Search results for: primary prevention

Authors: Justine Cyril E. Nunag, Nestor B. Sabado Jr., Jienne Chester M. Tolosa

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Concrete has high compressive strength but a low-tension strength. The small tensile strength of concrete is regarded as its primary weakness, which is why it is typically reinforced with steel, a material that is resistant to tension. Even with steel, however, cracking can occur. In strengthening concrete, only a few researchers have modified the water to be used in a concrete mix. This study aims to compare the split tensile strength of normal structural concrete to concrete prepared with magnetic water and a quick setting admixture. In this context, magnetic water is defined as tap water that has undergone a magnetic process to become magnetized water. To test the hypothesis that magnetized concrete leads to higher split tensile strength, twenty concrete specimens were made. There were five groups, each with five samples, that were differentiated by the number of cycles (0, 50, 100, and 150). The data from the Universal Testing Machine's split tensile strength were then analyzed using various statistical models and tests to determine the significant effect of magnetized water. The result showed a moderate (+0.579) but still significant degree of correlation. The researchers also discovered that using magnetic water for 50 cycles did not result in a significant increase in the concrete's split tensile strength, which influenced the analysis of variance. These results suggest that a concrete mix containing magnetic water and a quick-setting admixture alters the typical split tensile strength of normal concrete. Magnetic water has a significant impact on concrete tensile strength. The hardness property of magnetic water influenced the split tensile strength of concrete. In addition, a higher number of cycles results in a strong water magnetism. The laboratory test results show that a higher cycle translates to a higher tensile strength.

Keywords: hardness property, magnetic water, quick-setting admixture, split tensile strength, universal testing machine

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Authors: Xu Yifei, Le Yining, Yang Qingluan, Tu Yanjie

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Objective: This study aims to investigate the distribution features of Traditional Chinese Medicine (TCM) syndromes and syndrome elements in Epstein-Barr virus-associated diseases and then explores the relations between TCM syndromes or syndrome elements and laboratory indicators of Epstein-Barr virus-associated diseases. Methods: A cross-sectional study of 70 patients with EBV infection was described. We assessed the diagnostic information and laboratory indicators of these patients from Huashan Hospital Affiliated to Fudan University between November 2017 and July 2019. The disease diagnosis and syndrome differentiation were based on the diagnostic criteria of EBV-associated diseases and the theory of TCM respectively. Confidence correlation analysis, logistic regression analysis, cluster analysis, and the Sankey diagram were used to analyze the correlation between the data. Results: The differentiation of the 4 primary TCM syndromes in the collected patients was correlated with the indexes of immune function, liver function, inflammation, and anemia, especially the relationship between Qifen syndrome and high lactic acid dehydrogenase level. The common 11 TCM syndrome elements were associated with the increased CD3+ T cell rate, low hemoglobin level, high procalcitonin level, high lactic acid dehydrogenase level, and low albumin level. Conclusion: The changes in immune function indexes, procalcitonin, and liver function-related indexes in patients with EBV-associated diseases were consistent with the evolution law of TCM syndromes. This study provides a reference for judging the pathological stages of these kinds of diseases, predicting their prognosis, and guiding subsequent treatment strategies based on TCM syndrome type.

Keywords: EBV-associated diseases, traditional Chinese medicine syndrome, syndrome element, diagnostics

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Authors: Maria Jose Mendoza Gordillo

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Introduction: Research regarding breastfeeding is devoted to how essential breastfeeding is to guarantee wellbeing for the mother and the baby from a medical standpoint relegating the cultural, material and social barriers for breastfeeding. Consequently, worldwide breastfeeding rates are low, and Ecuador is not the exception, especially among working mothers. Worldwide, health care providers have low rates of breastfeeding due to several barriers to lactation, such as the work schedule, a lack of private places for pumping while at work, and negative emotions. Goals and Methods: This study aimed to explore how do Ecuadorian women embrace their identities as nutritionists and mothers within their breastfeeding experience. The primary data come from 20 synchronous semi-structured interviews, which follow a topic guide. The interviews were recorded and transcribed verbatim. The data analysis followed the Phronetic Iterative Approach. Results: Women shifted the preconceived idea of the ideal breastfeeding that came from the medicalized discourse of breastfeeding, and that was constructed in their training as nutritionists. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted through the experience of motherhood. When these women developed their identity as mothers, they understood that the ideal breastfeeding is different from the medicalized discourse. Although they have that clash between the ideal and the external reality, they continued breastfeeding their babies and those experiences made them improve their professional practice. Conclusions: The narratives that women shared illustrate how complex it was to manage the different roles and identities that they wanted to fulfill to keep their identity of a good mother who breastfeeds her baby and, at the same time, a good healthcare provider identity. The process of breastfeeding for this group of women who are mothers and healthcare professionals appears to be a unique relational and identity negotiation process.

Keywords: breastfeeding, identity, nutritionist, qualitative

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Authors: Franklin N. Mabe, Samuel A. Donkoh, Seidu Al-Hassan

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In order to increase and bridge the differences in rice yield, many farmers have resorted to adopting Farmer Innovation Systems (FISs) and Improved Agricultural Technologies (IATs). This study econometrically analysed the impacts of adoption of FISs and IATs on rice yield using multinomial endogenous switching regression (MESR). Nine-hundred and seven (907) rice farmers from Guinea Savannah Zone (GSZ), Forest Savannah Transition Zone (FSTZ) and Coastal Savannah Zone (CSZ) were used for the study. The study used both primary and secondary data. FBO advice, rice farming experience and distance from farming communities to input markets increase farmers’ adoption of only FISs. Factors that increase farmers’ probability of adopting only IATs are access to extension advice, credit, improved seeds and contract farming. Farmers located in CSZ have higher probability of adopting only IATs than their counterparts living in other agro-ecological zones. Age and access to input subsidy increase the probability of jointly adopting FISs and IATs. FISs and IATs have heterogeneous impact on rice yield with adoption of only IATs having the highest impact followed by joint adoption of FISs and IATs. It is important for stakeholders in rice subsector to champion the provision of improved rice seeds, the intensification of agricultural extension services and contract farming concept. Researchers should endeavour to researched into FISs.

Keywords: farmer innovation systems, improved agricultural technologies, multinomial endogenous switching regression, treatment effect

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Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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Authors: Sijing Xiong, Ran Su, Lit-Hsin Loo, Daniele Zink

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The kidney is a major target for toxic effects of drugs, industrial and environmental chemicals and other compounds. Typically, nephrotoxicity is detected late during drug development, and regulatory animal models could not solve this problem. Validated or accepted in silico or in vitro methods for the prediction of nephrotoxicity are not available. We have established the first and currently only pre-validated in vitro models for the accurate prediction of nephrotoxicity in humans and the first predictive platforms based on renal cells derived from human pluripotent stem cells. In order to further improve the efficiency of our predictive models, we recently developed a high content screening (HCS) platform. This platform employed automated imaging in combination with automated quantitative phenotypic profiling and machine learning methods. 129 image-based phenotypic features were analyzed with respect to their predictive performance in combination with 44 compounds with different chemical structures that included drugs, environmental and industrial chemicals and herbal and fungal compounds. The nephrotoxicity of these compounds in humans is well characterized. A combination of chromatin and cytoskeletal features resulted in high predictivity with respect to nephrotoxicity in humans. Test balanced accuracies of 82% or 89% were obtained with human primary or immortalized renal proximal tubular cells, respectively. Furthermore, our results revealed that a DNA damage response is commonly induced by different PTC-toxicants with diverse chemical structures and injury mechanisms. Together, the results show that the automated HCS platform allows efficient and accurate nephrotoxicity prediction for compounds with diverse chemical structures.

Keywords: high content screening, in vitro models, nephrotoxicity, toxicity prediction

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Authors: Saumya R. Jha, Krishanu Biswas, Nilesh P. Gurao

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Several recent investigations have revealed medium entropy alloys exhibiting better mechanical properties than their high entropy counterparts. This clearly establishes that although a higher entropy plays a vital role in stabilization of particular phase over complex intermetallic phases, configurational entropy is not the primary factor responsible for the high inherent strengthening in these systems. Above and beyond a high contribution from friction stresses and solid solution strengthening, strain hardening is an important contributor to the strengthening in these systems. In this regard, researchers have developed severe plastic deformation (SPD) techniques like High Pressure Torsion (HPT) to incorporate very high shear strain in the material, thereby leading to ultrafine grained (UFG) microstructures, which cause manifold increase in the strength. The presented work demonstrates a meticulous study of the variation in mechanical properties at different radial displacements from the center of HPT tested equiatomic ternary FeMnNi synthesized by casting route, which is a low stacking fault energy FCC alloy that shows significantly higher toughness than its high entropy counterparts like Cantor alloy. The gradient in grain sizes along the radial direction of these specimens has been modeled using microstructure entropy for predicting the mechanical properties, which has also been validated by indentation tests. The dislocation density is computed by FEM simulations for varying strains and validated by analyzing synchrotron diffraction data. Thus, the proposed model can be utilized to predict the strengthening behavior of similar systems deformed by HPT subjected to varying loading conditions.

Keywords: high pressure torsion, severe plastic deformation, configurational entropy, dislocation density, FEM simulation

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Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

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Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

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Authors: J. Magerman, P. Martin

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Nursing students' clinical abilities is highly dependent on the quality of the clinical experience obtained while placed in the clinical environment. The clinical environment has amongst other, key role players which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become the best practice nursing professionals. However, globally literature alludes to the failure of educating institutions to deliver competent nursing professionals to meet the needs of patients and deliver quality patient care. At the participating university, this may be due to various factors such as large student numbers and social and environmental challenges experienced by clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors who supervise nursing students at a higher education institution. The study employed a qualitative research approach utilizing a descriptive phenomenological design. Purposive sampling was used to select participants, who supervised first and second year nursing studnets at the higher education institution under study. TH esample comprised of eight clinical supervisors who supervise first and secon year nursing studnets at teh institution under study. Data was collected by means of in-depht interviews. Data was analysed using Collaizzi's seven steps method of qualitative analysis. Five major themes identified , focussed on the experiences regarding time a sa constraint to job productivity, the impact of teh organisational culture on the fluidity of support, interpersonal relationships a sa dynamic communication process, impact on the self, and limited resources. Trustworthiness of the data was ensured by means of applying Guba's model of truth value, applicability, consistency and neutrality. Reflexivity was also used by the researcher to further enhance trustworthiness.

Keywords: clinical supervision, clinical supervisors, nursing students, clinical placements

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Authors: Thananyada Buapian

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Overnutrition is emerging as a morbid disease in developing and Westernized countries. Because of its comorbidity diseases, it is cost-effective to prevent and manage this disease earlier. In Thailand, this alarming disease has long been studied, but the prevalence is still higher than that in the past. Physicians should recognize it well and have a definite direction to face and combat this dangerous disease. Rapid changes in the tremendous figure of overnutrition students indicate that genetic factors are not the primary determinants since human genes have remained unchanged for a century. This study aims to assess the prevalence of overnutrition students and to investigate the non-genetic factors affecting over nutrition students. A cross-sectional school-based survey was conducted. A two-stage sampling was adopted. Respondents included 1,850 students in grades 4 to 6 in Ayutthaya Province. An anthropometric measurement and questionnaire were developed. Childhood over nutrition was defined as a weight-for-height Z-score above +2SD of NCHS/WHO references. About thirty three percent of the children were over nutrition in Ayutthaya province. Stepwise multiple logistic regression analysis showed that 8 statistically significant non genetic factors explain the variation of childhood over nutrition by 18 percent. Sex is the prime factor to explain the variation of childhood over nutrition, followed by duration of light physical activities, duration of moderate physical activities, having been breastfed, the presence of a healthy role model of the caregiver, number of siblings, birth order, and occupation of the caregiver, respectively. Non genetic factors, especially the subjects’ demographic and physical activities, as well as the caregivers’ background and family environment, should be considered in viable approach to remedy this health imbalance in children.

Keywords: non genetic factors, non-genetic, over nutrition, over nutrition students

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Authors: A. Moawad, K. C. Yao, A. Mansour, R. Gautier

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The detecting of an occupied frequency band is a major issue in cognitive radio systems. The detection process becomes difficult if the signal occupying the band of interest has faded amplitude due to multipath effects. These effects make it hard for an occupying user to be detected. This work mitigates the missed-detection problem in the context of cognitive radio in frequency-selective fading channel by proposing blind channel estimation method that is based on scattering transform. By initially applying conventional energy detection, the missed-detection probability is evaluated, and if it is greater than or equal to 50%, channel estimation is applied on the received signal followed by channel equalization to reduce the channel effects. In the proposed channel estimator, we modify the Morlet wavelet by using its first derivative for better frequency resolution. A mathematical description of the modified function and its frequency resolution is formulated in this work. The improved frequency resolution is required to follow the spectral variation of the channel. The channel estimation error is evaluated in the mean-square sense for different channel settings, and energy detection is applied to the equalized received signal. The simulation results show improvement in reducing the missed-detection probability as compared to the detection based on principal component analysis. This improvement is achieved at the expense of increased estimator complexity, which depends on the number of wavelet filters as related to the channel taps. Also, the detection performance shows an improvement in detection probability for low signal-to-noise scenarios over principal component analysis- based energy detection.

Keywords: channel estimation, cognitive radio, scattering transform, spectrum sensing

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Authors: Adrien Cornille, Sylvain Caillol, Bernard Boutevon

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The development of polyurethanes began in 1937 at I. G. Farbenindustrie where Bayer with coworkers discovered the addition polymerization reaction between diisocyanates and diols. Since their discovery, the demand in PU has continued to increase and it will attain in 2016 a production of 18 million tons. However, isocyanates compounds are harmful to human and environment. Methylene diphenyl 4,4’-diisocyanate (MDI) and toluene diisocyanate (TDI), the most widely used isocyanates in PU industry, are classified as CMR (Carcinogen, Mutagen, and Reprotoxic). In order to design isocyanate-free materials, an interesting alternative is the use of Polyhydroxyurethanes (PHUs) by reaction between cyclic carbonate and polyfunctional amines. The main problem concerning PHUs synthesis relates to the low reactivity of carbonate/amine reaction. To solve this issue, many studies in the literature have been conducted to design PHU from more reactive cyclic-carbonates, bearing electro-withdrawing substituent or by using six-membered, seven-membered or thio-cyclic carbonate. The main drawback of all these systems remains the low molar masses obtained for the synthesized PHUs, which hinders their use for material applications. Therefore, we developed another strategy to afford new hybrid PHU with high conversion. This very innovative two-step approach consists in the first step in the synthesis of aminotelechelic PHU oligomers with different chain length from bis-cyclic carbonate with different excess of primary amine functions. In the second step, these aminotelechelic PHU oligomers were used in formulation with biobased epoxy monomers (from cashew nut shell liquid and tannins) to synthesize hybrid polyepoxyurethane polymers. These materials were then characterized by thermal and mechanical analyses.

Keywords: polyurethane, polyhydroxyurethane, aminotelechelic NIPU oligomers, carbonates, epoxy, amine, epoxyurethane polymers, hybrid polymers

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Authors: Lapatrada Numkham, Saowaluk Khakhong, Jeeraporn Kummabutr

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Non-communicable diseases (NCDs) are the leading cause of death in worldwide. Thailand also concerns and focuses on reduction a new case of these diseases. Community Health Volunteers (CHV) is important health personnel in primary health care and performs as a health leader in the community. If the health of CHV changes, it would impact on the performance to promote health of families and community. This cross-sectional study aimed to 1) describe the health status of community health volunteers and 2) examine the factors associated with health status among community health volunteers. The sample included 360 community health volunteers in a province in central Thailand during September-December 2014. Data were collected using questionnaires on health information, knowledge of health behaviors, and health behaviors. Body weight, height, waist circumference (WC), blood pressure (BP), and blood glucose (BS) (fingertip) were assessed. Data were analyzed using descriptive statistics and chi-square test. There were three hundred and sixty participants with 82.5% being women. The mean age was 54 + 8.9 years. Forty-seven percent of the participants had co-morbidities. Hypertension was the most common co-morbidity (26.7%). The results revealed that the health status of the volunteers included: no underlying disease, having risk of hypertension (HT) & diabetes mellitus (DM), and having HT&DM at 38.3%, 30.0%, and 31.7% respectively. The chi-square test revealed that the factors associated with health status among the volunteers were gender, age, WC and body mass index (BMI). The results suggested that community health nurses should; 1) implement interventions to decrease waist circumference and lose weight through education programs, especially females; 2) monitor people that have a risk of HT&DM and that have HT&DM by meeting and recording BP level, BS level, WC and BMI; and 3) collaborate with a district public health officer to initiate a campaign to raise awareness of the risks of chronic diseases among community health volunteers.

Keywords: community health volunteers, health status, risk of non-communicable disease, Thailand

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Authors: Buchh Aqsa, Inayat Umar

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Background- Clonidine, α 2 agonist, possesses several properties to make it valuable adjuvant for spinal anesthesia. The study was aimed to evaluate the clinical effects of oral clonidine premedication for laparoscopic gynecological procedures under subarachnoid block. Patients and method- Sixtyfour adult female patients of ASA physical status I and II, aged 25 to 45 years and scheduled for laparoscopic gynecological procedures under the subarachnoid block, were randomized into two comparable equal groups of 32 patients each to received either oral clonidine, 100 µg (Group I) or placebo (Group II), 90 minutes before the procedure. Subarachnoid block was established with of 3.5 ml of 0.5% hyperbaric bupivacaine in all patients. Onset and duration of sensory and motor block, maximum cephalad level, and the regression time to reach S1 sensory level were assessed as primary end points. Sedation, hemodynamic variability, and respiratory depression or any other side effects were evaluated as secondary outcomes. Results- The demographic profile was comparable. The intraoperative hemodynamic parameters showed significant differences between groups. Oral clonidine was accelerated the onset time of sensory and motor blockade and extended the duration of sensory block (216.4 ± 23.3 min versus 165 ± 37.2 min, P <0.05). The duration of motor block showed no significant difference. The sedation score was more than 2 in the clonidine group as compared to the control group. Conclusion- Oral clonidine premedication has extended the duration of sensory analgesia with arousable sedation. It also prevented the post spinal shivering of the subarachnoid block.

Keywords: oral clonidine, subarachnoid block, sensory analgesia, laparoscopic gynaecological

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Authors: Marcello De Falco, Gianluca Natrella, Mauro Capocelli

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CO₂ capture and utilization (CCU) is a promising approach to reduce GHG(greenhouse gas) emissions. Many technologies in this field are recently attracting attention. However, since CO₂ is a very stable compound, its utilization as a reagent is energetic intensive. As a consequence, it is unclear whether CCU processes allow for a net reduction of environmental impacts from a life cycle perspective and whether these solutions are sustainable. Among the tools to apply for the quantification of the real environmental benefits of CCU technologies, exergy analysis is the most rigorous from a scientific point of view. The exergy of a system is the maximum obtainable work during a process that brings the system into equilibrium with its reference environment through a series of reversible processes in which the system can only interact with such an environment. In other words, exergy is an “opportunity for doing work” and, in real processes, it is destroyed by entropy generation. The exergy-based analysis is useful to evaluate the thermodynamic inefficiencies of processes, to understand and locate the main consumption of fuels or primary energy, to provide an instrument for comparison among different process configurations and to detect solutions to reduce the energy penalties of a process. In this work, the exergy analysis of a process for the production of Dimethyl Ether (DME) from green hydrogen generated through an electrolysis unit and pure CO₂ captured from flue gas is performed. The model simulates the behavior of all units composing the plant (electrolyzer, carbon capture section, DME synthesis reactor, purification step), with the scope to quantify the performance indices based on the II Law of Thermodynamics and to identify the entropy generation points. Then, a plant optimization strategy is proposed to maximize the exergy efficiency.

Keywords: green DME production, exergy analysis, energy penalties, exergy efficiency

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Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

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Authors: Ajit Kumar Behera, Saranya P., Sudhir Kumar, Krishnakumar A

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The stable isotope (δ¹⁸ O and δ²H) composition of groundwater of the coastal areas of Periyar and Mahanadi basins falling along East and West coast of India during North-East (NE) monsoon season have been studied. The east and west coast regions are surrounded by the Bay of Bengal and the Arabian Sea respectively, which are considered to be the primary sources for precipitation over India. The major difference between the Bay of Bengal and the Arabian Sea is that a number of large rivers feed the Bay of Bengal, whereas the Arabian Sea is fed by very few small rivers, resulting in enriched stable isotopic composition of the Arabian Sea than the Bay of Bengal. Previous studies have reported depleted ratios of stable isotopes during Northeast monsoon along East and West coasts due to the influence of the Bay of Bengal moisture source. The isotopic composition of groundwater of the Mahanadi delta in the east coast region varies from -6.87 ‰ to -3.40 ‰ for δ¹⁸ O and -45.42 ‰ to -22.43‰ for δ²H. However, the groundwater of the Periyar basin in the west coast has enriched stable isotope value varying from -4.3‰ to -2.5 ‰ for δ¹⁸ O and for δ²H from -23.7 to -6.4 ‰ which is a characteristic of South-West monsoon season. This suggests the groundwater system of the Mahanadi delta and the Periyar basins are influenced by dissimilar moisture sources. The δ¹⁸ O and δ² H relationship (δ²H= 6.513 δ¹⁸ O - 1.39) and d-excess value (< 10) in the east coast region indicates the influence of NE monsoon implying the quick groundwater recharge after precipitation with significant amount of evaporation. In contrast, the δ¹⁸ O and δ²H regression line (δ²H= 8.408 δ¹⁸ O + 11.71) with high d-excess value (>10) in the west coast region implies delayed recharge due to SW monsoon. The observed isotopic enrichment in west coast suggests that NE winter monsoon rainfall does not replenish groundwater quick enough to produce isotopic depletion during the season.

Keywords: Arabian sea, bay of Bengal, groundwater, monsoon, stable isotope

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Authors: Allen Seylani

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Lysosome-dependent autophagy is a nutrient-deprivation-induced evolutionarily conserved intracellular recycling program that sequestrates intracellular cargo into autophagosomes (AP), which then fuse with lysosomes to form autolysosomes (ALs) for cargo digestion. To restore free lysosomes, autophagic lysosome reformation (ALR) is initiated by extrusion of tubular structures from autolysosomes at the final stage of autophagy, in a process called lysosomal tubulation (LT). This project aimed to investigate the molecular mechanism of GCN5L1 in LT and the following lysosomal signaling. GCN5L1 belongs to the BORC multiprotein complexes and is involved in controlling lysosomal trafficking; however, the effect of GCN5L1 on lysosome tubulation remains largely unknown. Genetic ablation of GCN5L1 in the mouse primary hepatocytes showed dramatically increased autolysosomes (ALs), decreased lysosome regeneration and absence of lysosomal tubulation. This phenotype suggests the possibility of disruption in lysosome tubulation, which results in the disturbance of the overall lysosome homeostasis. The formation of tubulars from ALs requires kinesin motor protein KIF5B. Immunoprecipitation was employed and confirmed the interaction of GCN5L1 with the ARL8B-KIF5B complex, which recruited KIF5B to ALs. At the same time, GCN5L1 interacted with WHAMM, which promotes the actin nucleation factor, which brings actin cytoskeleton to ALs and initiates LT. Furthermore, impaired LT in GCN5L1 deficient hepatocytes was restored by overexpression of GCN5L1, and this rescue effect was attenuated by knockdown of KIF5B. Additionally, lysosomal mTORC1 activity was upregulated in GCN5L1-/- hepatocytes, while inhibition of mTORC1 abrogated the GCN5L1 mediated rescue of LT in knockout hepatocytes. Altogether these findings revealed a novel mechanism of ALR, in which a simultaneous interaction of GCN5L1 with KIF5B and WHAMM is required for LT and downstream mTORC1 signaling.

Keywords: autophagy, autolysosome, GCN5L1, lysosome

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Authors: Demelash Kassaye Debalkie

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The primary objective of this study is to report the tributes that are significantly impeding the Ethiopian police's ability to provide quality services to the people. Policing in Ethiopia started in the medieval period. However, modern policing was introduced instead of vigilantism in the early 1940s. The progress counted since the date police became modernized is, however, under contention when viewed from the standpoint of officers’ development and technologies in the 21st century. The police in Ethiopia are suffering a lot to be set free from any form of political interference by the government and to be loyal to impartiality, equity, and justice in enforcing the law. Moreover, the institutional competence of the police in Ethiopia is currently losing its power derived from the constitution as a legitimate enforcement agency due to the country’s political landscape encouraging ethnic-based politics. According to studies, the impact of ethnic politics has been a significant challenge for police in controlling conflicts between two ethnic groups. The study used qualitative techniques and data was gathered from key informants selected purposely. The findings indicate that governments in the past decades were skeptical about establishing a constitutional police force in the country. This has certainly been one of the challenges of pluralizing the police: building police-community relations based on trust. The study conducted to uncover the obstructions has finally reported that the government’s commitment to form a non-partisan, functionally decentralized, and operationally demilitarized police force is too minimal and appalling. They mainly intend to formulate the missions of the police in accordance with their interests and political will to remain in power. It, therefore, reminds the policymakers, law enforcement officials, and the government in power to revise its policies and working procedures already operational to strengthen the police in Ethiopia based on public participation and engagement.

Keywords: community, constitution, Ethiopia, law enforcement

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Authors: Kunal Mankodi, Sudhir Pandey

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This study aims to assess the factors that play a role in setting up and running a social enterprise driven towards sustainability at the intersection of energy, environment, and poverty alleviation. According to the theory of sustainability-oriented innovation (SOI), conventional organisations adapt their processes to focus on sustainability-oriented innovations. On the other hand, social enterprises that are purpose-driven are also influenced by the context of innovation, which need due attention. This paper presents an account of innovation at Oorja - an Indian social enterprise operating with a farming-as-a-service business model. It aims to illustrate the contexts in which the innovative solutions were developed to work at an intersection between agriculture and clean energy, thereby allowing small farmers access to efficient solutions in the agriculture cycle. Primary data was collected through in-depth interviews, and secondary data was collected from company sources. The study finds that in the case of a social enterprise, the definition of innovation assumes a wider scope by going beyond the introduction of a new product/service. The context of innovation for social enterprise is affected by organisational factors such as organisation’s philosophical mindset, behaviour towards innovation, organisation’s capabilities, regulatory environment, and customer receptiveness. Additionally, the study also finds that the context of innovation for a social enterprise is affected by its organizational structure. A majority of these organizational factors are, in turn, affected by individual (Founder’s) factors such as the founder’s formative years, education, direct exposure to relevant issues, complementary skills of co-founders, and a common calling.

Keywords: context of innovation, social enterprise, sustainability oriented innovations, emerging markets, agriculture

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Authors: William Cheng, Rini Sekartini

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Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

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Authors: Hossam Hegazi

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Global culture museums play a pivotal role in fostering cross-cultural connections, enhancing mutual understanding, and safeguarding the rich tapestry of cultural heritage. These institutions serve as dynamic bridges, facilitating the exchange of ideas and values among diverse societies. One of the primary functions of global culture museums is to connect people from different backgrounds. By showcasing the artistic expressions, traditions, and historical artifacts of various civilizations, these museums create a shared space for dialogue. Visitors are afforded the opportunity to explore and appreciate the nuances of cultures different from their own, promoting a sense of global interconnectedness. Moreover, these museums contribute significantly to mutual understanding. Through interactive exhibits, innovative technologies, and educational programs, they offer immersive experiences that transcend linguistic and geographical barriers. Visitors gain insights into the customs, beliefs, and lifestyles of others, fostering empathy and appreciation for cultural diversity. Preserving cultural heritage stands as another key objective of global culture museums. By housing and curating artifacts, artworks, and historical items, these institutions play a crucial role in safeguarding the collective memory of humanity. This preservation effort ensures that future generations have access to the cultural legacies that have shaped societies across the globe. In conclusion, global culture museums serve as dynamic hubs that bring people together, promote understanding, and safeguard the wealth of human cultural heritage. Their impact extends beyond the walls of exhibition halls, contributing to a more interconnected and culturally enriched world.

Keywords: global culture museums, cross-cultural connections, mutual understanding, societal dialogue

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Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits

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Background data. This is a study in the field of health humanities. The 1930s were years of rapid cultural and economic development in Europe and in Estonia. The urban way of life the glamorous lifestyle gained popularity, although the society of Estonia in the 1930s had traditionally been agrarian. People's free time increased, which needed to be filled with activities either at home or outside the home. Therefore, the number of popular magazines aimed at housewives increased. More than 200 magazines and bulletins were published in the Republic of Estonia before the Second World War (in 1934, the population of Estonia was 1,126,000). In the 1930s, the Republic of Estonia faced several challenges in healthcare. Infectious diseases, alcoholism, prostitution and child mortality had to be dealt with. Healers without medical education operated in the villages. For the average person, medical care was quite expensive, and despite efforts, by 1940, only 20% of the population was covered by health insurance. Advice published in popular family magazines provided help in solving, understanding and preventing health problems. Aim. The aim of the study is to analyze the health counseling through magazines during the Republic of Estonia (1930-1940) in historical and cultural context. Method. In total, 420 magazine issues were processed. An extensive textual analysis, as well as an analysis of photographs and illustrations from the aspect of health advice was carried out to achieve the research objective. Results. Health counseling was written by well-known doctors of the time, leaders of the abstinence movement and others. There was advice in various areas: prevention of infectious and non-infectious diseases and their treatment with simple methods, first aid, combating sexually transmitted diseases, women's and children's health, mental health, folk medicine techniques, abstinence, healthy eating, skin care, hygiene, introducing pharmacy products. Advice was offered in both written and visual form. Photos and illustrations helped to empower the health advice. Folk heritage and health knowledge of the time were relied upon, and a scientific point of view was popularized. Aspirations towards a European lifestyle were reflected in articles and illustrations. Contribution. The article has an ethnological attitude, and its impact comes down to understanding the history of health care in its socio-cultural context. The health counseling topics of the 1930s are also applicable in today's health education and research. Health counseling builds on the legacy of the past, and it helps to understand that the past is in the future and the main principles of health counseling arise from our history and background.

Keywords: estonian republic, health counseling, lifestyle, magazines, media

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Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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Authors: H. Mayton, X. Yan, A. G. Taylor

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Infested tomato seeds were used to investigate the influence of Xanthomonas euvesicatoria on germination and seed to seedling transmission in a controlled environment and greenhouse assays in an effort to develop effective seed treatments and characterize seed borne transmission of bacterial leaf spot of tomato. Bacterial leaf spot of tomato, caused by four distinct Xanthomonas species, X. euvesicatoria, X. gardneri, X. perforans, and X. vesicatoria, is a serious disease worldwide. In the United States, disease prevention is expensive for commercial growers in warm, humid regions of the country, and crop losses can be devastating. In this study, four different infested tomato seed lots were extracted from tomato fruits infected with bacterial leaf spot from a field in New York State in 2017 that had been inoculated with X. euvesicatoria. In addition, vacuum infiltration at 61 kilopascals for 1, 5, 10, and 15 minutes and seed soaking for 5, 10, 15, and 30 minutes with different bacterial concentrations were used to artificially infest seed in the laboratory. For controlled environment assays, infested tomato seeds from the field and laboratory were placed othe n moistened blue blotter in square plastic boxes (10 cm x 10 cm) and incubated at 20/30 ˚C with an 8/16 hour light cycle, respectively. Infested tomato seeds from the field and laboratory were also planted in small plastic trays in soil (peat-lite medium) and placed in the greenhouse with 24/18 ˚C day and night temperatures, respectively, with a 14-hour photoperiod. Seed germination was assessed after eight days in the laboratory and 14 days in the greenhouse. Polymerase chain reaction (PCR) using the hrpB7 primers (RST65 [5’- GTCGTCGTTACGGCAAGGTGGTG-3’] and RST69 [5’-TCGCCCAGCGTCATCAGGCCATC-3’]) was performed to confirm presence or absence of the bacterial pathogen in seed lots collected from the field and in germinating seedlings in all experiments. For infested seed lots from the field, germination was lowest (84%) in the seed lot with the highest level of bacterial infestation (55%) and ranged from 84-98%. No adverse effect on germination was observed from artificially infested seeds for any bacterial concentration and method of infiltration when compared to a non-infested control. Germination in laboratory assays for artificially infested seeds ranged from 82-100%. In controlled environment assays, 2.5 % were PCR positive for the pathogen, and in the greenhouse assays, no infected seedlings were detected. From these experiments, X. euvesicatoria does not appear to adversely influence germination. The lowest rate of germination from field collected seed may be due to contamination with multiple pathogens and saprophytic organisms as no effect of artificial bacterial seed infestation in the laboratory on germination was observed. No evidence of systemic movement from seed to seedling was observed in the greenhouse assays; however, in the controlled environment assays, some seedlings were PCR positive. Additional experiments are underway with green fluorescent protein-expressing isolates to further characterize seed to seedling transmission of the bacterial leaf spot pathogen in tomato.

Keywords: bacterial leaf spot, seed germination, tomato, Xanthomonas euvesicatoria

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Authors: Jaber Shurrab, Matloub Hussain

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The rapid pace of changes in the construction industry, technological advancements, and rising costs present tremendous challenges for project managers. Project managers are under severe pressure to minimize the waste, improve the efficiency of the entire operations and the philosophy of ‘lean thinking’ so that ‘more could be achieved with less’ is becoming very popular. Though, lean management has strong roots in manufacturing industry and over the last decade lean philosophy has started gaining attention in the service industry as well. However, little has been known in the context of waste minimization and lean implementation in the construction industry and this paper deals with this important issue. The primary objective of this paper is to propose a conceptual framework for the exploration of appropriate lean techniques applicable to medium and large construction companies and measure their impact on the competitiveness and economic performance of construction companies of United Arab Emirates (UAE). To this end, a comprehensive literature review and interviews with eight project managers of medium and large construction companies of UAE have been conducted. It has been found that competitive, reduce waste and costs are critical to the construction industry. This is an ongoing research in lean management, giving project managers a practical framework for improving the efficiency of their project through various lean techniques. Originality/value: Research significance emphasizes increasing the effectiveness of the construction industry, influences the development of lean construction framework which improves lean construction practices using the lean techniques. This contributes to the effort of applying lean techniques in the construction industry. Limited publications were done in the construction industry mainly in United Arab Emirates (UAE) compared to the lean manufacturing. This research will recommend a systematic approach for the implementing of the anticipated framework within a cyclical look-ahead period and emphasizes the practical implications of the proposed approach.

Keywords: construction, lean, lean manufacturing, waste

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Authors: Farid Rezaei, Zahra Reza Soltani, Behrouz Tavana, Afsaneh Dadarkhah, Masoume Bahrami Asl, S. Alireza Mirghasemi

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Introduction: Fibromyalgia is a syndrome comprised of a group of symptoms. The primary symptom of fibromyalgia is pain propagation is associated by Secondary symptoms include fatigue, cognitive disorders, sleep disorders and hypersensitivity to painful stimuli. Recent studies have shown that there is a direct relationship between fibromyalgia and certain changes in brain activity. Aim: The aim of this study is determining the effect of tDCS in pain and quality of life in patients with fibromyalgia. Method: 68 patients with fibromyalgia who had inclusion criterias were randomly divided into two groups of case and control. Groups were matched in terms of gender, age, education, duration of pain and PMS. Patient groups treated with tDCS device manufacture by Enraf company made in Netherlands (M1 anodal stimulation, 2 mA constant current, 20 minutes, for 10 sessions (3 days a week)). Also the protocol was done for control group, in sham mode of tDCS device that had no current, for 10 sessions of 20 minutes. Before treatment, immediately after the end of 10 sessions treatment (short-term) and 10 week later (long-term effect), pain intensity questionnaires (VAS) and quality of life in fibromyalgia patients questionnaire was completed by the patient. Results: Pain intensity were significantly lower in the treatment group than the sham group 2 weeks and 10 weeks after treatment than before treatment (P < 0.001). Although the quality of life of patients 2 weeks after treatment showed no significant change, but ten weeks after treatment were more than sham group (P < 0.0001). Conclusion: Our results suggest that tDCS is a safe and effective in treating fibromyalgia patients and an important effect in reducing pain and increasing quality of their life.

Keywords: fibromyalgia, tDCS, quality of life, VAS score

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Authors: Issam A. Al-Khatib

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In order to achieve a significant reduction of waste amount flowing into landfills, it is important to first understand the composition of the solid municipal waste generated. Hence a detailed analysis of municipal solid waste composition has been conducted in Nablus city. The aim is to provide data on the potential recyclable fractions in the actual waste stream, with a focus on the plastic fraction. Hence, waste-sorting campaigns were conducted on mixed waste containers from five districts in Nablus city. The districts vary in terms of infrastructure and average income. The target is to obtain representative data about the potential quantity and quality of household plastic waste. The study has measured the composition of municipal solid waste collected/ transported by Nablus municipality. The analysis was done by categorizing the samples into eight primary fractions (organic and food waste, paper and cardboard, glass, metals, textiles, plastic, a fine fraction (<10 mm), and others). The study results reveal that the MSW stream in Nablus city has a significant bio- and organic waste fraction (about 68% of the total MSW). The second largest fraction is paper and cardboard (13.6%), followed by plastics (10.1%), textiles (3.2%), glass (1.9%), metals (1.8%), a fine fraction (0.5%), and other waste (0.3%). After this complete and detailed characterization of MSW collected in Nablus and taking into account the content of biodegradable organic matter, the composting could be a solution for the city of Nablus where the surrounding areas of Nablus city have agricultural activities and could be a natural outlet to the compost product. Different waste management options could be practiced in the future in addition to composting, such as energy recovery and recycling, which result in a greater possibility of reducing substantial amounts that are disposed of at landfills.

Keywords: developing countries, composition, management, recyclable, waste.

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Authors: Hondozi Jahja

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There is an obvious need to learn Arabic language and teach it to other speakers through the new curricula. The idea is to bridge the gap between theory and practice. To that end, we have sought to offer some means of help to master the Arabic language, in addition to our efforts to apply these means, enriching the culture of the student and develop his vocabulary. There is no doubt that taking care of the practical aspect of the grammar was our constant goal, and this particular aspect is what builds the student’s positive values and refine his taste and develop his language. In addressing these issues, we have adopted a school-based approach based primarily on the active and positive participation of the student. The theoretical linguistic issues - in our opinion - are not a primary goal, but the goal is to be used them by students through speaking and applying them. Among the objectives of this research is to establish the basic language skills of the students using new means that help the student to acquire these skills and apply them in various subjects of interest in his progress and development. Unfortunately, some of our students consider the grammar as ‘difficult’, ‘complex’ and ‘heavy’ in itself. This is one of the obstacles that stand in the way of their desired results. As a consequence, they end up talking – mumbling - about the difficulties they face in applying those rules. Therefore, some of our students finish their university studies and are unable to express what they feel using language correctly. For this purpose, we have sought in this research to follow a new integrated approach, which is to study the grammar of the language through modern means of the consolidation of the principle of functional language, and that the rule implies to control tongues and linguistic expressions properly. This research is a result of a practical experience as a teacher of Arabic language for non-native speakers at the ‘Hassan Pristina’ University, located in Pristina, the capital of Kosovo and at the Qatar Training Center since its establishment in 2012.

Keywords: arabic, applied methods, acquire, learning

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Authors: Tebogo Sethibe, Jabulile Mabuza

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The COVID-19 pandemic has been commonly referred to as a ‘black swan event’; it has changed the world, from how people live, learn, work and socialise. It is believed that the pandemic has fast-tracked the adoption of technology in many organisations to ensure business continuity and business sustainability; broadly said, the pandemic has fast-tracked digital transformation (DT) in different organisations. This paper aims to study the impact of the COVID-19 pandemic on DT in organisations in South Africa by focusing on the changes in IT capabilities in the DT framework. The research design is qualitative. The data collection was through semi-structured interviews with information communication technology (ICT) leaders representing different organisations in South Africa. The data were analysed using the thematic analysis process. The results from the study show that, in terms of ICT in the organisation, the pandemic had a direct and positive impact on ICT strategy and ICT operations. In terms of IT capability transformation, the pandemic resulted in the optimisation and expansion of existing IT capabilities in the organisation and the building of new IT capabilities to meet emerging business needs. In terms of the focus of activities during the pandemic, there seems to be a split in organisations between the primary focus being on ‘digital IT’ or ‘traditional IT’. Overall, the findings of the study show that the pandemic had a positive and significant impact on DT in organisations. However, a definitive conclusion on this would require expanding the scope of the research to all the components of a comprehensive DT framework. This study is significant because it is one of the first studies to investigate the impact of the COVID-19 pandemic on organisations, on ICT in the organisation, on IT capability transformation and, to a greater extent, DT. The findings from the study show that in response to the pandemic, there is a need for: (i) agility in organisations; (ii) organisations to execute on their existing strategy; (iii) the future-proofing of IT capabilities; (iv) the adoption of a hybrid working model; and for (v) organisations to take risks and embrace new ideas.

Keywords: digital transformation, COVID-19, bimodal-IT, digital transformation framework

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