Search results for: delayed diagnosis and poor outcome

Authors: K. Frahtia, I. Mihoubi, S. Picot

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Leishmaniasis is a group of parasitic disease with a varied clinical expression caused by flagellate protozoa of the Leishmania genus. These diseases are transmitted to humans and animals by the sting of a vector insect, the female sandfly. Among the groups of dipteral disease vectors, Phlebotominae occupy a prime position and play a significant role in human pathology, such as leishmaniasis that affects nearly 350 million people worldwide. The vector control operation launched by health services throughout the country proves to be effective since despite the prevalence of the disease remains high especially in rural areas, leishmaniasis appears to be declining in Algeria. In this context, this study mainly concerns molecular detection of Leishmania from the vector. Furthermore, a molecular diagnosis has also been made on skin samples taken from patients in the region of Constantine, located in the North-East of Algeria. Concerning the vector, 5858 sandflies were captured, including 4360 males and 1498 females. Male specimens were identified based on their morphological. The morphological identification highlighted the presence of the Phlebotomus genus with a prevalence of 93% against 7% represented by the Sergentomyia genus. About the identified species, P. perniciosus is the most abundant with 59.4% of the male identified population followed by P. longicuspis with 24.7% of the workforce. P. perfiliewi is poorly represented by 6.7% of specimens followed by P. papatasi with 2.2% and 1.5% S. dreyfussi. Concerning skin samples, 45/79 (56.96%) collected samples were found positive by real-time PCR. This rate appears to be in sharp decline compared to previous years (alert peak of 30,227 cases in 2005). Concerning the detection of Leishmania from sandflies by RT-PCR, the results show that 3/60 PCR performed genus are positive with melting temperatures corresponding to that of the reference strain (84.1 +/- 0.4 ° C for L. infantum). This proves that the vectors were parasitized. On the other side, identification by RT-PCR species did not give any results. This could be explained by the presence of an insufficient amount of leishmanian DNA in the vector, and therefore support the hypothesis of the regression of leishmaniasis in Constantine.

Keywords: Algeria, molecular diagnostic, phlebotomus, real time PCR

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Authors: Rui-heng Ray Huang

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This study compares the syntax and semantics of two kinds of passives in Mandarin Chinese: bèi passives and yóu passives. To express a Chinese equivalent for ‘The thief was taken away by the police,’ either bèi or yóu can be used, as in Xiǎotōu bèi/yóu jǐngchá dàizǒu le. It is shown in this study that bèi passives and yóu passives differ semantically and syntactically. The semantic observations are based on the theta theory, dealing with thematic roles. On the other hand, the syntactic analysis draws heavily upon the generative grammar, looking into thematic structures. The findings of this study are as follows. First, the core semantics of bèi passives is centered on the Patient NP in the subject position. This Patient NP is essentially an Affectee, undergoing the outcome or consequence brought up by the action represented by the predicate. This may explain why in the sentence Wǒde huà bèi/*yóu tā niǔqū le ‘My words have been twisted by him/her,’ only bèi is allowed. This is because the subject NP wǒde huà ‘my words’ suffers a negative consequence. Yóu passives, in contrast, place the semantic focus on the post-yóu NP, which is not an Affectee though. Instead, it plays a role which has to take certain responsibility without being affected in a way like an Affectee. For example, in the sentence Zhèbù diànyǐng yóu/*bèi tā dānrèn dǎoyǎn ‘This film is directed by him/her,’ only the use of yóu is possible because the post-yóu NP tā ‘s/he’ refers to someone in charge, who is not an Affectee, nor is the sentence-initial NP zhèbù diànyǐng ‘this film’. When it comes to the second finding, the syntactic structures of bèi passives and yóu passives differ in that the former involve a two-place predicate while the latter a three-place predicate. The passive morpheme bèi in a case like Xiǎotōu bèi jǐngchá dàizǒu le ‘The thief was taken away by the police’ has been argued by some Chinese syntacticians to be a two-place predicate which selects an Experiencer subject and an Event complement. Under this analysis, the initial NP xiǎotōu ‘the thief’ in the above example is a base-generated subject. This study, however, proposes that yóu passives fall into a three-place unergative structure. In the sentence Xiǎotōu yóu jǐngchá dàizǒu le ‘The thief was taken away by the police,’ the initial NP xiǎotōu ‘the thief’ is a topic which serves as a Patient taken by the verb dàizǒu ‘take away.’ The subject of the sentence is assumed to be an Agent, which is in a null form and may find its reference from the discourse or world knowledge. Regarding the post-yóu NP jǐngchá ‘the police,’ its status is dual. On the one hand, it is a Patient introduced by the light verb yóu; on the other, it is an Agent assigned by the verb dàizǒu ‘take away.’ It is concluded that the findings in this study contribute to better understanding of what makes the distinction between the two kinds of Chinese passives.

Keywords: affectee, passive, patient, unergative

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Fei Ye, Åsa Barrefelt, Manuchehr Abedi-Valugerdi, Khalid M. Abu-Salah, Salman A. Alrokayan, Mamoun Muhammed, Moustapha Hassan

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With appropriate encapsulation in functional nanoparticles drugs are more stable in physiological environment and the kinetics of the drug can be more carefully controlled and monitored. Furthermore, targeted drug delivery can be developed to improve chemotherapy in cancer treatment, not only by enhancing intracellular uptake by target cells but also by reducing the adverse effects in non-target organs. Inorganic imaging agents, delivered together with anti-cancer drugs, enhance the local imaging contrast and provide precise diagnosis as well as evaluation of therapy efficacy. We have developed biodegradable polymeric vesicles as a nanocarrier system for multimodal bio-imaging and anticancer drug delivery. The poly (lactic-co-glycolic acid) PLGA) vesicles were fabricated by encapsulating inorganic imaging agents of superparamagnetic iron oxide nanoparticles (SPION), manganese-doped zinc sulfide (MN:ZnS) quantum dots (QDs) and the anticancer drug busulfan into PLGA nanoparticles via an emulsion-evaporation method. T2-weighted magnetic resonance imaging (MRI) of PLGA-SPION-Mn:ZnS phantoms exhibited enhanced negative contrast with r2 relaxivity of approximately 523 s-1 mM-1 Fe. Murine macrophage (J774A) cellular uptake of PLGA vesicles started fluorescence imaging at 2 h and reached maximum intensity at 24 h incubation. The drug delivery ability PLGA vesicles was demonstrated in vitro by release of busulfan. PLGA vesicles degradation was studied in vitro, showing that approximately 32% was degraded into lactic and glycolic acid over a period of 5 weeks. The biodistribution of PLGA vesicles was investigated in vivo by MRI in a rat model. Change of contrast in the liver could be visualized by MRI after 7 min and maximal signal loss detected after 4 h post-injection of PLGA vesicles. Histological studies showed that the presence of PLGA vesicles in organs was shifted from the lungs to the liver and spleen over time.

Keywords: biodegradable polymers, multifunctional nanoparticles, quantum dots, anticancer drugs

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Authors: Feixiong Chen, Naoufel Haddour, Marie Frenea-Robin, Yves MéRieux, Yann Chevolot, Virginie Monnier

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Neonatal thrombopenia occurs when the mother generates antibodies against her baby’s platelet antigens. It is particularly critical for newborns because it can cause coagulation troubles leading to intracranial hemorrhage. In this case, diagnosis must be done quickly to make platelets transfusion immediately after birth. Before transfusion, platelet antigens must be tested carefully to avoid rejection. The majority of thrombopenia (95 %) are caused by antibodies directed against Human Platelet Antigen 1a (HPA-1a) or 5b (HPA-5b). The common method for antigen platelets detection is polymerase chain reaction allowing for identification of gene sequence. However, it is expensive, time-consuming and requires significant blood volume which is not suitable for newborns. We propose to develop a point-of-care device based on double functionalized magnetic colloids with 1) antibodies specific to antigen platelets and 2) highly sensitive electroactive molecules in order to be detected by an electrochemical microsensor. These magnetic colloids will be used first to isolate platelets from other blood components, then to capture specifically platelets bearing HPA-1a and HPA-5b antigens and finally to attract them close to sensor working electrode for improved electrochemical signal. The expected advantages are an assay time lower than 20 min starting from blood volume smaller than 100 µL. Our functionalization procedure based on amine dendrimers and NHS-ester modification of initial carboxyl colloids will be presented. Functionalization efficiency was evaluated by colorimetric titration of surface chemical groups, zeta potential measurements, infrared spectroscopy, fluorescence scanning and cyclic voltammetry. Our results showed that electroactive molecules and antibodies can be immobilized successfully onto magnetic colloids. Application of a magnetic field onto working electrode increased the detected electrochemical signal. Magnetic colloids were able to capture specific purified antigens extracted from platelets.

Keywords: Magnetic Nanoparticles , Electroactive Molecules, Antibody, Platelet

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Authors: Fen-Ling Kuo, Hsin-Chieh Lee, Han-Yun Hsiao, Jui-Chi Lin

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Background: Children with cerebral palsy (CP) usually suffered from mild to maximum upper limb dysfunction such as having difficulty in reaching and picking up objects, which profoundly affects their participation in activities of daily living (ADLs). Robot-assisted rehabilitation provides intensive physical training in improving sensorimotor function of the hand. Many researchers have extensively studied the effects of robot-assisted therapy (RT) for the paretic upper limb in patients with stroke in recent years. However, few studies have examined the effect of RT on hand function in children with CP. The purpose of this study is to investigate the effectiveness of Gloreha Sinfonia, a robotic device with a dynamic arm support system mainly focus on distal upper-limb training, on improvements of hand function and ADLs in children with CP. Methods: Seven children with moderate CP were recruited in this case series study. RT using Gloreha Sinfonia was performed 2 sessions per week, 60 min per session for 6 consecutive weeks, with 12 times in total. Outcome measures included the Fugl-Meyer Assessment-upper extremity (FMA-UE), the Box and Block Test, the electromyography activity of the extensor digitorum communis muscle (EDC) and brachioradialis (BR), a grip dynamometer for motor evaluation, and the ABILHAND-Kids for measuring manual ability to manage daily activities, were performed at baseline, after 12 sessions (end of treatment) and at the 1-month follow-up. Results: After 6 weeks of robot-assisted treatment of hand function, there were significant increases in FMA-UE shoulder/elbow scores (p=0.002), FMA-UE wrist/hand scores (p=0.002), and FMA-UE total scores (p=0.002). There were also significant improvements in the BR mean value (p = 0.015) and electrical agonist-antagonist muscle ratio (p=0.041) in grasping a 1-inch cube task. These gains were maintained for a month after the end of the intervention. Conclusion: RT using Gloreha Sinfonia for hand function training may contribute toward the improvement of upper extremity function and efficacy in recruiting BR muscle in children with CP. The results were maintained at one month after intervention.

Keywords: activities of daily living, cerebral palsy, hand function, robotic rehabilitation

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Authors: Wenyang Wan

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The study of urban land use and landscape pattern is the current hotspot in the fields of planning and design, ecology, etc., which is of great significance for the construction of the overall humanistic ecosystem of the city and optimization of the urban spatial structure. Banan District, as the main part of the eastern eco-city planning of Chongqing Municipality, is a new high ground for highlighting the ecological characteristics of Chongqing, realizing effective transformation of ecological value, and promoting the integrated development of urban and rural areas. The analytical methods of land use transfer matrix (GIS) and landscape pattern index (Fragstats) were used to study the characteristics and laws of the evolution of land use landscape pattern in Banan District from 2000 to 2020, which provide some reference value for Banan District to alleviate the ecological contradiction of landscape. The results of the study show that: ① Banan District is rich in land use types, of which the area of cultivated land will still account for 57.15% of the total area of the landscape until 2020, accounting for an absolute advantage in the land use structure of Banan District; ② From 2000 to 2020, land use conversion in Banan District is characterized as: Cropland > woodland > grassland > shrubland > built-up land > water bodies > wetlands, with cropland converted to built-up land being the largest; ③ From 2000 to 2020, the landscape elements of Banan District were distributed in a balanced way, and the landscape types were rich and diversified, but due to the influence of human interference, it also presented the characteristics that the shape of the landscape elements tended to be irregular, and the dominant patches were distributed in a scattered manner, and the patches had poor connectivity. It is recommended that in future regional ecological construction, the layout should be rationally optimized, the relationship between landscape components should be coordinated, and the connectivity between landscape patches should be strengthened, and the degree of landscape fragmentation should be reduced.

Keywords: land use transfer, landscape pattern evolution, GIS and FRAGSTATS, Banan District

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Authors: Abdullah Al Farwan, Ya Zhang

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In today’s educational arena, it is critical to understand educational data and be able to evaluate important aspects, particularly data on student achievement. Educational Data Mining (EDM) is a research area that focusing on uncovering patterns and information in data from educational institutions. Teachers, if they are able to predict their students' class performance, can use this information to improve their teaching abilities. It has evolved into valuable knowledge that can be used for a wide range of objectives; for example, a strategic plan can be used to generate high-quality education. Based on previous data, this paper recommends employing data mining techniques to forecast students' final grades. In this study, five data mining methods, Decision Tree, JRip, Naive Bayes, Multi-layer Perceptron, and Random Forest with wrapper feature selection, were used on two datasets relating to Portuguese language and mathematics classes lessons. The results showed the effectiveness of using data mining learning methodologies in predicting student academic success. The classification accuracy achieved with selected algorithms lies in the range of 80-94%. Among all the selected classification algorithms, the lowest accuracy is achieved by the Multi-layer Perceptron algorithm, which is close to 70.45%, and the highest accuracy is achieved by the Random Forest algorithm, which is close to 94.10%. This proposed work can assist educational administrators to identify poor performing students at an early stage and perhaps implement motivational interventions to improve their academic success and prevent educational dropout.

Keywords: classification algorithms, decision tree, feature selection, multi-layer perceptron, Naïve Bayes, random forest, students’ academic performance

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Authors: Leilani Forby, Farid Pazhoohi, Alan Kingstone

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There is abundant research on the nature and content of mind wandering (MW) in neurotypical (NT) adults, however, there is little to no research in these areas on autistic individuals. The objective of the current study was to uncover any differences between low and high autistic trait individuals in their MW. In particular, we examined their attitudes toward, and the themes and temporal dimensions (past, present, future) of, their MW episodes. For our online study, we recruited 518 students (394 women and 124 men), between the ages of 18 and 51 years (M = 20.93, SD = 3.40) from the undergraduate Human Subject Pool at the University of British Columbia. Participants completed the Short Imaginal Processes Inventory (SIPI), which includes the three subscales Positive-Constructive Daydreaming (SIPI-PC), Guilt and Fear of Failure Daydreaming (SIPI-GFF), and Poor Attentional Control (SIPI-PAC). Participants also completed the Past (IPI-past) and Present (IPI-present) subscales of the Imaginal Processes Inventory (IPI), the Deliberate (MW-D) and Spontaneous (MW-S) Mind Wandering scales, the Short Form Perceived Stress Scale (PSS-4), and the 10-item Autism Quotient (AQ-10). Results showed that overall, participant AQ-10 scores were significantly correlated with MW-S, SIPI-GFF, and PSS-4 scores, such that as the number of autistic traits endorsed by participants increased, so did their reports of spontaneous mind wandering, guilt and fear of failure themed day dreaming, and stress levels. This same pattern held for female participants, however, AQ-10 scores were positively correlated with only PSS-4 scores for males. These results suggest that compared to males with autistic traits, MW in females with autistic traits is more similar to individuals with low autistic traits in terms of content and intentionality. Results are discussed in terms of clinical implications, their limitations, and suggested directions for future research.

Keywords: autism, deliberate, mind wandering, spontaneous, perceived stress

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Authors: Hailu Kebede Bekele

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Construction delays are suitable where project events occur at a certain time expected due to causes related to the client, consultant, and contractor. Delay is the major cause of the cost overrun that leads to the poor efficiency of the project. The cost difference between completion and the originally estimated is known as cost overrun. The common ways of cost overruns are not simple issues that can be neglected, but more attention should be given to prevent the organization from being devastated to be failed, and financial expenses to be extended. The reasons that may raised in different studies show that the problem may arise in construction projects due to errors in budgeting, lack of favorable weather conditions, inefficient machinery, and the availability of extravagance. The study is focused on the pace of mega projects that can have a significant change in the cost overrun calculation.15 mega projects are identified to study the problem of the cost overrun in the site. The contractor, consultant, and client are the principal stakeholders in the mega projects. 20 people from each sector were selected to participate in the investigation of the current mega construction project. The main objective of the study on the construction cost overrun is to prioritize the major causes of the cost overrun problem. The methodology that was employed in the construction cost overrun is the qualitative methodology that mostly rates the causes of construction project cost overrun. Interviews, open-ended and closed-ended questions group discussions, and rating qualitative methods are the best methodologies to study construction projects overrun. The result shows that design mistakes, lack of labor, payment delay, old equipment and scheduling, weather conditions, lack of skilled labor, payment delays, transportation, inflation, and order variations, market price fluctuation, and people's thoughts and philosophies, the prior cause of the cost overrun that fail the project performance. The institute shall follow the scheduled activities to bring a positive forward in the project life.

Keywords: cost overrun, delay, mega projects, design

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Authors: Buhari Samaila, Buhari Maidamma

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Background: The use of ionizing radiation in medical diagnostics and treatment is indispensable for accurate imaging and effective cancer therapies. However, radiation exposure carries inherent risks, necessitating strict protection measures to safeguard both patients and healthcare workers. This review critically examines the existing radiation protection measures in diagnostic radiology and radiotherapy, highlighting technological advancements, regulatory frameworks, and challenges. Objective: The objective of this review is to critically evaluate the effectiveness of current radiation protection measures in diagnostic and therapeutic radiology, focusing on minimizing patient and staff exposure to ionizing radiation while ensuring optimal clinical outcomes and propose future directions for improvement. Method: A comprehensive literature review was conducted, covering scientific studies, regulatory guidelines, and international standards on radiation protection in both diagnostic radiology and radiotherapy. Emphasis was placed on ALARA principles, dose optimization techniques, and protective measures for both patients and healthcare workers. Results: Radiation protection measures in diagnostic radiology include the use of shielding devices, minimizing exposure times, and employing advanced imaging technologies to reduce dose. In radiotherapy, accurate treatment planning and image-guided techniques enhance patient safety, while shielding and dose monitoring safeguard healthcare personnel. Challenges such as limited infrastructure in low-income settings and gaps in healthcare worker training persist, impacting the overall efficacy of protection strategies. Conclusion: While significant advancements have been made in radiation protection, challenges remain in optimizing safety, especially in resource-limited settings. Future efforts should focus on enhancing training, investing in advanced technologies, and strengthening regulatory compliance to ensure continuous improvement in radiation safety practices.

Keywords: radiation protection, diagnostic radiology, radiotherapy, ALARA, patient safety, healthcare worker safety

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Authors: Alvin Saputra, Felix Wijovi

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Background: Adults with Autism Spectrum Disorder (ASD) often experience emotional dysregulation and heightened suicidality. Dialectical Behavior Therapy (DBT) and Radically Open DBT (RO-DBT) have shown promise in addressing these challenges, though research on their effectiveness in ASD populations remains limited. This systematic review aims to evaluate the impact of DBT and RO-DBT on emotional regulation, depression, and suicidality in adults with ASD. Methods: A systematic review was conducted by searching databases such as PubMed, PsycINFO, and Scopus for studies published on DBT and RO-DBT interventions in adults with Autism Spectrum Disorder (ASD). Inclusion criteria were peer-reviewed studies that reported on emotional regulation, suicidality, or depression outcomes. Data extraction focused on sample characteristics, intervention details, and outcome measures. Quality assessment was performed using standard systematic review criteria to ensure reliability and relevance of findings. Results: 4 studies comprising a total of 343 participants were included in this study. DBT and RO-DBT interventions demonstrated a medium effect size (Cohen's d = 0.53) in improving emotional regulation for adults with ASD, with ASD participants achieving significantly better outcomes than non-ASD individuals. RO-DBT was particularly effective in reducing maladaptive overcontrol, though high attrition and a predominantly White British sample limited generalizability. At end-of-treatment, DBT significantly reduced suicidal ideation (z = −2.24; p = 0.025) and suicide attempts (z = −3.15; p = 0.002) compared to treatment as usual (TAU), although this effect did not sustain at 12 months. Depression severity decreased with DBT (z = −1.99; p = 0.046), maintaining significance at follow-up (z = −2.46; p = 0.014). No significant effects were observed for social anxiety, and two suicides occurred in the TAU group. Conclusions: DBT and RO-DBT show potential efficacy in reducing emotional dysregulation, suicidality, and depression in adults with ASD, though the effects on suicidality may diminish over time. High dropout rates and limited sample diversity suggest further research is needed to confirm long-term benefits and improve applicability across broader populations.

Keywords: dialectical behaviour therapy, emotional dysregulation, autism spectrum disorder, suicidality

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Authors: David Ahiamadia, Ramilan Thiagarajah, Peter Tozer

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In Sub Saharan Africa, farm typologies have been used as a practical way to address heterogeneity among farming systems which is mostly done by grouping farms into subsets with similar characteristics. Due to the complexity in farming systems among farm households, it is not possible to formulate policy recommendations for individual farmers. As a result, this study employs a multivariate statistical approach using Principal Component Analysis (PCA) coupled with cluster analysis to reduce heterogeneity in a 615-household data set from the Africa Rising Baseline Evaluation Survey for 25 farming communities in Northern Ghana. Variables selected for the study were mostly socio-economic, production potential, production intensity, production orientation, crop diversity, food security, resource endowments, and climate risk variables. To avoid making some individuals in the subpopulation worse off when aclimate risk intervention is broadly implemented, the findings of the study also account for diversity in climate risk perception among the different farm types identified and their response strategies towards climate risk. The climate risk variables used in this study involve the most severeclimate shock types perceived by the household, household response to climate shock type, and reason for crop failure (i.e., maize, rice, and groundnut). Eventually, four farm types, each with an adequate level of homogeneity in climate risk perception and response strategies, were identified. Farm type 1 and 3 were wealthy with a lower degree of climate risk perception compared to farm type 2 and 4. Also, relatively wealthy farmers used asset liquidation as a climate risk management strategy, whereas poor farmers resorted to engaging in spiritual activities such as prayers, sacrifices, and divine consultations.

Keywords: smallholder, households, climate risk, variables, typologies

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Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

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Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

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Authors: Debarshi Bhattacharya

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In 2015, historic Land Boundary Agreement (LBA) executed between India and Bangladesh finally settled almost seven decades long overdue critical enclave problems of the two neighbouring countries. Enclaves within India and Bangladesh were the awful outcome of the partition of India in 1947. As a dire consequence, the populace within these enclaves enormously suffered from getting basic rights and opportunities and governmental support services till long 67 years after India’s independence and partition. As per LBA, 2015, 51 Bangladeshi (BD) enclaves inside Indian territory and 111 Indian enclaves inside Bangladesh territory were actually transferred to each other. But, by virtue of LBA, 1974 executed earlier between the two countries, one BD enclave situated inside India, namely Dohogram-Angarpota (D-A) twin enclave, had not yet been exchanged by means of LBA, 2015 and it still remains as an integral part, may not be contiguous, of Bangladesh completely surrounded by Indian territory. A study was undertaken through an extensive field survey to assess the impact of the existence of D-A BD enclave inside Indian territory from India’s perspective. Field survey was conducted for the purpose in the form of an interview, group discussion, questionnaire survey, personal interaction etc. to gather information from the Indian people residing adjacent to D-A enclave and Tin Bigha Corridor (TBC), people of D-A enclave, officials of Border Security Forces of India and Bangladesh, public representatives, representatives of political organizations etc. The issue of the existence of D-A BD enclave inside Indian territory seriously brought apprehension of future problems to the people of Kuchlibari Region of Mekhligunj Block, India, on its contiguity with Indian mainland due to 24-hour open access for the BD people through TBC. The anxiety of the local Indian people regarding threats to the national security of India as well as to the law and order issues of the locality due to the open border of D-A BD enclave in the region. On the other hand, it was observed that 24 hours opening of TBC brought significant positive changes to the people of D-A BD enclave in terms of their socio-economic condition and security status.

Keywords: enclave, exchange of enclaves, land boundary agreement, Dohogram-Angarpota (D-A) Bangladeshi (BD) enclave, Tin Bigha Corridor

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Authors: Wei-Kuang Liu, Ya-Hsu Chiang

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In the coming of an aging society, the issues of living quality, health care, and social security for the elderly have been gradually taken seriously. In order to maintain favorable living condition, urban societies are also facing the challenge of disasters caused by extreme climate change. However, in the practice of disaster prevention, elderly people are always weak due to their physiological conditions. That is to say, in the planning of resilient urbanism, the aging society is relatively in need of more care. Thus, this research aims to map areas where have high-density elderly population and fragile environmental condition in Taiwan, and to understand the actual situation of disaster prevention management in these areas, so as to provide suggestions for the development of intellectual resilient urban management. The research takes the cities of Taoyuan and Taichung as examples for explorations. According to GIS mapping of areas with high aging index, high-density population and high flooding potential, the communities of Sihai and Fuyuan in Taoyuan and the communities of Taichang and Nanshih in Taichung are highlighted. In these communities, it can be found that there are more elderly population and less labor population with high-density living condition. In addition, they are located in the areas where they have experienced severe flooding in the recent past. Based on a series of interviews with community organizations, there is only one community out of the four using flood information mobile app and Line messages for the management of disaster prevention, and the others still rely on the traditional approaches that manage the works of disaster prevention by their community security patrol teams and community volunteers. The interview outcome shows that most elderly people are not interested in learning the use of intellectual devices. Therefore, this research suggests to keep doing the GIS mapping of areas with high aging index, high-density population and high flooding potential for grasping the high-risk communities and to help develop smart monitor and forecast systems for disaster prevention practice in these areas. Based on case-study explorations, the research also advises that it is important to develop easy-to-use bottom-up and two-way immediate communication mechanism for the management of aging society’s disaster prevention.

Keywords: aging society, disaster prevention, GIS, resilient, Taiwan

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Authors: Najih Amina

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Our study focuses on monitoring the spatial evolution of a number of physico-chemical parameters of wells waters located at different distances from the discharge of the city of Khouribga (S0 upstream station, S1, S2 et S3 are respectively located at 5.5, 7.5, 11 Km away from solid waste discharge of the city). The absence of a source of drinking water in this region involves the population to feeding on its groundwater wells. Through the results, we note that most of the analyzed parameters exceed the potable water standards from S1. At this source of water, we find that the conductivity (1290 μmScm-1; Standard 1000 μmScm-1), Total Hardness TH (67.2°F/ Standard 50° F), Ca2 + (146 mg l-1 standard 60 mg l-1), Cl- (369 mg l-1 standard 150 mg l-1), NaCl (609 mgl-1), Methyl orange alakanity “M. alk” (280 mg l-1) greatly exceed the drinking water standards. By following these parameters, it is obvious that some values have decreased in the downstream stations, while others become important. We find that the conductivity is always higher than 950 μmScm-1; the TH registers 72°F in S3; Ca 2+ is in the range of 153 mg l-1 in S3, Cl- and NaCl- reached 426 mg l-1 and 702 mg l-1 respectively in S2, M alk becomes higher and reaches 430 to 350 in S3. At the wells S2, we found that the nitrites are well beyond the standard 1.05 mg l-1. Whereas, at the control station S0, the values are lower or at the limit of drinking water standards: conductivity (452 μmScm-1), TH (34 F°), Ca2+ (68 mg l-1), Cl- (157 mg l-1), NaCl- (258 mg l-1), M alk (220 mg l-1). Thus, the diagnosis reveals the presence of a high pollution caused by the leachates of the household waste discharge and by the effluents of the sewage waste water plant (SWWP). The phenomenon of the water hardness could, also, be generated by the processes of erosion, leaching and soil infiltration in the region (phosphate layers, intercalated layers of marl and limestone), phenomenons also caused by the acidity due to this surrounding pollution. The source S1 is the nearest surrounding site of the discharge and the most affected by the phenomenon of pollution, especially, it is near to a superficial water source S’1 polluted by the effluents coming from the sewage waste water plant of the city. In the light of these data, we can deduce that the consumption of this water from S1 does not conform the standards of drinking waters, and could affect the human health.

Keywords: physico-chemical parameters, ground water wells, infiltration, leaching, pollution, leachate discharge effluent SWWP, human health.

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Authors: Shulamit Sternin

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Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.

Keywords: athlete, injury, musician, psychological response

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Authors: Saba Farheen, Uday Shankar

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Background- Attaining equality among all humans and eliminating all forms of discrimination against them are fundamental human rights. These rights are based on the belief that all human beings are born free with equal dignity, esteem, and honour. In India, more than 30 percent politicians are having criminal background. They are also illiterate, which obstacle them in governing the system. They do not know the basic human rights. Because of this, they cannot decide what to do for the sake of the nation. Bihar is the third largest populated state of India and is characterized by corrupt politicians and poor literacy rate. If the politicians can aware about the human rights, then they will show positive attitude towards these. Aim- The main goal of the present research was to study the subjects’ knowledge or awareness towards their human rights. It was an attempt to identify social-psychological conditions that inhibit or facilitate awareness among public representatives towards their human rights in the special context of Bihar, India. Thus the main variable awareness towards human rights has been treated as the main dependent variable. The other two variables-socio economic status and Educational status, have been treated as independent variables. Method- The subjects were 400 public representatives in the age group of 35 to 50 years. They were from High socio economic status (N=150), Middle socio economic status (N=150), and Low socio economic status (N=100). The subjects were either educated (N=200) or Uneducated (N=200). The subjects were selected randomly from the different districts of Bihar, India. “Human Rights Awareness Scale” by Dr. Iftekhar Hossain, Dr. Saba Farheen, and Dr. Uday Shankar was applied in this study. Results- Results have shown that the public representatives have very low level of awareness towards the human rights. Also, the subjects from Middle SES have highest awareness in comparison with subjects of High and Low SES. Uneducated public representatives have less awareness than the educated one about human rights. Conclusion- Conclusively, it can be stated that human rights awareness among the public representatives of India is very low, and it is being affected by their Socio economic status and literacy level.

Keywords: human rights, awareness, public representatives, bihar, India

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Authors: Carin Lindskog

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Introduction: Long-term success requires an organizational balance between continuity (exploitation) and change (exploration). The problem of balancing exploitation and exploration is a common issue in studies of organizational learning. In order to better face the tough competition in the face of changes, organizations need to exploit their current business and explore new business fields by developing new capabilities. The purpose of this work in progress is to develop a conceptual framework to shed light on the relevance of 'learning activities', i.e., exploitation and exploration, on different levels. The research questions that will be addressed are as follows: What sort of learning activities are found in the Business Process Management (BPM) field? How can these activities be linked to the individual level, group, level, and organizational level? In the work, a literature review will first be conducted. This review will explore the status of learning activities in the BPM field. An outcome from the literature review will be a conceptual framework of learning activities based on the included publications. The learning activities will be categorized to focus on the categories exploitation, exploration or both and into the levels of individual, group, and organization. The proposed conceptual framework will be a valuable tool for analyzing the research field as well as identification of future research directions. Related Work: BPM has increased in popularity as a way of working to strengthen the quality of the work and meet the demands of efficiency. Due to the increase in BPM popularity, more and more organizations reporting on BPM failure. One reason for this is the lack of knowledge about the extended scope of BPM to other business contexts that include, for example, more creative business fields. Yet another reason for the failures are the fact of the employees’ are resistant to changes. The learning process in an organization is an ongoing cycle of reflection and action and is a process that can be initiated, developed and practiced. Furthermore, organizational learning is multilevel; therefore the theory of organizational learning needs to consider the individual, the group, and the organization level. Learning happens over time and across levels, but it also creates a tension between incorporating new learning (feed-forward) and exploiting or using what has already been learned (feedback). Through feed-forward processes, new ideas and actions move from the individual to the group to the organization level. At the same time, what has already been learned feeds back from the organization to a group to an individual and has an impact on how people act and think.

Keywords: business process management, exploitation, exploration, learning activities

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Authors: Hussein Bizimana, Osman Sönmez

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Constructed wetlands are current the most widely recognized waste water treatment option, especially in developing countries where they have the potential for improving water quality and creating valuable wildlife habitat in ecosystem with treatment requirement relatively simple for operation and maintenance cost. Lack of grey waste water treatment facilities in Kigali İnstitute of Science and Technology in Rwanda, causes pollution in the surrounding localities of Rugunga sector, where already a problem of poor sanitation is found. In order to treat grey water produced at Kigali İnstitute of Science and Technology, with high BOD concentration, high nutrients concentration and high alkalinity; a Horizontal Sub-surface Flow pilot-scale constructed wetland was designed and can operate in Kigali İnstitute of Science and Technology. The study was carried out in a sedimentation tank of 5.5 m x 1.42 m x 1.2 m deep and a Horizontal Sub-surface constructed wetland of 4.5 m x 2.5 m x 1.42 m deep. The grey waste water flow rate of 2.5 m3/d flew through vegetated wetland and sandy pilot plant. The filter media consisted of 0.6 to 2 mm of coarse sand, 0.00003472 m/s of hydraulic conductivity and cattails (Typha latifolia spp) were used as plants species. The effluent flow rate of the plant is designed to be 1.5 m3/ day and the retention time will be 24 hrs. 72% to 79% of BOD, COD, and TSS removals are estimated to be achieved, while the nutrients (Nitrogen and Phosphate) removal is estimated to be in the range of 34% to 53%. Every effluent characteristic will meet exactly the Rwanda Utility Regulatory Agency guidelines primarily because the retention time allowed is enough to make the reduction of contaminants within effluent raw waste water. Treated water reuse system was developed where water will be used in the campus irrigation system again.

Keywords: constructed wetlands, hydraulic conductivity, grey waste water, cattails

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Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

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Authors: Kazunori Nomura, Hiromichi Ogi, Masaumi Nakahara, Sou Watanabe, Atsuhiro Shibata

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Chemical Processing Facility of Japan Atomic Energy Agency is a basic research field for advanced back-end technology developments with using actual high-level radioactive materials such as irradiated fuels from the fast reactor, high-level liquid waste from reprocessing plant. In the nature of a research facility, various kinds of chemical reagents have been offered for fundamental tests. Most of them were treated properly and stored in the liquid waste vessel equipped in the facility, but some were not treated and remained at the experimental space as a kind of legacy waste. It is required to treat the waste in safety. On the other hand, we formulated the Medium- and Long-Term Management Plan of Japan Atomic Energy Agency Facilities. This comprehensive plan considers Chemical Processing Facility as one of the facilities to be decommissioned. Even if the plan is executed, treatment of the “legacy” waste beforehand must be a necessary step for decommissioning operation. Under this circumstance, we launched a collaborative research project called the STRAD project, which stands for Systematic Treatment of Radioactive liquid waste for Decommissioning, in order to develop the treatment processes for wastes of the nuclear research facility. In this project, decomposition methods of chemicals causing a troublesome phenomenon such as corrosion and explosion have been developed and there is a prospect of their decomposition in the facility by simple method. And solidification of aqueous or organic liquid wastes after the decomposition has been studied by adding cement or coagulants. Furthermore, we treated experimental tools of various materials with making an effort to stabilize and to compact them before the package into the waste container. It is expected to decrease the number of transportation of the solid waste and widen the operation space. Some achievements of these studies will be shown in this paper. The project is expected to contribute beneficial waste management outcome that can be shared world widely.

Keywords: chemical processing facility, medium- and long-term management plan of JAEA facilities, STRAD project, treatment of radioactive waste

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Authors: Lien Gysens, Bert Vanmechelen, Maarten Haspeslagh, Piet Maes, Ann Martens

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Bovine papillomavirus (BPV) types 1 and 2 play a central role in the etiology of the most common neoplasm in horses, the equine sarcoid. The unknown mechanism behind the unique variety in a clinical presentation on the one hand and the host-dependent clinical outcome of BPV-1 infection, on the other hand, indicate the involvement of additional factors. Earlier studies have reported the potential functional significance of intratypic sequence variants, along with the existence of sarcoid-sourced BPV variants. Therefore, intratypic sequence variation seems to be an important emerging viral factor. This study aimed to give a broad insight in sarcoid-sourced BPV variation and explore its potential association with disease presentation. In order to do this, a nanopore sequencing approach was successfully optimized for screening a wide spectrum of clinical samples. Specimens of each tumour were initially screened for BPV-1/-2 by quantitative real-time PCR. A custom-designed primer set was used on BPV-positive samples to amplify the complete viral genome in two multiplex PCR reactions, resulting in a set of overlapping amplicons. For phylogenetic analysis, separate alignments were made of all available complete genome sequences for BPV-1/-2. The resulting alignments were used to infer Bayesian phylogenetic trees. We found substantial genetic variation among sarcoid-derived BPV-1, although this variation could not be linked to disease severity. Several of the BPV-1 genomes had multiple major deletions. Remarkably, the majority of the cluster within the region coding for late viral genes. Together with the extensiveness (up to 603 nucleotides) of the described deletions, this suggests an altered function of L1/L2 in disease pathogenesis. By generating a significant amount of complete-length BPV genomes, we succeeded in introducing next-generation sequencing into veterinary research focusing on the equine sarcoid, thus facilitating the first report of both nanopore-based sequencing of complete sarcoid-sourced BPV-1/-2 and the simultaneous nanopore sequencing of multiple complete genomes originating from a single clinical sample.

Keywords: Bovine papillomavirus, equine sarcoid, horse, nanopore sequencing, phylogenetic analysis

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Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya

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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.

Keywords: public health, emergency management, covid-19, pandemic

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Authors: E. Bittar, A. Quiñonez, F. Mencia, E. Aguero, M. Delgado, V. Arriola, R. López

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In the western region of Paraguay, the poor condition of the roads has negatively affected the development of this zone, where the absence of petrous material has led engineers to opt for the stabilization of soils with lime or cement as the main structure for bases and subbases of these roads. In several areas of this region, high sulfate contents have been found both in groundwater and in soils, which, when reacted with lime or cement, generate a new problem instead of solving it. On the other hand, the use of industrial waste as granulated slag and fly ash proved to be a sustainable practice widely used in the manufacture of cement, and now also, in the stabilization of soils worldwide. Works related to soils containing sulfates stabilized either with granulated slag or fly ash and lime shown a good performance in their mechanical behaviour. This research seeks to evaluate the mechanical behaviour of soils with high contents of sulfates stabilized with lime by curing them both, at the normalized temperature (23 ± 2 °C) and at 40 ± 2 °C. Moreover, it attempts to asses if the addition of rice husk ash has a positive influence on the new geomaterial. The 40 ± 2 °C curing temperature was selected trying to simulate the average local temperature in summer and part of spring session whereas rice husk ash is an affordable waste produced in the region. An extensive experimental work, which includes unconfined compression, durability and free swell tests were carried out considering different dry unit weights, lime content and the addition of 20% of rice husk ash. The results showed that the addition of rice husk ash increases the resistance and durability of the material and decreases the expansion of this, moreover, the specimens cured at a temperature of 40 ± 2 °C showed higher resistance, better durability and lower expansion compared to those cured at the normalized temperature of 23 ± 2 °C.

Keywords: durability, expansion, lime stabilization, rice husk ash, sulfate

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Authors: Abir Dey, Shams Noman

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Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

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Authors: Mohammed Al-Zubaidi, Katherine Ong, Pravin Viswambaram, Steve McCombie, Oliver Oey, Jeremy Ong, Richard Gauci, Ronny Low, Dickon Hayne

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Objective: Lymph node involvement along with distant metastasis in a patient with invasive bladder cancer determines the disease survival, therefeor, it is an essential determinant of the therapeutic management and outcome. This retrospective study aims to determine the accuracy of FDG PET scan in detecting lymphatic involvement and distant metastatic urothelial cancer compared to conventional CT staging. Method: A retrospective review of 76 patients with UC or BC who underwent surgery or confirmatory biopsy that was staged with both CT and 18F-FDG-PET (up to 8 weeks apart) between 2015 and 2020. Fifty-sevenpatients (75%) had formal pelvic LN dissection or biopsy of suspicious metastasis. 18F-FDG-PET reports for positive sites were qualitative depending on SUV Max. On the other hand, enlarged LN by RECIST criteria 1.1 (>10 mm) and other qualitative findings suggesting metastasis were considered positive in CT scan. Histopathological findings from surgical specimens or image-guided biopsies were considered the gold standard in comparison to imaging reports. 18F-FDG-avid or enlarged pelvic LNs with surgically proven nodal metastasis were considered true positives. Performance characteristics of 18F-FDG-PET and CT, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (PPV), were calculated. Results: Pelvic LN involvement was confirmed histologically in 10/57 (17.5%) patients. Sensitivity, specificity, PPV and NPV of CT for detecting pelvic LN metastases were 41.17% (95% CI:18-67%), 100% (95% CI:90-100%) 100% (95% CI:59-100%) and 78.26% (95% CI:64-89%) respectively. Sensitivity, specificity, PPV and NPV of 18F-FDG-PET for detecting pelvic LN metastases were 62.5% (95% CI:35-85%), 83.78% (95% CI:68-94%), 62.5% (95% CI:35-85%), and 83.78% (95% CI:68-94%) respectively. Pre-operative staging with 18F-FDG-PET identified the distant metastatic disease in 9/76 (11.8%) patients who were occult on CT. This retrospective study suggested that 18F-FDG-PET may be more sensitive than CT for detecting pelvic LN metastases. 7/76 (9.2%) patients avoided cystectomy due to 18F-FDG-PET diagnosed metastases that were not reported on CT. Conclusion: 18F-FDG-PET is more sensitive than CT for pelvic LN metastases, which can be used as the standard modality of bladder cancer staging, as it may change the treatment by detecting lymph node metastasis that was occult in CT. Further research involving randomised controlled trials comparing the diagnostic yield of 18F-FDG-PET and CT in detecting nodal and distant metastasis in UC or BC is warranted to confirm our findings.

Keywords: FDG PET, CT scan, urothelial cancer, bladder cancer

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