Search results for: regular term

Authors: Mohammad Zamani, Ramin Mansouri

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Spillways are one of the most important hydraulic structures of dams that provide the stability of the dam and downstream areas at the time of flood. A circular vertical spillway with various inlet forms is very effective when there is not enough space for the other spillway. Hydraulic flow in a vertical circular spillway is divided into three groups: free, orifice, and under pressure (submerged). In this research, the hydraulic flow characteristics of a Circular Vertical Spillway are investigated with the CFD model. Two-dimensional unsteady RANS equations were solved numerically using Finite Volume Method. The PISO scheme was applied for the velocity-pressure coupling. The mostly used two-equation turbulence models, k-ε and k-ω, were chosen to model Reynolds shear stress term. The power law scheme was used for the discretization of momentum, k, ε, and ω equations. The VOF method (geometrically reconstruction algorithm) was adopted for interface simulation. In this study, three types of computational grids (coarse, intermediate, and fine) were used to discriminate the simulation environment. In order to simulate the flow, the k-ε (Standard, RNG, Realizable) and k-ω (standard and SST) models were used. Also, in order to find the best wall function, two types, standard wall, and non-equilibrium wall function, were investigated. The laminar model did not produce satisfactory flow depth and velocity along the Morning-Glory spillway. The results of the most commonly used two-equation turbulence models (k-ε and k-ω) were identical. Furthermore, the standard wall function produced better results compared to the non-equilibrium wall function. Thus, for other simulations, the standard k-ε with the standard wall function was preferred. The comparison criterion in this study is also the trajectory profile of jet water. The results show that the fine computational grid, the input speed condition for the flow input boundary, and the output pressure for the boundaries that are in contact with the air provide the best possible results. Also, the standard wall function is chosen for the effect of the wall function, and the turbulent model k-ε (Standard) has the most consistent results with experimental results. When the jet gets closer to the end of the basin, the computational results increase with the numerical results of their differences. The mesh with 10602 nodes, turbulent model k-ε standard and the standard wall function, provide the best results for modeling the flow in a vertical circular Spillway. There was a good agreement between numerical and experimental results in the upper and lower nappe profiles. In the study of water level over crest and discharge, in low water levels, the results of numerical modeling are good agreement with the experimental, but with the increasing water level, the difference between the numerical and experimental discharge is more. In the study of the flow coefficient, by decreasing in P/R ratio, the difference between the numerical and experimental result increases.

Keywords: circular vertical, spillway, numerical model, boundary conditions

Procedia PDF Downloads 86

Authors: Davendra S. Malik

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Bhimtal lake is located between 290 21’ N latitude and 790 24’ E longitude, at an elevation of 1332m above mean sea level in the Kumaun region of Uttarakhand of Indian subcontinent. The lake surface area is decreasing in water area, depth level in relation to ecological and biological characteristics due to climatic variations, invasive land use pattern, degraded forest zones and changed agriculture pattern in lake catchment basin. The present study is focused on long and short term effects of climate change on aquatic biodiversity and productivity of Bhimtal lake. The meteorological data of last fifteen years of Bhimtal lake catchment basin revealed that air temperature has been increased 1.5 to 2.1oC in summer, 0.2 to 0.8 C in winter, relative humidity increased 4 to 6% in summer and rainfall pattern changed erratically in rainy seasons. The surface water temperature of Bhimtal lake showed an increasing pattern as 0.8 to 2.6 C, pH value decreased 0.5 to 0.2 in winter and increased 0.4 to 0.6 in summer. Dissolved oxygen level in lake showed a decreasing trend as 0.7 to 0.4mg/l in winter months. The mesotrophic nature of Bhimtal lake is changing towards eutrophic conditions and contributed for decreasing biodiversity. The aquatic biodiversity of Bhimtal lake consisted mainly phytoplankton, zooplankton, benthos and fish species. In the present study, a total of 5 groups of phytoplankton, 3 groups of zooplankton, 11 groups of benthos and 15 fish species were recorded from Bhimtal lake. The comparative data of biodiversity of Bhimtal lake since January, 2000 indicated the changing pattern of phytoplankton biomass were decreasing as 1.99 and 1.08% of Chlorophyceae and Bacilleriophyceae families respectively. The biomass of Cynophyceae was increasing as 0.45% and contributing the algal blooms during summer season in lake. The biomass of zooplankton and benthos were found decreasing in winter season and increasing during summer season. The endemic fish species (18 no.) were found in year 2000-05, as while the fish species (15 no.) were recorded in present study. The relative fecundity of major fish species were observed decreasing trends during their breeding periods in lake. The natural and anthropogenic factors were identified as ecological threats for existing aquatic biodiversity of Bhimtal lake. The present research paper emphasized on the effect of changing pattern of different climatic variables on species composition, biomass of phytoplankton, zooplankton, benthos, and fishes in Bhimtal lake of Kumaun region. The present research data will be contributed significantly to assess the changing pattern of aquatic biodiversity and productivity of Bhimtal lake with different time scale.

Keywords: aquatic biodiversity, Bhimtal lake, climate change, lake ecology

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Authors: Kay Fielden, Eelin Tan, Lan Nguyen

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In this research project, data was gathered at a Covid 19 Conference held in June 2021 from industry leaders who discussed the impact of the global pandemic on the status of the New Zealand hospitality industry. Panel discussions on financials, human resources, health and safety, and recovery were conducted. The themes explored for the finance panel were customer demographics, hospitality sectors, financial practices, government impact, and cost of compliance. The aim was to see how the hospitality industry has responded to the global pandemic and the steps that have been taken for the industry to recover or sustain their business. The main research question for this qualitative study is: What are the factors that have impacted on finance for the hospitality industry in New Zealand due to Covid 19? For financials, literature has been gathered to study global effects, and this is being compared with the data gathered from the discussion panel through the lens of resilience theory. Resilience theory applied to the hospitality industry suggests that the challenges imposed by Covid 19 have been the catalyst for government initiatives, technical innovation, engaging local communities, and boosting confidence. Transformation arising from these ground shifts have been a move towards sustainability, wellbeing, more awareness of climate change, and community engagement. Initial findings suggest that there has been a shift in customer base that has prompted regional accommodation providers to realign offers and to become more flexible to attract and maintain this realigned customer base. Dynamic pricing structures have been required to meet changing customer demographics. Flexible staffing arrangements include sharing staff between different accommodation providers, owners with multiple properties adopting different staffing arrangements, maintaining a good working relationship with the bank, and conserving cash. Uncertain times necessitate changing revenue strategies to cope with external factors. Financial support offered by the government has cushioned the financial downturn for many in the hospitality industry, and managed isolation and quarantine (MIQ) arrangements have offered immediate financial relief for those hotels involved. However, there is concern over the long-term effects. Compliance with mandated health and safety requirements has meant that the hospitality industry has streamlined its approach to meeting those requirements and has invested in customer relations to keep paying customers informed of the health measures in place. Initial findings from this study lie within the resilience theory framework and are consistent with findings from the literature.

Keywords: global pandemic, hospitality industry, new Zealand, resilience

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Authors: Jasmine Renner, Alice Njuguna

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The booming technological revolution is driving a change in the mode of delivery systems especially for e-learning and distance learning in higher education. The report and findings of the study; an assessment of digital platforms, student online learning, teaching pedagogies, research and training at Kenya College of Accounting University (hereinafter 'KCA') was undertaken as a joint collaboration project between the Carnegie African Diaspora Fellowship and input from the staff, students and faculty at KCA University. The participants in this assessment/research met for selected days during a six-week period during which, one-one consultations, surveys, questionnaires, foci groups, training, and seminars were conducted to ascertain 'online learning and teaching, curriculum development, research and training at KCA.' The project was organized into an eight-week project workflow with each week culminating in project activities designed to assess digital online teaching and learning at KCA. The project also included the training of distance learning instructors at KCA and the evaluation of KCA’s distance platforms and programs. Additionally, through a curriculum audit and redesign, the project sought to enhance the curriculum development activities related to of distance learning at KCA. The findings of this assessment/research represent the systematic deliberate process of gathering, analyzing and using data collected from DL students, DL staff and lecturers and a librarian personnel in charge of online learning resources and access at KCA. We engaged in one-on-one interviews and discussions with staff, students, and faculty and collated the findings to inform practices that are effective in the ongoing design and development of eLearning earning at KCA University. Overall findings of the project led to the following recommendations. First, there is a need to address infrastructural challenges that led to poor internet connectivity for online learning, training needs and content development for faculty and staff. Second, there is a need to manage cultural impediments within KCA; for example fears of vital change from one platform to another for effectiveness and Institutional goodwill as a vital promise of effective online learning. Third, at a practical and short-term level, the following recommendations based on systematic findings of the research conducted were as follows: there is a need for the following to be adopted at KCA University to promote the effective adoption of online learning: a) an eLearning compatible faculty lab, b) revision of policy to include an eLearn strategy or strategic management, c) faculty and staff recognitions engaged in the process of training for the adoption and implementation of eLearning and d) adequate website resources on eLearning. The report and findings represent a comprehensive approach to a systematic assessment of online teaching and learning, research and training at KCA.

Keywords: e-learning, digital platforms, student online learning, online teaching pedagogies

Procedia PDF Downloads 191

Authors: Hussain Bohra, Pradyuman Sharma

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This study highlights the significance of Balance Sheet Indicators on the corporate performance in the case of Indian manufacturing companies. Balance sheet indicators show the actual financial health of the company and it helps to the external investors to choose the right company for their investment and it also help to external financing agency to give easy finance to the manufacturing companies. The period of study is 2000 to 2014 for 813 manufacturing companies for which the continuous data is available throughout the study period. The data is collected from PROWESS data base maintained by Centre for Monitoring Indian Economy Pvt. Ltd. Panel data methods like fixed effect and random effect methods are used for the analysis. The Likelihood Ratio test, Lagrange Multiplier test and Hausman test results proof the suitability of the fixed effect model for the estimation. Return on assets (ROA) is used as the proxy to measure corporate performance. ROA is the best proxy to measure corporate performance as it already used by the most of the authors who worked on the corporate performance. ROA shows return on long term investment projects of firms. Different ratios like Current Ratio, Debt-equity ratio, Receivable turnover ratio, solvency ratio have been used as the proxies for the Balance Sheet Indicators. Other firm specific variable like firm size, and sales as the control variables in the model. From the empirical analysis, it was found that all selected financial ratios have significant and positive impact on the corporate performance. Firm sales and firm size also found significant and positive impact on the corporate performance. To check the robustness of results, the sample was divided on the basis of different ratio like firm having high debt equity ratio and low debt equity ratio, firms having high current ratio and low current ratio, firms having high receivable turnover and low receivable ratio and solvency ratio in the form of firms having high solving ratio and low solvency ratio. We find that the results are robust to all types of companies having different form of selected balance sheet indicators ratio. The results for other variables are also in the same line as for the whole sample. These findings confirm that Balance sheet indicators play as significant role on the corporate performance in India. The findings of this study have the implications for the corporate managers to focus different ratio to maintain the minimum expected level of performance. Apart from that, they should also maintain adequate sales and total assets to improve corporate performance.

Keywords: balance sheet, corporate performance, current ratio, panel data method

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Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

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Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

Procedia PDF Downloads 263

Authors: Rabia Genc, Aysun Eksioglu, Emine Serap Sarican, Sibel Icke

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Today the habit of cigarette smoking is among one of the most important public health concerns because of the health problems it leads to. The most important and hazardous group to use tobacco and tobacco products is adolescents and teenagers. And one of the most effective ways to prevent them from starting to smoke is education. This research is a kind of educational intervention study which was carried out in order to evaluate the effect of peer education on the teenagers' knowledge about smoking. The research was carried out between October 15, 2013 and September 9, 2015 at Ege University Ataturk Vocational Health School. The population of the research comprised of the students that have been studying at Ege University Atatürk Vocational Health School, Midwifery Department (N=390). The peer educator group that would give training on smoking consisted of 10 people, and the peer groups that would be trained were divided into two groups via simple randomization as experimental group (n=185) and control group (n=185). Questionnaire, information evaluation form, and informed consent forms were used as date collection tools. The analysis of the data which were collected in the study was carried out on Statistical Package for Social Science (SPSS 15.0). It was found out that 62.5 % of the students who were in peer educator group had smoked in some period of their lives; however, none of them continued to smoke. When they were asked about their reasons to start smoking, 25% said they just wanted to try it, and 25% of them answered that it was because of their friend groups. When the pre-peer education and post-peer education point averages of peer educator group were evaluated, the results showed that there was a significant difference between the point averages (p < 0.05). When the cigarette use of experimental group and the control group were evaluated, it was clear that 18.2% of the experimental group and 24.2%of the control group still smokes. 9.1% of the experimental group and 14.8% of control group stated that they started smoking because of their friend groups. Among the students who smoke 15.9% of the ones who belongs to the experimental group and 21.9% of the ones who belong to the control group stated they are thinking of quitting smoking. It was clear that there is a significant difference between the pre-education and post-education point averages of experimental group statistically (p ≤ 0.05); however, in terms of control group, there were no significant differences between the pre-test post-test averages statistically. Between the pre-test post-test averages of experimental and control groups there were not any statistically significant differences (p > 0.05). It was found out in the study that the peer education programme is not effective on the smoking habit of Vocational Health School students. When the future studies are being planned in order to evaluate the peer education activity, it can be taken into consideration that the peer education takes a long term and the students in the educator group will be more enthusiastic and a kind of leader in their environment.

Keywords: midwifery, peer, peer education, smoking

Procedia PDF Downloads 222

Authors: Yi-Hung Ho, Chih-Wei Wang, Chih-Hsien Chen, Chih-Han Chang

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Unilateral laminotomy and bilateral laminotomies were successful decompressions methods for managing spinal stenosis that numerous studies have reported. Thus, unilateral laminotomy was rated technically much more demanding than bilateral laminotomies, whereas the bilateral laminotomies were associated with a positive benefit to reduce more complications. There were including incidental durotomy, increased radicular deficit, and epidural hematoma. However, no relative biomechanical analysis for evaluating spinal instability treated with unilateral and bilateral laminotomies. Therefore, the purpose of this study was to compare the outcomes of different decompressions methods by experimental and finite element analysis. Three porcine lumbar spines were biomechanically evaluated for their range of motion, and the results were compared following unilateral or bilateral laminotomies. The experimental protocol included flexion and extension in the following procedures: intact, unilateral, and bilateral laminotomies (L2–L5). The specimens in this study were tested in flexion (8 Nm) and extension (6 Nm) of pure moment. Spinal segment kinematic data was captured by using the motion tracking system. A 3D finite element lumbar spine model (L1-S1) containing vertebral body, discs, and ligaments were constructed. This model was used to simulate the situation of treating unilateral and bilateral laminotomies at L3-L4 and L4-L5. The bottom surface of S1 vertebral body was fully geometrically constrained in this study. A 10 Nm pure moment also applied on the top surface of L1 vertebral body to drive lumbar doing different motion, such as flexion and extension. The experimental results showed that in the flexion, the ROMs (±standard deviation) of L3–L4 were 1.35±0.23, 1.34±0.67, and 1.66±0.07 degrees of the intact, unilateral, and bilateral laminotomies, respectively. The ROMs of L4–L5 were 4.35±0.29, 4.06±0.87, and 4.2±0.32 degrees, respectively. No statistical significance was observed in these three groups (P>0.05). In the extension, the ROMs of L3–L4 were 0.89±0.16, 1.69±0.08, and 1.73±0.13 degrees, respectively. In the L4-L5, the ROMs were 1.4±0.12, 2.44±0.26, and 2.5±0.29 degrees, respectively. Significant differences were observed among all trials, except between the unilateral and bilateral laminotomy groups. At the simulation results portion, the similar results were discovered with the experiment. No significant differences were found at L4-L5 both flexion and extension in each group. Only 0.02 and 0.04 degrees variation were observed during flexion and extension between the unilateral and bilateral laminotomy groups. In conclusions, the present results by finite element analysis and experimental reveal that no significant differences were observed during flexion and extension between unilateral and bilateral laminotomies in short-term follow-up. From a biomechanical point of view, bilateral laminotomies seem to exhibit a similar stability as unilateral laminotomy. In clinical practice, the bilateral laminotomies are likely to reduce technical difficulties and prevent perioperative complications; this study proved this benefit through biomechanical analysis. The results may provide some recommendations for surgeons to make the final decision.

Keywords: unilateral laminotomy, bilateral laminotomies, spinal stenosis, finite element analysis

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Authors: Siddhartha Khare, Nitish Kr Boro, Omm Animesh Mishra

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Recent food price hikes may signal the end of an era of predictable global grain crop plenty due to climate change, population expansion, and dietary changes. Food consumption will treble in 20 years, requiring enormous production expenditures. Climate and the atmosphere changed owing to rainfall and seasonal cycles in the past decade. India's tropical agricultural relies on evapotranspiration and monsoons. In places with limited resources, the global environmental change affects agricultural productivity and farmers' capacity to adjust to changing moisture patterns. Motivated by these difficulties, satellite remote sensing might be combined with near-surface imaging data (smartphones, UAVs, and PhenoCams) to enable phenological monitoring and fast evaluations of field-level consequences of extreme weather events on smallholder agriculture output. To accomplish this technique, we must digitally map all communities agricultural boundaries and crop kinds. With the improvement of satellite remote sensing technologies, a geo-referenced database may be created for rural Indian agriculture fields. Using AI, we can design digital agricultural solutions for individual farms. Main objective is to Geo-enable each farm along with their seasonal crop information by combining Artificial Intelligence (AI) with satellite and near-surface data and then prepare long term crop monitoring through in-depth field analysis and scanning of fields with satellite derived vegetation indices. We developed an AI based algorithm to understand the timelapse based growth of vegetation using PhenoCam or Smartphone based images. We developed an android platform where user can collect images of their fields based on the android application. These images will be sent to our local server, and then further AI based processing will be done at our server. We are creating digital boundaries of individual farms and connecting these farms with our smart phone application to collect information about farmers and their crops in each season. We are extracting satellite-based information for each farm from Google earth engine APIs and merging this data with our data of tested crops from our app according to their farm’s locations and create a database which will provide the data of quality of crops from their location.

Keywords: artificial intelligence, satellite remote sensing, crop monitoring, android and web application

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Authors: E. Hegazy, S. Anderberg, J. Krook

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The city's wire-based infrastructure systems (WBIS) are responsible for the delivery of electricity, telecommunications, sanitation, drainage, and district heating and are a necessity for sustainable modern urban life. Maintaining the functionality of these structures involves high costs and, brings disturbance to the local community and effects on the environment. One key reason for this is that the cables and pipes are placed under streets, making system parts easily worn and their service lifetime reduced, and all maintenance and renewal rely on recurrent needs for excavation. In Sweden, a significant part of wire-based infrastructure is already outdated and will need to be replaced in the coming decades. The replacement of these systems will entail massive costs as well as important traffic disruption and environmental disturbance. However, this challenge may also open a unique opportunity to introduce new, more sustainable technologies and management practices. The transformation of WBIS management for long-term sustainability and meeting maintenance and renewal needs does not have a comprehensive approach. However, a systemic approach may inform WBIS management. This approach considers both technical and non-technical aspects, as well as time-related factors. Nevertheless, there is limited systemic knowledge of how different factors influence current management practices. The aim of this study is to address this knowledge gap and contribute to the understanding of what factors influence the current practice of WBIS management. A case study approach is used to identify current management practices, the underlying factors that influence them, and their implications for sustainability outcomes. The case study is based on both quantitative data on the local system and data from interviews and workshops with local practitioners and other stakeholders. Linköping was selected as a case since it provided good accessibility to the water administration and relevant data for analyzing water infrastructure management strategies. It is a sufficiently important city in Sweden to be able to identify challenges, which, to some extent, are common to all Swedish cities. By uncovering current practices and what is influencing Linköping, knowledge gaps and uncertainties related to sustainability consequences were highlighted. The findings show that goals, priorities, and policies controlling management are short-termed, and decisions on maintenance and renewal are often restricted to finding solutions to the most urgent issues. Sustainability transformation in the infrastructure area will not be possible through individual efforts without coordinated technical, organizational, business, and regulatory changes.

Keywords: case study, infrastructure, management, practice, Sweden

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Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman

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Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.

Keywords: leuprolide, lupus nephritis, scleroderma, SLE

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Authors: Rajish Shil, Amal Alduhoori, Vipin Thomachan, Jamal Teir, Radhakrishnan Renganathan

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Background: Antiphospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and non-thrombotic clinical manifestations. We present a case of APS presenting with seizure, stroke, and atrial mass. Case Description: A 38-year-old male presented with headache of 10 days duration and tonic-clonic seizure. The neurological examination was normal. Magnetic resonance imaging of brain showed small acute right cerebellar infarct. Magnetic resonance angiography of brain and neck showed a focal narrowing in the origin of the internal carotid artery bilaterally. Electroencephalogram was normal. He was started on aspirin, atorvastatin, and carbamazepine. Transthoracic and trans-esophageal echocardiography showed a pedunculated and lobular atrial mass, measuring 1 X 1.5 cm, which was freely mobile across mitral valve opening across the left ventricular inflow. Autoimmune screening showed positive Antiphospholipid antibodies in high titer (Cardiolipin IgG > 120 units/ml, B2 glycoprotein IgG 90 units/mL). Anti-nuclear antibody was negative. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Platelet count was low (111 x 109/L). The patient underwent successful surgical removal of the mass, which looked like a thrombotic clot, and Histopathological analysis confirmed it as a fibrinous clot, with no evidence of tumor cells. The patient was started on full anticoagulation treatment and was followed up regularly in the clinic, where our patient did not have any further complications from the disease. Discussion: Our patient was diagnosed to have APS based on the features of high positive anticardiolipin antibody IgG and B2 glycoprotein IgG levels, Stroke, thrombocytopenia, and abnormal echo findings. Thrombotic vegetation can mimic an atrial myxoma on echo. Conclusion: APS can present with neurological and cardiac manifestations, and therefore a high index of suspicion is necessary for a diagnosis of the disease as it can affect both short and long term treatment plans and prognosis. Therefore, in patients presenting with neurological symptoms like seizures, weakness and radiological diagnosis of stroke in a young patient, where atrial masses could be thought to be the cause of stroke, they should be screened for any concomitant findings of thrombocytopenia and/or activated partial thromboplastin time prolongation, which should raise the suspicion of vasculitis, specifically APS to be the primary cause of the clinical presentation.

Keywords: antiphospholipid syndrome, seizures, atrial mass, stroke

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Authors: Jephte Sompud, Emily A. Gilbert, Andy Russel Mojiol, Cynthia B. Sompud, Alim Biun

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Naturally regenerated acacia forest and secondary indigenous forest forms some of the urban forests in Sabah. Naturally regenerated acacia trees are usually seen along the road that exists as forest islands. Acacia tree is not an indigenous tree species in Sabah that was introduced in the 1960’s as fire breakers that eventually became one of the preferred trees for forest plantation for paper and pulp production. Due to its adaptability to survive even in impoverished soils and poor-irrigated land, this species has rapidly spread throughout Sabah through natural regeneration. Currently, there is a lack of study to investigate the bird population in the naturally regenerated acacia forest. This study is important because it shed some light on the role of naturally regenerated acacia forest on bird’s population, as bird is known to be a good bioindicator forest health. The aim of this study was to document the bird’s population in naturally regenerated acacia forest with that adjacent secondary indigenous forest. The study site for this study was at Universiti Malaysia Sabah (UMS) Campus. Two forest types in the campus were chosen as a study site, of which were naturally regenerated Acacia Forest and adjacent secondary indigenous forest, located at the UMS Hill. A total of 21 sampling days were conducted in each of the forest types. The method used during this study was solely mist nets with three pockets. Whenever a bird is caught, it is extracted from the net to be identified and measurements were recorded in a standard data sheet. Mist netting was conducted from 6 morning until 5 evening. This study was conducted between February to August 2014. Birds that were caught were ring banded to initiate a long-term study on the understory bird’s population in the Campus The data was analyzed using descriptive analysis, diversity indices, and t-test. The bird population diversity at naturally regenerated Acacia forest with those at the secondary indigenous forest was calculated using two common indices, of which were Shannon-Wiener and Simpson diversity index. There were 18 families with 33 species that were recorded from both sites. The number of species recorded at the naturally regenerated acacia forest was 26 species while at the secondary indigenous forest were 19 species. The Shannon diversity index for Naturally Regenerated Acacia Forest and secondary indigenous forests were 2.87 and 2.46. The results show that there was very significantly higher species diversity at the Naturally Regenerated Acacia Forest as opposed to the secondary indigenous forest (p<0.001). This suggests that Naturally Regenerated Acacia forest plays an important role in urban bird conservation. It is recommended that Naturally Regenerated Acacia Forests should be considered as an established urban forest conservation area as they do play a role in biodiversity conservation. More future studies in Naturally Regenerated Acacia Forest should be encouraged to determine the status and value of biodiversity conservation of this ecosystem.

Keywords: naturally regenerated acacia forest, bird population diversity, Universiti Malaysia Sabah, biodiversity conservation

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Authors: Jacob Lewis Watts, Adam F. A. Pellegrini

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Prairies, grasslands, and forests cover an expansive portion of the world’s surface and contribute significantly to Earth’s carbon cycle. The largest driver of carbon dynamics in some of these ecosystems is fire. As the global climate changes, most fire-dominated ecosystems will experience increased fire frequency and intensity, leading to increased carbon flux into the atmosphere and soil nutrient depletion. The plant communities associated with different fire regimes are important for reassimilation of carbon lost during fire and soil recovery. More frequent fires promote conservative plant functional traits aboveground; however, belowground fine root traits are poorly explored and arguably more important drivers of ecosystem function as the primary interface between the soil and plant. The root economic spectrum (RES) hypothesis describes single-dimensional covariation between important fine-root traits along a range of plant strategies from acquisitive to conservative – parallel to the well-established leaf economic spectrum (LES). However, because of the paucity of root trait data, the complex nature of the rhizosphere, and the phylogenetic conservatism of root traits, it is unknown whether the RES hypothesis accurately describes plant nutrient and water acquisition strategies. This project utilizesplants grown in common garden conditions in the Cambridge University Botanic Garden and a meta-analysis of long-term fire manipulation experiments to examine the belowground physiological traits of fire-adapted and non-fire-adapted herbaceous species to 1) test the RES hypothesis and 2) describe the effect of fire regimes on fine root functional traits – which in turn affect carbon and nutrient cycling. A suite of morphological, chemical, and biological root traits (e.g. root diameter, specific root length, percent N, percent mycorrhizal colonization, etc.) of 50 herbaceous species were measuredand tested for phylogenetic conservatism and RES dimensionality. Fire-adapted and non-fire-adapted plants traits were compared using phylogenetic PCA techniques. Preliminary evidence suggests that phylogenetic conservatism may weaken the single-dimensionality of the RES, suggesting that there may not be a single way that plants optimize nutrient and water acquisition and storage in the complex rhizosphere; additionally, fire-adapted species are expected to be more conservative than non-fire-adapted species, which may be indicative of slower carbon cycling with increasing fire frequency and intensity.

Keywords: climate change, fire regimes, root economic spectrum, fine roots

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Authors: Diana Cunha, Catarina Coelho, Ana Paula Relvas, Elisabeth Kastenholz

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Context: Tourist experiences have a recognized impact on the well-being of individuals. However, studies on the specific benefits of tourist experiences for families are scattered across different disciplines. This study aims to systematically review the literature to synthesize the evidence on the benefits of tourist experiences for families. Research Aim: The main objective is to systematize the evidence in the literature regarding the benefits of tourist experiences for families. Methodology: A systematic literature review was conducted using Nvivo, analyzing 33 scientific studies obtained from various databases. The search terms used were "family"/ "couple" and "tourist experience". The studies included quantitative, qualitative, mixed methods, and literature reviews. All works prior to the year 2000 were excluded, and the search was restricted to full text. A language filter was also used, considering articles in Portuguese, English, and Spanish. For NVivo analysis, information was coded based on both deductive and inductive perspectives. To minimize the subjectivity of the selection and coding process, two of the authors discussed the process and agreed on criteria that would make the coding more objective. Once the coding process in NVivo was completed, the data relating to the identification/characterization of the works were exported to the Statistical Package for the Social Sciences (SPPS), to characterize the sample. Findings: The results highlight that tourist experiences have several benefits for family systems, including the strengthening of family and marital bonds, the creation of family memories, and overall well-being and life satisfaction. These benefits contribute to both immediate relationship quality improvement and long-term family identity construction and transgenerational transmission. Theoretical Importance: This study emphasizes the systemic nature of the effects and relationships within family systems. It also shows that no harm was reported within these experiences, with only some challenges related to positive outcomes. Data Collection and Analysis Procedures: The study collected data from 33 scientific studies published predominantly after 2013. The data were analyzed using Nvivo, employing a systematic review approach. Question Addressed: The study addresses the question of the benefits of tourist experiences for families and how these experiences contribute to family functioning and individual well-being. Conclusion: Tourist experiences provide opportunities for families to enhance their interpersonal relationships and create lasting memories. The findings suggest that formal interventions based on evidence could further enhance the potential benefits of these experiences and be a valuable preventive tool in therapeutic interventions.

Keywords: family systems, individual and family well-being, marital satisfaction, tourist experiences

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Authors: Abdolamir Allameh, Shahnaz Esmaeili, Mina Allameh, Safoura Khajeniazi

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Stem cells with therapeutic applications can be isolated from human placenta/umblical cord blood (UCB) as well as the cord tissue (UC). Stem cells in culture are vulnerable to oxidative stress, particularly when subjected to differentiation process. The aim of this study was to examine the chnages in the rate of oxidation that occurs to cellular macromolecules during hepatic differentiation of mononuclear cells (MSCs). In addition, the impact of the hepatic differentiation process of MSC on cellular and biological activity of the cells will be undertaken. For this purpose, first mononuclear cells (MNCs) were isolated from human UCB which was obtained from a healthy full-term infant. The cells were cultured at a density of 3×10⁵ cells/cm² in DMEM- low-glucose culture media supplemented with 20% FBS, 2 mM L-glutamine, 100 μg/ml streptomycin and 100 U/ml penicillin. Cell cultures were then incubated at 37°C in a humidified 5% CO₂ incubator. After removing non-adherent cells by replacing culture medium, fibroblast-like adherent cells were resuspended in 0.25% trypsin-EDTA and plated in 25 cm² flasks (1×10⁴/ml). Characterization of the MSCs was routinely done by observing their morphology and growth curve. MSCs were subjected to a 2-step hepatocyte differentiation protocol in presence of hepatocyte growth factor (HGF), dexamethazone (DEX) and oncostatin M (OSM). The hepatocyte-like cells derived from MSCs were checked every week for 3 weeks for changes in lipid peroxidation, protein carbonyl formation and DNA oxidation i.e., 8-hydroxy-2'-deoxyguanosine (8-OH-dG) assay. During the 3-week differentiation process of MSCs to hepatocyte-like cells we found that expression liver-specific markers such as albumin, was associated with increased levels of lipid peroxidation and protein carbonyl formation. Whereas, undifferentiated MSCs has relatively low levels of lipid peroxidation products. There was a significant increase ( p < 0.05) in lipid peroxidation products in hepatocytes on days 7, 14, and 21 of differentiation. Likewise, the level of protein carbonyls in the cells was elevated during the differentiation. The level of protein carbonyls measured in hepatocyte-like cells obtained 3 weeks after differentiation induction was estimated to be ~6 fold higher compared to cells recovered on day 7 of differentiation. On the contrary, there was a small but significant decrease in DNA damage marker (8-OH-dG) in hepatocytes recovered 3 weeks after differentiation onset. The level of 8-OHdG which was in consistent with formation of reactive oxygen species (ROS). In conclusion, this data suggest that despite the elevation in oxidation of lipid and protein molecules during hepatocyte development, the cells were normal in terms of DNA integrity, morphology, and biologically activity.

Keywords: adult stem cells, DNA integrity, free radicals, hepatic differentiation

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Authors: Radhika Jain

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

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

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Authors: Cristina Felipeto, Catherine Bore, Eduardo Calil

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This work aims to analyze and compare the punctuation marks (PM) in school texts of Brazilian and French students and the comments on these PM made spontaneously by the students during the ongoing text. Assuming textual genetics as an investigative field within a dialogical and enunciative approach, we defined a common methodological design in two 1st year classrooms (7 years old) of the primary school, one classroom in Brazil (Maceio) and the other one in France (Paris). Through a multimodal capture system of writing processes in real time and space (Ramos System), we recorded the collaborative writing proposal in dyads in each of the classrooms. This system preserves the classroom’s ecological characteristics and provides a video recording synchronized with dialogues, gestures and facial expressions of the students, the stroke of the pen’s ink on the sheet of paper and the movement of the teacher and students in the classroom. The multimodal register of the writing process allowed access to the text in progress and the comments made by the students on what was being written. In each proposed text production, teachers organized their students in dyads and requested that they should talk, combine and write a fictional narrative. We selected a Dyad of Brazilian students (BD) and another Dyad of French students (FD) and we have filmed 6 proposals for each of the dyads. The proposals were collected during the 2nd Term of 2013 (Brazil) and 2014 (France). In 6 texts written by the BD there were identified 39 PMs and 825 written words (on average, a PM every 23 words): Of these 39 PMs, 27 were highlighted orally and commented by either student. In the texts written by the FD there were identified 48 PMs and 258 written words (on average, 1 PM every 5 words): Of these 48 PM, 39 were commented by the French students. Unlike what the studies on punctuation acquisition point out, the PM that occurred the most were hyphens (BD) and commas (FD). Despite the significant difference between the types and quantities of PM in the written texts, the recognition of the need for writing PM in the text in progress and the comments have some common characteristics: i) the writing of the PM was not anticipated in relation to the text in progress, then they were added after the end of a sentence or after the finished text itself; ii) the need to add punctuation marks in the text came after one of the students had ‘remembered’ that a particular sign was needed; iii) most of the PM inscribed were not related to their linguistic functions, but the graphic-visual feature of the text; iv) the comments justify or explain the PM, indicating metalinguistic reflections made by the students. Our results indicate how the comments of the BD and FD express the dialogic and subjective nature of knowledge acquisition. Our study suggests that the initial learning of PM depends more on its graphic features and interactional conditions than on its linguistic functions.

Keywords: collaborative writing, erasure, graphic marks, learning, metalinguistic awareness, textual genesis

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Authors: Asfaw Gezae Daful, Mohsen Alimandagari, Kathleen Haigh, Somayeh Farzad, Eugene Van Rensburg, Johann F. Görgens

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The sugar industry has to 're-invent' itself to ensure long-term economic survival and opportunities for job creation and enhanced community-level impacts, given increasing pressure from fluctuating and low global sugar prices, increasing energy prices and sustainability demands. We propose biorefineries for re-vitalisation of the sugar industry using low value lignocellulosic biomass (sugarcane bagasse, leaves, and tops) annexed to existing sugar mills, producing a spectrum of high value platform chemicals along with biofuel, bioenergy, and electricity. Opportunity is presented for greener products, to mitigate climate change and overcome economic challenges. Xylose from labile hemicellulose remains largely underutilized and the conversion to value-add products a major challenge. Insight is required on pretreatment and/or extraction to optimize production of cellulosic ethanol together with lactic acid, furfural or biopolymers from sugarcane bagasse, leaves, and tops. Experimental conditions for alkaline and pressurized hot water extraction dilute acid and steam explosion pretreatment of sugarcane bagasse and harvest residues were investigated to serve as a basis for developing various process scenarios under a sugarcane biorefinery scheme. Dilute acid and steam explosion pretreatment were optimized for maximum hemicellulose recovery, combined sugar yield and solids digestibility. An optimal range of conditions for alkaline and liquid hot water extraction of hemicellulosic biopolymers, as well as conditions for acceptable enzymatic digestibility of the solid residue, after such extraction was established. Using data from the above, a series of energy efficient biorefinery scenarios are under development and modeled using Aspen Plus® software, to simulate potential factories to better understand the biorefinery processes and estimate the CAPEX and OPEX, environmental impacts, and overall viability. Rigorous and detailed sustainability assessment methodology was formulated to address all pillars of sustainability. This work is ongoing and to date, models have been developed for some of the processes which can ultimately be combined into biorefinery scenarios. This will allow systematic comparison of a series of biorefinery scenarios to assess the potential to reduce negative impacts on and maximize the benefits of social, economic, and environmental factors on a lifecycle basis.

Keywords: biomass, biorefinery, green economy, sustainability

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Authors: Adriana Garcia G., Alberto A. Escobar P., Amira D. Calvo L., Gabriel Lizama U., Alejandro Zepeda P., Fernando Martínez B., Susana Rincón A.

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Different studies have recently been focused on the use of antioxidants such as polyphenols because of to its anticarcinogenic capacity. However, these compounds are highly sensible to environmental factors such as light and heat, so lose its long-term stability, besides possess an astringent and bitter taste. Nevertheless, the polyphenols can be protected by microcapsule formulation. In this sense, a rich source of polyphenols is sorghum, besides presenting a high starch content. Due to the above, the aim of this work was to obtain modified starches from sorghum by extrusion to encapsulate polyphenols the sorghum by spray drying. Polyphenols were extracted by ethanol solution from sorghum (Pajarero/red) and determined by the method of Folin-Ciocalteu, obtaining GAE at 30 mg/g. Moreover, was extracted starch of sorghum (Sinaloense/white) through wet milling (yield 32 %). The hydrolyzed starch was modified with three treatments: acetic anhydride (2.5g/100g), sodium tripolyphosphate (4g/100g), and sodium tripolyphosphate/ acetic anhydride (2g/1.25g by each 100 g) by extrusion. Processing conditions of extrusion were as follows: barrel temperatures were of 60, 130 and 170 °C at the feeding, transition, and high-pressure extrusion zones, respectively. Analysis of Fourier Transform Infrared spectroscopy (FTIR), showed bands exhibited of acetyl groups (1735 cm-1) and phosphates (1170 cm-1, 910 cm-1 and 525 cm-1), indicating the respective modification of starch. Besides, all modified starches not developed viscosity, which is a characteristic required for use in the encapsulation of polyphenols using the spray drying technique. As result of the modification starch, was obtained a water solubility index (WSI) from 33.8 to 44.8 %, and crystallinity from 8 to 11 %, indicating the destruction of the starch granule. Afterwards, microencapsulation of polyphenols was developed by spray drying, with a blend of 10 g of modified starch, 60 ml polyphenol extract and 30 ml of distilled water. Drying conditions were as follows: inlet air temperature 150 °C ± 1, outlet air temperature 80°C ± 5. As result of the microencapsulation: were obtained yields of 56.8 to 77.4 % and an efficiency of encapsulation from 84.6 to 91.4 %. The FTIR analysis showed evidence of microcapsules loaded with polyphenols in bands 1042 cm-1, 1038 cm-1 and 1148 cm-1. Analysis Differential scanning calorimetry (DSC) showed transition temperatures from 144.1 to 173.9 °C. For the order hand, analysis of Scanning Electron Microscopy (SEM), were observed rounded surfaces with concavities, typical feature of microcapsules produced by spray drying, how result of rapid evaporation of water. Finally, the modified starches were obtained by extrusion with good characteristics for use as cover materials by spray drying, where the phosphorylated starch was the best treatment in this work, according to the encapsulation yield, efficiency, and transition temperature.

Keywords: encapsulation, extrusion, modified starch, polyphenols, spray drying

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Authors: Hui-Ling Yang, Kuei-Ru Chou

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Background: Studies show that cognitive training can effectively delay cognitive failure. However, there are several gaps in the previous studies of cognitive training in mild cognitive impairment: 1) previous studies enrolled mostly healthy older adults, with few recruiting older adults with cognitive impairment; 2) they also had limited generalizability and lacked long-term follow-up data and measurements of the activities of daily living functional impact. Moreover, only 37% were randomized controlled trials (RCT). 3) Limited cognitive training has been specifically developed for mild cognitive impairment. Objective: This study sought to investigate the changes in cognitive function, activities of daily living and degree of depressive symptoms in older adults with mild cognitive impairment after cognitive training. Methods: This double-blind randomized controlled study has a 2-arm parallel group design. Study subjects are older adults diagnosed with mild cognitive impairment in residential care facilities. 124 subjects will be randomized by the permuted block randomization, into intervention group (Cognitive training, CT), or active control group (Passive information activities, PIA). Therapeutic adherence, sample attrition rate, medication compliance and adverse events will be monitored during the study period, and missing data analyzed using intent-to-treat analysis (ITT). Results: Training sessions of the CT group are 45 minutes/day, 3 days/week, for 12 weeks (36 sessions each). The training of active control group is the same as CT group (45min/day, 3days/week, for 12 weeks, for a total of 36 sessions). The primary outcome is cognitive function, using the Mini-Mental Status Examination (MMSE); the secondary outcome indicators are: 1) activities of daily living, using the Lawton’s Instrumental Activities of Daily Living (IADLs) and 2) degree of depressive symptoms, using the Geriatric Depression Scale-Short form (GDS-SF). Latent growth curve modeling will be used in the repeated measures statistical analysis to estimate the trajectory of improvement by examining the rate and pattern of change in cognitive functions, activities of daily living and degree of depressive symptoms for intervention efficacy over time, and the effects will be evaluated immediate post-test, 3 months, 6 months and one year after the last session. Conclusions: We constructed a rigorous CT program adhering to the Consolidated Standards of Reporting Trials (CONSORT) reporting guidelines. We expect to determine the improvement in cognitive function, activities of daily living and degree of depressive symptoms of older adults with mild cognitive impairment after using the CT.

Keywords: mild cognitive impairment, cognitive training, randomized controlled study

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Authors: Misagh Ghobadi, Rich Crane, Karen Hudson-Edwards, Clemens Vinzenz Ullmann

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Lithium is recognized as the critical energy metal of the 21st century, comparable in importance to coal in the 19th century and oil in the 20th century, often termed 'white gold'. Current global demand for lithium, estimated at 0.95-0.98 million metric tons (Mt) of lithium carbonate equivalent (LCE) annually in 2024, is projected to rise to 1.87 Mt by 2027 and 3.06 Mt by 2030. Despite anticipated short-term stability in supply and demand, meeting the forecasted 2030 demand will require the lithium industry to develop an additional capacity of 1.42 Mt of LCE annually, exceeding current planned and ongoing efforts. Brine resources constitute nearly 65% of global lithium reserves, underscoring the importance of exploring lithium recovery from underutilized sources, especially geothermal brines. However, conventional lithium extraction from brine deposits faces challenges due to its time-intensive process, low efficiency (30-50% lithium recovery), unsuitability for low lithium concentrations (<300 mg/l), and notable environmental impacts. Addressing these challenges, direct lithium extraction (DLE) methods have emerged as promising technologies capable of economically extracting lithium even from low-concentration brines (>50 mg/l) with high recovery rates (75-98%). However, most studies (70%) have predominantly focused on synthetic brines instead of native (natural/real), with limited application of these approaches in real-world case studies or industrial settings. This study aims to bridge this gap by investigating a geothermal brine sample collected from a real case study site in the UK. A Mn-based lithium-ion sieve (LIS) adsorbent was synthesized and employed to selectively extract lithium from the sample brine. Adsorbents with a Li:Mn molar ratio of 1:1 demonstrated superior lithium selectivity and adsorption capacity. Furthermore, the pristine Mn-based adsorbent was modified through transition metals doping, resulting in enhanced lithium selectivity and adsorption capacity. The modified adsorbent exhibited a higher separation factor for lithium over major co-existing cations such as Ca, Mg, Na, and K, with separation factors exceeding 200. The adsorption behaviour was well-described by the Langmuir model, indicating monolayer adsorption, and the kinetics followed a pseudo-second-order mechanism, suggesting chemisorption at the solid surface. Thermodynamically, negative ΔG° values and positive ΔH° and ΔS° values were observed, indicating the spontaneity and endothermic nature of the adsorption process.

Keywords: adsorption, critical minerals, DLE, geothermal brines, geochemistry, lithium, lithium-ion sieves

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Authors: Joe Dorbor Wuokolo

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Thousands of smallholder farmers in Todee District, Montserrado county, are currently vulnerable to the negative impact of climate change. The district, which is the agricultural hot spot for the county, is faced with unfavorable changes in the daily temperature due to climate change. Farmers in the district have observed a dramatic change in the ratio of rainfall to sunshine, which has caused a chilling effect on their crop yields. However, there is a lack of documentation regarding how farmers perceive and respond to these changes and challenges. A study was conducted in the region to examine the perceptions of smallholder farmers regarding the negative impact of climate change, the adaptation strategies practice, and the barriers that hinder the process of advancing adaptation strategy. On purpose, a sample of 41 respondents from five towns was selected, including five town chiefs, five youth leaders, five women leaders, and sixteen community members. Women and youth leaders were specifically chosen to provide gender balance and enhance the quality of the investigation. Additionally, to validate the barriers farmers face during adaptation to climate change, this study interviewed eight experts from local and international organizations and government ministries and agencies involved in climate change and agricultural programs on what they perceived as the major barrier in both local and national level that impede farmers adaptation to climate change impact. SPSS was used to code the data, and descriptive statistics were used to analyze the data. The weighted average index (WAI) was used to rank adaptation strategies and the perceived importance of adaptation practices among farmers. On a scale from 0 to 3, 0 indicates the least important technique, and 3 indicates the most effective technique. In addition, the Problem Confrontation Index (PCI) was used to rank the barriers that prevented farmers from implementing adaptation measures. According to the findings, approximately 60% of all respondents considered the use of irrigation systems to be the most effective adaptation strategy, with drought-resistant varieties making up 30% of the total. Additionally, 80% of respondents placed a high value on drought-resistant varieties, while 63% percent placed it on irrigation practices. In addition, 78% of farmers ranked and indicated that unpredictability of the weather is the most significant barrier to their adaptation strategies, followed by the high cost of farm inputs and lack of access to financing facilities. 80% of respondents believe that the long-term changes in precipitation (rainfall) and temperature (hotness) are accelerating. This suggests that decision-makers should adopt policies and increase the capacity of smallholder farmers to adapt to the negative impact of climate change in order to ensure sustainable food production.

Keywords: adaptation strategies, climate change, farmers’ perception, smallholder farmers

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Authors: I. Tiahi

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The aim of the current paper is to explore educational practices in contemporary Algeria. Researches explain such practices bear traditional approach and the overlooks modern teaching methods such as mobile learning. That is why the research output of examining student engagement in respect of mobile learning was obtained from the following objectives: (1) To evaluate the current practice of English language teaching within Algerian higher education institutions, (2) To explore how social constructivism theory and m-learning help students’ engagement in the classroom and (3) To explore the feasibility and acceptability of m-learning amongst institutional leaders. The methodology underpins a case study and action research. For the case study, the researcher engaged with 6 teachers, 4 institutional leaders, and 30 students subjected for semi-structured interviews and classroom observations to explore the current teaching methods for English as a foreign language. For the action research, the researcher applied an intervention course to investigate the possibility and implications for future implementation of mobile learning in higher education institutions. The results were deployed using thematic analysis. The research outcome showed that the disengagement of students in English language learning has many aspects. As seen from the interviews from the teachers, the researcher found that they do not have enough resources except for using ppt for some teacher. According to them, the teaching method they are using is mostly communicative and competency-based approach. Teachers informed that students are disengaged because they have psychological barriers. In classroom setting, the students are conscious about social approval from the peer, and thus if they are to face negative reinforcement which would damage their image, it is seen as a preventive mechanism to be scared of committing mistakes. This was also very reflective in this finding. A lot of other arguments can be given for this claim; however, in Algerian setting, it is usual practice where teachers do not provide positive reinforcement which is open up students for possible learning. Thus, in order to overcome such a psychological barrier, proper measures can be taken. On a conclusive remark, it is evident that teachers, students, and institutional leaders provided positive feedback for using mobile learning. It is not only motivating but also engaging in learning processes. Apps such as Kahoot, Padlet and Slido were well received and thus can be taken further to examine its higher impact in Algerian context. Thus, in the future, it will be important to implement m-learning effectively in higher education to transform the current traditional practices into modern, innovative and active learning. Persuasion for this change for stakeholder may be challenging; however, its long-term benefits can be reflective from the current research paper.

Keywords: Algerian context, mobile learning, social constructivism, student engagement

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Authors: Clara Voyvodic

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Transitions from conflict to peace are by no means smooth nor linear, particularly from the perspective of those living through them. Over the last few decades, the changing focus in peacebuilding studies has come to appreciate the everyday experience of communities and how that provides a lens through which the relative success or efficacy of these transitions can be understood. In particular, the demobilization of a significant conflict actor is not without consequences, not just for the macro-view of state stabilization and peace, but for the communities who find themselves without a clear authority of territorial control. In Colombia, the demobilization and disarmament of the FARC guerilla group provided a brief respite to the conflict and a major political win for President Manuel Santos. However, this victory has proven short-lived. Drawing from extensive field research in Colombia within the last year, including interviews with local communities and actors operating in these regions, field observations, and other primary resources, this paper examines the post-accord transitions in Colombia and the everyday security experiences of local communities in regions formerly controlled by the FARC. In order to do so, the research focused on a semi-ethnographic approach in the northern region of the department of Antioquia and the coastal area of the border department of Nariño that documented how individuals within these marginalized communities have come to understand and negotiate their security in the years following the accord and the demobilization of the FARC. This presentation will argue that the removal of the FARC as an informal governance actor opened a space for multiple actors to attempt to control the same territory, including the state. This shift has had a clear impact on the everyday security experiences of the local communities. With an exploration of the dynamics of local governance and its impact on lived security experiences, this research seeks to demonstrate how distinct patterns of armed group behavior are emerging not only from a vacuum of control left by the FARC but from an increase in state presence that nonetheless remains inconsistent and unpersuasive as a monopoly of force in the region. The increased multiplicity of actors, particularly the state, has meant that the normal (informal) rules for communities to navigate these territories are no longer in play as the identities, actions, and intentions of different competing groups have become frustratingly opaque. This research provides a prescient analysis on how the shifting dynamics of territorial control in a post-peace accord landscape produce uncertain realities that affect the daily lives of the local communities and endanger the long-term prospect of human-centered security.

Keywords: armed actors, conflict transitions, informal governance, post-accord, security experiences

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Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

Abstract:

Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

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Authors: Rommila Chandra, Harshika Choudhary

Abstract:

The value of integrated, participatory, and community based sustainable development strategies is eminent, but in practice, it still remains fragmentary and often leads to short-lived results. Despite the global presence of climate change, its impacts are felt differently by different communities based on their vulnerability. The developing countries have the low adaptive capacity and high dependence on environmental variables, making them highly susceptible to outmigration and poverty. We need to understand how to enable these approaches, taking into account the various governmental and non-governmental stakeholders functioning at different levels, to deliver long-term socio-economic and environmental well-being of local communities. The research assessed the financial and natural vulnerability of Himalayan networks, focusing on their potential to adapt to various changes, through accessing their perceived reactions and local knowledge. The evaluation was conducted by testing indices for vulnerability, with a major focus on indicators for adaptive capacity. Data for the analysis were collected from the villages around Govind National Park and Wildlife Sanctuary, located in the Indian Himalayan Region. The villages were stratified on the basis of connectivity via road, thus giving two kinds of human settlements connected and isolated. The study focused on understanding the complex relationship between outmigration and the socio-cultural sentiments of local people to not abandon their land, assessing their adaptive capacity for livelihood opportunities, and exploring their contribution that integrated participatory methodologies can play in delivering sustainable development. The result showed that the villages having better road connectivity, access to market, and basic amenities like health and education have a better understanding about the climatic shift, natural hazards, and a higher adaptive capacity for income generation in comparison to the isolated settlements in the hills. The participatory approach towards environmental conservation and sustainable use of natural resources were seen more towards the far-flung villages. The study helped to reduce the gap between local understanding and government policies by highlighting the ongoing adaptive practices and suggesting precautionary strategies for the community studied based on their local conditions, which differ on the basis of connectivity and state of development. Adaptive capacity in this study has been taken as the externally driven potential of different parameters, leading to a decrease in outmigration and upliftment of the human environment that could lead to sustainable livelihood development in the rural areas of Himalayas.

Keywords: adaptive capacity, Indian Himalayan region, participatory, sustainable livelihood development

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Authors: Babarina Maria, Andropova Margarita

Abstract:

Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

Abstract:

Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Malcolm Richardson, Gabriele Richardson

Abstract:

This paper illustrates how historical problems can be studied successfully using GIS even in cases in which data, in the modern sense, is fragmentary. The overall problem under investigation is how early (1300-1500) English schools of Common Law moved from apprenticeship training in random individual London inns run in part by clerks of the royal chancery to become what is widely called 'the Third University of England,' a recognized system of independent but connected legal inns. This paper focuses on the preparatory legal inns, called the Inns of Chancery, rather than the senior (and still existing) Inns of Court. The immediate problem studied in this paper is how the junior legal inns were organized, staffed, and located from 1292 to about 1500, and what maps tell us about the role of the chancery clerks as managers of legal inns. The authors first uncovered the names of all chancery clerks of the period, most of them unrecorded in histories, from archival sources in the National Archives, Kew. Then they matched the names with London property leases. Using ArcGIS, the legal inns and their owners were plotted on a series of maps covering the period 1292 to 1500. The results show a distinct pattern of ownership of the legal inns and suggest a narrative that would help explain why the Inns of Chancery became serious centers of learning during the fifteenth century. In brief, lower-ranking chancery clerks, always looking for sources of income, discovered by 1370 that legal inns could be a source of income. Since chancery clerks were intimately involved with writs and other legal forms, and since the chancery itself had a long-standing training system, these clerks opened their own legal inns to train fledgling lawyers, estate managers, and scriveners. The maps clearly show growth patterns of ownership by the chancery clerks for both legal inns and other London properties in the areas of Holborn and The Strand between 1450 and 1417. However, the maps also show that a royal ordinance of 1417 forbidding chancery clerks to live with lawyers, law students, and other non-chancery personnel had an immediate effect, and properties in that area of London leased by chancery clerks simply stop after 1417. The long-term importance of the patterns shown in the maps is that while the presence of chancery clerks in the legal inns likely created a more coherent education system, their removal forced the legal profession, suddenly without a hostelry managerial class, to professionalize the inns and legal education themselves. Given the number and social status of members of the legal inns, the effect on English education was to free legal education from the limits of chancery clerk education (the clerks were not practicing common lawyers) and to enable it to become broader in theory and practice, in fact, a kind of 'finishing school' for the governing (if not noble) class.

Keywords: GIS, law, London, education

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