildings. This situation increases the risk of heavy accidents. In such cases, complex monitoring of potential earthquake localities would be relevant. Even though the number of successful real-time forecasts of earthquakes is not great, it is well in excess, such as may be under random guessing. Experimental performed time-lapse study and analysis consist of searching seismic, biological, meteorological, and light earthquake precursors, processing such data with the help of fuzzy sets, collecting weather information, utilizing a database of terrain, and computing risk of slope processes under the temblor in a given setting. Works were done in a real-time environment and broadly acceptable results took place. Observations from already in-place seismic recording systems are used. Furthermore, a look back study of precursors of known earthquakes is done. Situations before Ashkhabad, Tashkent, and Haicheng seismic events are analyzed. Fairish findings are obtained. Results of earthquake forecasts can be used for predicting dangerous natural phenomena caused by temblors such as avalanches and mudslides. They may also be utilized for prophylaxis of some diseases and their complications. Relevant software is worked out too. It should be emphasized that such control does not require serious financial expenses and can be performed by a small group of professionals. Thus, complex monitoring of potential earthquake localities, including short-term earthquake forecasts and analysis of possible hazardous consequences of temblors, may further the safety of pipeline facilities.

Keywords: risk, earthquake, monitoring, forecast, precursor

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Authors: Suneet Jagdev

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The development of the original Bauhaus occurred at a time in the beginning of the 20th century when the industrialization of Germany had reached a climax. The cities were a reflection of the new living conditions of an industrialized society. The Bauhaus can be interpreted as an ambitious attempt to find appropriate answers to the challenges by using architecture-urban development and design. The core elements of the conviction of the day were the belief in the necessary crossing of boundaries between the various disciplines and courage to experiment for a better solution. Even after 100 years, the situation in our cities is shaped by similar complexity. The urban consequences of developments are difficult to estimate and to predict. The paper critically reflected on the central aspects of the history of the Bauhaus and its role in bringing the modernism in India by comparative studies of the methodology adopted by the artists and designer in both the countries. The paper talked in detail about how the Bauhaus Exhibition in 1922 offered Indian artists a new weapon of anti-colonial resistance. The original Bauhaus fought its aesthetic and political battles in the context of economic instability and the rise of German fascism. The Indians had access to dominant global languages and in a particular English. The availability of print media and a vibrant indigenous intellectual culture provided Indian people a tool to accept technology while denying both its dominant role in culture and the inevitability of only one form of modernism. The indigenous was thus less an engagement with their culture as in the West than a tool of anti-colonial struggle. We have shown how the Indian people used Bauhaus as a critique of colonialism itself through an undermining of its typical modes of representation and as a means of incorporating the Indian desire for spirituality into art and as providing the cultural basis for a non-materialistic and anti-industrial form of what we might now term development. The paper reflected how through painting the Bauhaus entered the artistic consciousness of the sub-continent not only for its stylistic and technical innovations but as a tool for a critical and even utopian modernism that could challenge both the hegemony of academic and orientalist art and as the bearer of a transnational avant-garde as much political as it was artistic, and as such the basis of a non-Eurocentric but genuinely cosmopolitan alternative to the hierarchies of oppression and domination that had long bound India and were at that moment rising once again to a tragic crescendo in Europe. We have talked about how the Bauhaus of today can offer an innovative orientation towards discourse around architecture and design.

Keywords: anti-colonial struggle, art over architecture, Bauhaus exhibition of 1922, industrialization

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Authors: Nikita Koradia

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Hyundai Motor Company, which started off as a small fish in a big sea, paved its way out successfully and established itself as an independent group from the conglomerate. Hyundai, with its officious power across the globe and particularly in South Korea in the automobile industry, has one the most complex yet fascinating governance structure. Being the second largest contributor to the Gross Domestic Product of South Korea after Samsung and having a market share of 51.3% domestically in automobile industry, Hyundai has faced its part of criticism owing to its anti-labor union approach and owing to its internalization of supply chain management. The censure has been coming from across jurisdictions like China, India, Canada, the EU, etc. The paper focuses on the growth of Hyundai and its inward and outward investment structure. The paper questions the ability of Hyundai to become a mini-state in itself by focusing on its governance structure. The paper further elaborates on its compliance and disclosure regime in the field of Corporate social responsibility and explores how far the business structure adopted by Hyundai works in its favor to become one of the leading automobile contenders in the market.

Keywords: compliance regime, disclosure regime, Hyundai motor company, supply-chain management

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Authors: Anna Carolina De Paula Sermarini, Rodrigo Flora Calili

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Energy Efficiency (EE) needs investments, new technologies, greater awareness and management on the side of citizens and organizations, and more planning. However, this issue is usually remembered and discussed only in moments of energy crises, and opportunities are missed to take better advantage of the potential of EE in the various sectors of the economy. In addition, there is little concern about the subject among the less favored classes, especially in low-income communities. Accordingly, this article presents suggestions for public policies that aim to increase EE for low-income housing and communities based on international and national experiences. After reviewing the literature, eight policies were listed, and to evaluate them; a multicriteria decision model was developed using the AHP (Analytical Hierarchy Process) and TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) methods, combined with fuzzy logic. Nine experts analyzed the policies according to 9 criteria: economic impact, social impact, environmental impact, previous experience, the difficulty of implementation, possibility/ease of monitoring and evaluating the policies, expected impact, political risks, and public governance and sustainability of the sector. The results found in order of preference are (i) Incentive program for equipment replacement; (ii) Community awareness program; (iii) EE Program with a greater focus on low income; (iv) Staggered and compulsory certification of social interest buildings; (v) Programs for the expansion of smart metering, energy monitoring and digitalization; (vi) Financing program for construction and retrofitting of houses with the emphasis on EE; (vii) Income tax deduction for investment in EE projects in low-income households made by companies; (viii) White certificates of energy for low-income. First, the policy of equipment substitution has been employed in Brazil and the world and has proven effective in promoting EE. For implementation, efforts are needed from the federal and state governments, which can encourage companies to reduce prices, and provide some type of aid for the purchase of such equipment. In second place is the community awareness program, promoting socio-educational actions on EE concepts and with energy conservation tips. This policy is simple to implement and has already been used by many distribution utilities in Brazil. It can be carried out through bids defined by the government in specific areas, being executed by third sector companies with public and private resources. Third on the list is the proposal to continue the Energy Efficiency Program (which obliges electric energy companies to allocate resources for research in the area) by suggesting the return of the mandatory investment of 60% of the resources in projects for low income. It is also relatively simple to implement, requiring efforts by the federal government to make it mandatory, and on the part of the distributors, compliance is needed. The success of the suggestions depends on changes in the established rules and efforts from the interested parties. For future work, we suggest the development of pilot projects in low-income communities in Brazil and the application of other multicriteria decision support methods to compare the results obtained in this study.

Keywords: energy efficiency, low-income community, public policy, multicriteria decision making

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Authors: James Beauchemin

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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: yoga, mental health, incarceration, wellness

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Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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Authors: Corinna Zeli, Silvia Calati, Marco Simeoni, Chiara Comastri

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Developmental stuttering affects about 10% of preschool children; although the high percentage of natural recovery, a quarter of them will become an adult who stutters. An effective early intervention should help those children with high persistence risk for the future. The Psicodizione method for early stuttering is an Italian behavior indirect treatment for preschool children who stutter in which method parents act as good guides for communication, modeling their own fluency. In this study, we give a preliminary measure to evaluate the long-term effectiveness of Psicodizione method on stuttering preschool children with a high persistence risk. Among all Italian children treated with the Psicodizione method between 2018 and 2019, we selected 8 kids with at least 3 high risk persistence factors from the Illinois Prediction Criteria proposed by Yairi and Seery. The factors chosen for the selection were: one parent who stutters (1pt mother; 1.5pt father), male gender, ≥ 4 years old at onset; ≥ 12 months from onset of symptoms before treatment. For this study, the families were contacted after an average period of time of 14,7 months (range 3 - 26 months). Parental reports were gathered with a standard online questionnaire in order to obtain data reflecting fluency from a wide range of the children’s life situations. The minimum worthwhile outcome was set at "mild evidence" in a 5 point Likert scale (1 mild evidence- 5 high severity evidence). A second group of 6 children, among those treated with the Piscodizione method, was selected as high potential for spontaneous remission (low persistence risk). The children in this group had to fulfill all the following criteria: female gender, symptoms for less than 12 months (before treatment), age of onset <4 years old, none of the parents with persistent stuttering. At the time of this follow-up, the children were aged 6–9 years, with a mean of 15 months post-treatment. Among the children in the high persistence risk group, 2 (25%) hadn’t had stutter anymore, and 3 (37,5%) had mild stutter based on parental reports. In the low persistency risk group, the children were aged 4–6 years, with a mean of 14 months post-treatment, and 5 (84%) hadn’t had stutter anymore (for the past 16 months on average).62,5% of children at high risk of persistence after Psicodizione treatment showed mild evidence of stutter at most. 75% of parents confirmed a better fluency than before the treatment. The low persistence risk group seemed to be representative of spontaneous recovery. This study’s design could help to better evaluate the success of the proposed interventions for stuttering preschool children and provides a preliminary measure of the effectiveness of the Psicodizione method on high persistence risk children.

Keywords: early treatment, fluency, preschool children, stuttering

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Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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Authors: Mehdi Tajdari, Farzad Mokhtarnejad, Fatemeh Moradi, Mehdi Najafizadeh

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Nowadays, energy absorbing devices have been widely used in all vehicles and moving parts such as railway couches, aircraft, ships and lifts. The aim is to protect these structures from serious damages while subjected to impact loads, or to minimize human injuries while collision is occurred in transportation systems. These energy-absorbing devices can dissipate kinetic energy in a wide variety of ways like friction, facture, plastic bending, crushing, cyclic plastic deformation and metal cutting. On the other hand, various structures may be used as collapsible energy absorbers. Metallic cylindrical tubes have attracted much more attention due to their high stiffness and strength combined with the low weight and ease of manufacturing process. As a matter of fact, favorable crash worthiness characteristics for energy dissipation purposes can be achieved from axial collapse of tubes while they crush progressively in symmetric modes. However, experimental and theoretical results have shown that depending on various parameters such as tube geometry, material properties of tube, boundary and loading conditions, circular tubes buckle in different modes of deformation, namely, diamond and Euler collapsing modes. It is shown that when the tube length is greater than the critical length, the tube deforms in overall Euler buckling mode, which is an inefficient mode of energy absorption and needs to be avoided in crash worthiness applications. This study develops a new method with the aim of improving energy absorption characteristics of long steel circular tubes. Inserting a helical spring into the tubes is proved experimentally to be an efficient solution. In fact when a long tube is subjected to axial compression load, the spring prevents of undesirable Euler or diamond collapsing modes. This is because the spring reinforces the internal wall of tubes and it causes symmetric deformation in tubes. In this research three specimens were prepared and three tests were performed. The dimensions of tubes were selected so that in axial compression load buckling is occurred. In the second and third tests a spring was inserted into tubes and they were subjected to axial compression load in quasi-static and impact loading, respectively. The results showed that in the second and third tests buckling were not happened and the tubes deformed in symmetric modes which are desirable in energy absorption.

Keywords: energy absorption, circular tubes, collapsing deformation, crashworthiness

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