Search results for: functional background heterogeneity

Authors: Atiwit Sinyoo, Sekh Thanprasertsuk, Sithiporn Agthong, Pasakorn Watanatada, Shaun Peter Qureshi, Saknan Bongsebandhu-Phubhakdi

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Background: Since the SARS-CoV-2 virus became extensively disseminated throughout the world, online learning has become one of the most hotly debated topics in educational reform. While some studies have already shown the advantage of online learning, there are still questions concerning how online learning affects students’ learning behavior and academic achievement when each student learns in a different way. Hence, we aimed to develop a guide for preclinical medical students to avoid drawbacks and get benefits from online learning that possibly a double-edged sword. Methods: We used a multiple-choice questionnaire to evaluate the learning behavior of second-year Thai medical students in the neuroscience course. All traditional face-to-face lecture classes were video-recorded and promptly posted to the online learning platform throughout this course. Students could pick and choose whatever classes they wanted to attend, and they may use online learning as often as they wished. Academic performance was evaluated as summative score, spot exam score and pre-post-test improvement. Results: More frequently students used online learning platform, the less they attended lecture classes (P = 0.035). High proactive online learners (High PO) who were irregular attendee (IrA) had significantly lower summative scores (P = 0.026), spot exam score (P = 0.012) and pre-post-test improvement (P = 0.036). In the meanwhile, conditional attendees (CoA) who only attended classes with attendance check had significantly higher summative score (P = 0.025) and spot exam score (P = 0.001) if they were in the High PO group. Conclusions: The benefit and drawbacks edges of using an online learning platform were demonstrated in our research. Based on this double-edged sword effect, we believe that online learning is a valuable learning strategy, but students must carefully plan their study schedule to gain the “benefit edge” meanwhile avoiding its “drawback edge”.

Keywords: academic performance, assessment, attendance, online learning, preclinical medical students

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Authors: Tinatin Sabauri, Eduard Gelagutashvili, Salome Pataridze

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The COVID-19 pandemic presents a serious challenge to all sectors of the country. Particularly difficult and important was the rapid mobilization of educational institutions to ensure the continuous flow of the educational process and effective fulfillment of the transaction. Developed countries managed to overcome this challenge quickly because, before the pandemic, part of universities had implemented blended learning (a mixture of online and face-to-face learning). The article aims to evaluate the use of electronic platforms by non-Georgian-speaking students and their involvement in the e-learning process at Ilia State University. Based on the phenomenological research design, a comparative analysis has been conducted - what was the use of electronic systems by non-Georgian-speaking students before 2019, and what was it like during the COVID-19 pandemic? Concretely, the phenomenological design was used in the research to evaluate the efficiency of distance learning with non-Georgian speaking students at Ilia State University. Focus groups were created within the phenomenological design. In the focus groups, students answered a pre-designed semi-structured questionnaire. Based on the analysis of the questionnaires, it was revealed that online learning and access to electronic portals were not a particular difficulty for ethnic minorities. The following positive and negative aspects of e-learning were identified in the research. Students named as positive aspects: Enables joining online classes directly from home before the start of the lecture, It saves time and money on travel and accommodation (for some students). It was named as negative aspects: Learning a language online is more difficult than in face-to-face classrooms, lack of teamwork activity, lack of strong and stable internet connections, and audio problems. Based on the results of the research, it was shown that in the post-pandemic period, the involvement of non-Georgian speaking students has significantly increased; therefore, the use of electronic systems by non-Georgian speaking students.

Keywords: electronic system, distance learning, COVID-19, students

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Authors: Ali Arazeem Abdullahi, Mariam Seedat-Khan, Bamidele S. Akanni

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Background: Like the rest of the world, cancer of the breast is a life-threatening disease to Nigerian women. The utilization of mammography is however very poor among the general population. Whereas, there strong indications that women who engage in the regular screening of breast cancer using mammography are more likely to have a lower risk of developing and dying from advanced breast cancer compared to unscreened women. This study examined knowledge of breast cancer and utilization of mammography among undergraduate female students at the University of Ilorin, Nigeria. Health Belief Model (HBM) was deployed to guide the conduct of the study. Method: Self-administered questionnaire was used to collect data from 292 undergraduate female students from the faculties of Social and Management Sciences of the University. A simple random sampling technique was used to select the respondents. Data was analyzed using both descriptive and inferential statistics. Results: The study found that apart from high knowledge of breast cancer and mammography, perceived threat, perceived susceptibility and perceived seriousness of breast cancer were equally high. However, the uptake of mammography was very poor largely due to perceived barriers including being single and young and poor history of breast cancer in families (cues to action). The test of hypotheses showed that there is a weak relationship of about 6.8% between knowledge of breast cancer and utilization of mammography (p-value= 0.244) at 0.05 level of significance. However, 64.4% of the respondents were willing to utilize mammography in the future if the opportunity arises. While the study found a significant statistical relationship between the perceived benefits of mammography and its utilization among the respondents, no significant statistical association was found between the socio-demographic characteristics of the respondents and the uptake of mammography. Recommendations: Findings highlight the need for health education interventions to promote breast cancer screening and the utilization mammography, while addressing barriers to the uptake of mammography among female undergraduate students of the University of Ilorin and Nigeria in general.

Keywords: cancer of the breast, mammography, female undergraduate students, health belief model, University of Ilorin

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Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul

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Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.

Keywords: CCHE, chemotherapy, enucleation, retinoblastoma

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Authors: Yulii D. Shikhmurzaev

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The modelling of the non-isothermal free-surface flows coupled with the solidification process has become the topic of intensive research with the advent of additive manufacturing, where complex 3-dimensional structures are produced by successive deposition and solidification of microscopic droplets of different materials. The issue is that both the spreading of liquids over solids and the propagation of the solidification front into the fluid and along the solid substrate pose fundamental difficulties for their mathematical modelling. The first of these processes, known as ‘dynamic wetting’, leads to the well-known ‘moving contact-line problem’ where, as shown recently both experimentally and theoretically, the contact angle formed by the free surfac with the solid substrate is not a function of the contact-line speed but is rather a functional of the flow field. The modelling of the propagating solidification front requires generalization of the classical Stefan problem, which would be able to describe the onset of the process and the non-equilibrium regime of solidification. Furthermore, given that both dynamic wetting and solification occur concurrently and interactively, they should be described within the same conceptual framework. The present work addresses this formidable problem and presents a mathematical model capable of describing the key element of additive manufacturing in a self-consistent and singularity-free way. The model is illustrated simple examples highlighting its main features. The main idea of the work is that both dynamic wetting and solidification, as well as some other fluid flows, are particular cases in a general class of flows where interfaces form and/or disappear. This conceptual framework allows one to derive a mathematical model from first principles using the methods of irreversible thermodynamics. Crucially, the interfaces are not considered as zero-mass entities introduced using Gibbsian ‘dividing surface’ but the 2-dimensional surface phases produced by the continuum limit in which the thickness of what physically is an interfacial layer vanishes, and its properties are characterized by ‘surface’ parameters (surface tension, surface density, etc). This approach allows for the mass exchange between the surface and bulk phases, which is the essence of the interface formation. As shown numerically, the onset of solidification is preceded by the pure interface formation stage, whilst the Stefan regime is the final stage where the temperature at the solidification front asymptotically approaches the solidification temperature. The developed model can also be applied to the flow with the substrate melting as well as a complex flow where both types of phase transition take place.

Keywords: dynamic wetting, interface formation, phase transition, solidification

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Authors: Denise Schrama, Claudia Raposo, Pedro Rodrigues

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Background: Food allergies are conducted by a hypersensitive response of the immune system. These allergies are a global concern for the public health. Consumption of fish is increasing worldwide as it is a healthy meat with high nutritional value. Unfortunately, fish can cause adverse immune-mediate reactions, affecting part of the population with higher incidence in children. β-parvalbumin, a small, highly conserved stable, calcium or magnesium binding muscle protein is the main fish allergen. In fish-allergic patients, cross-reactivity between different fish species exist due to recognition of highly identical protein regions. Enolases, aldolases, or fish gelatin are other identified fish allergens in some fish species. With no available cure for fish allergies, clinical management is only based on an avoidance diet aiming at the total exclusion of offending food. Methods: Mediterranean fish (S. aurata and D. labrax) were fed specifically designed diets, enriched in components that target the expression or inactivation of parvalbumin (creatine and EDTA, respectively). After 90 days fish were sampled and biological tissues were excised. Proteomics was used to access fish allergens characterization and expression in muscle while IgE assays to confirm the lower allergenic potential are conducted in patients with history of fish allergies. Fish welfare and quality of flesh were established with biochemical, texture and sensorial analysis. Results: Fish welfare shows no major impact between diets. In case of creatine supplementation in D. labrax proteomic analysis show a slight decrease in parvalbumin expression. No accumulation of this compound was found in muscle. For EDTA supplementation in S. aurata IgE assay show a slight decrease in allergenicity when using sera of fish allergic patients. Conclusion: Supplementation with these two compounds seems to change slightly the allergenicity of the two mean Mediterranean species.

Keywords: fish allergies, fish nutrition, proteomics, aquaculture

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Authors: Marjeta Misigoj Durakovic, Maroje Soric, Lovro Stefan

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Background and aim: Physical inactivity has been linked with increased morbidity and premature mortality and adolescence has been recognised as the critical period for a decline in physical activity (PA) level. In order to properly direct interventions aimed at increasing PA, high-risk groups of individuals should be identified. Therefore, the aim of this study is to describe gender differences in: a) PA level; b) weekly PA patterns. Methods: This investigation is a part of the CRO-PALS study which is an on-going longitudinal study conducted in a representative sample of urban youth in Zagreb (Croatia). CRO-PALS involves 903 adolescents and for the purpose of this study data from a subgroup of 190 participants with information on objective PA level were analysed (116 girls; mean age [SD]=15.6[0.3] years). Duration of moderate and vigorous PA was measured during 5 consecutive by a multiple-sensor physical activity monitor (SenseWear Armband, BodyMedia inc., Pittsburgh, USA). Gender differences in PA level were evaluated using independent samples t-test. Differences in school week and weekend levels of activity were assessed using mixed ANOVA with gender as between-subjects factor. The amount of vigorous PA had to be log-transformed to achieve normality in the distribution. Results: Boys were more active than girls. Duration of moderate-to-vigorous PA averaged 111±44 min/day in boys and 80±38 min/day in girls (mean difference=31 min/day, 95%CI=20-43 min/day). Vigorous PA was 2.5 times higher in boys compared to girls (95%CI=1.9-3.5). Participants were more active during school days than on weekends. The magnitude of the difference in moderate-to-vigorous PA was similar in both gender (p value for time*gender interaction = 0.79) and averaged 19 min/day (95%CI=11-27 min/day). Similarly, vigorous PA was 36% lower on weekends compared with school days (95%CI=22-46%) with no gender difference (p value for time*gender interaction = 0.52). Conclusion: PA level was higher in boys than in girls throughout the week. Still, in both boys and girls, the amount of PA reduced markedly on weekends compared with school days.

Keywords: adolescence, multiple-sensor physical activity monitor, physical activity level, weekly physical activity pattern

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Authors: Cheng Hong YEO

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Introduction: Objective: To evaluate the effectiveness of Spectral Dual Layer CT (DECT) in diagnosing choledocholithiasis, specifically focusing on its accuracy in detecting small biliary stones compared to other imaging modalities. Background: DECT has shown promise in improving the detection and characterization of gallstones in the common bile duct, offering potential advantages over traditional imaging methods like standard CT and ultrasonography. Methodology: Study Design: Single-blinded retrospective study conducted at a teaching hospital. Patient Selection: Reviewed records of patients who underwent DECT for suspected choledocholithiasis and had follow-up MRCP, ERCP, or IOC within 8 weeks. 23 patients with proven choledocholithiasis and 23 controls without biliary filling defects were included. DECT Protocol: Used a Philips IQ 256-slice dual-energy CT scanner with standard protocols including 120 kVp and 40 keV mono-E images. Assessment: Four radiologists, blinded to the study question, evaluated images for the presence of choledocholithiasis. Sensitivity, specificity, PPV, and NPV were calculated based on consensus diagnoses. Results: Diagnostic Performance: DECT showed an overall sensitivity of 47.8% and specificity of 78.3% for detecting choledocholithiasis. The accuracy of the diagnosis ranged from 54% to 63% among observers. Stone Detection: Of the identified stones, 6 were calcified and 17 non-calcified. Detection of calcified stones was more accurate (83.3%) compared to non-calcified stones (35.3%). Differences in signal between stones and bile were noted in certain imaging parameters. Interobserver Agreement: The agreement among radiologists was fair, with a Fleiss Kappa coefficient of 0.30. Conclusion: This is the first study to specifically analyse the performance of spectral CT in choledocholithiasis detection using a control group and blinding of reviewers. Our modest results demonstrating lower overall sensitivity than had been reported previously at 47.8% overall while identifying 40% of non-calcified stones <9 mm. We believe further research and development on advancements in spectral CT technology or newer techniques such as photon counting CT is warranted.

Keywords: dual energy CT, choledocholithiasis, gallstones, body imaging

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Authors: Said Abdirasak Abidrahman, Ibrahim Mohamed

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Background: Urinary Tract Infections (UTIs) are the commonest infections described among diabetes mellitus patients. More often, empirical antimicrobial therapy is initiated before the laboratory results are made available with minimal treatment success. The knowledge of the etiology and antibiotic susceptibility patterns of the organisms causing urinary tract infections among diabetes mellitus patients remains scarce, despite its vitality. This study sought to determine the prevalence, bacteria species, and drug susceptibility patterns of common causes of urinary tract infections among diabetes mellitus patients attending Bosaso health centers. Materials and methods: We conducted a cross-sectional study involving adult diabetic patients at Bosaso health centers between the months of May and July 2020. Laboratory assay of mid-stream urine samples was done to isolate bacteria causes of UTIs. These were biochemically identified using Gram stain, Kligler iron agar (KIA), Indole test, citrate, urea, coagulase, catalase, motility agar, and lysine iron agar. Their antibiotic susceptibility pattern for the isolated organisms was made for Ampicillin 10μg, Ciprofloxacin 5μg, Cotrimoxazole 25μg, Gentamycin 10μg, Ceftriaxone 10μg, and determined using the Kirby Bauer Disc Diffusion method. Results: Of 177 participants, 69 (39.0%) were males and 108 (61.0%) were females. Their mean age was 33.1 years (range; 18-67 years). Of these, 14.7% (26/177) of the samples revealed significant growth (>= 105 CFU/mL) giving a prevalence of 14.9 % (95% CI: 10.6 to 16.3). The organisms isolated were Escherichia coli -50% (N=13), Klebsiella pneumonia 30.8% (N=8), Staphylococcus aureus 15.4% (N=4), and unidentified organism 3.8% (N=1), and these were associated with such socio-demographic factors like history of catheterization and sexual activity. Antibiotic susceptibility to the commonly used agents for treating UTIs indicated higher sensitivity to Gentamicin and Ceftriaxone.

Keywords: antimicrobials, bacteria, urinary tract infections, diabetes

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Authors: A. M. Tarola, R. Preti, A. M. Girelli, P. Campana

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Safeguarding, studying and enhancing biodiversity play an important and indispensable role in re-launching agriculture. The ancient local varieties are therefore a precious resource for genetic and health improvement. In order to protect biodiversity through the recovery and valorization of autochthonous varieties, in this study we analyzed 12 samples of four ancient apple cultivars representative of Friuli Venezia Giulia, selected by local farmers who work on a project for the recovery of ancient apple cultivars. The aim of this study is to evaluate the polyphenolic profile and the antioxidant capacity that characterize the organoleptic and functional qualities of this fruit species, besides having beneficial properties for health. In particular, for each variety, the following compounds were analyzed, both in the skins and in the pulp: gallic acid, catechin, chlorogenic acid, epicatechin, caffeic acid, coumaric acid, ferulic acid, rutin, phlorizin, phloretin and quercetin to highlight any differences in the edible parts of the apple. The analysis of individual phenolic compounds was performed by High Performance Liquid Chromatography (HPLC) coupled with a diode array UV detector (DAD), the antioxidant capacity was estimated using an in vitro essay based on a Free Radical Scavenging Method and the total phenolic compounds was determined using the Folin-Ciocalteau method. From the results, it is evident that the catechins are the most present polyphenols, reaching a value of 140-200 μg/g in the pulp and of 400-500 μg/g in the skin, with the prevalence of epicatechin. Catechins and phlorizin, a dihydrohalcone typical of apples, are always contained in larger quantities in the peel. Total phenolic compounds content was positively correlated with antioxidant activity in apple pulp (r² = 0,850) and peel (r² = 0,820). Comparing the results, differences between the varieties analyzed and between the edible parts (pulp and peel) of the apple were highlighted. In particular, apple peel is richer in polyphenolic compounds than pulp and flavonols are exclusively present in the peel. In conclusion, polyphenols, being antioxidant substances, have confirmed the benefits of fruit in the diet, especially as a prevention and treatment for degenerative diseases. They demonstrated to be also a good marker for the characterization of different apple cultivars. The importance of protecting biodiversity in agriculture was also highlighted through the exploitation of native products and ancient varieties of apples now forgotten.

Keywords: apple, biodiversity, polyphenols, antioxidant activity, HPLC-DAD, characterization

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Authors: Monireh Ahmadi Bani, Adel Khorramrouz, Lalenoor Morvarid, Bagheri Mahtab

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Background:- Foot disorders are common in musculoskeletal problems. Plantar pressure distribution measurement is one the most important part of foot disorders diagnosis for quantitative analysis. However, the association of plantar pressure and foot disorders is not clear. With the growth of dataset and machine learning methods, the relationship between foot disorders and plantar pressures can be detected. Significance of the study:- The purpose of this study was to predict the probability of common foot disorders based on peak plantar pressure distribution and center of pressure during walking. Methodologies:- 2323 participants were assessed in a foot therapy clinic between 2015 and 2021. Foot disorders were diagnosed by an experienced physician and then they were asked to walk on a force plate scanner. After the data preprocessing, due to the difference in walking time and foot size, we normalized the samples based on time and foot size. Some of force plate variables were selected as input to a deep neural network (DNN), and the probability of any each foot disorder was measured. In next step, we used support vector machine (SVM) and run dataset for each foot disorder (classification of yes or no). We compared DNN and SVM for foot disorders prediction based on plantar pressure distributions and center of pressure. Findings:- The results demonstrated that the accuracy of deep learning architecture is sufficient for most clinical and research applications in the study population. In addition, the SVM approach has more accuracy for predictions, enabling applications for foot disorders diagnosis. The detection accuracy was 71% by the deep learning algorithm and 78% by the SVM algorithm. Moreover, when we worked with peak plantar pressure distribution, it was more accurate than center of pressure dataset. Conclusion:- Both algorithms- deep learning and SVM will help therapist and patients to improve the data pool and enhance foot disorders prediction with less expense and error after removing some restrictions properly.

Keywords: deep neural network, foot disorder, plantar pressure, support vector machine

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Authors: Jaqueline Bohn Donada

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The significance of Euripides’ Medea for contemporary literature is noticeable. Even if the bulk of Classical Reception studies does not tend to look carefully and consistently to the literature produced outside the Anglophone world, Brazilian literature offers abundant materials for such studies. Indeed, a certain Classical background can be observed in Brazilian literature at least since 1975 when Gota d’Água [The Final Straw, in English], a play that recreates the story of Medea and sets it in a favela in Rio de Janeiro. Also worthy of notice is Ivo Bender’s Trilogia Perversa [Perverse Trilogy, in English], a series of three historical plays set in Southern Brazil and based on Aeschylus’ Oresteia and on Euripides’ Iphigenia in Aulis published in the 1980s. Since then, a number of works directly inspired by the plays of Aeschylus, Sophocles and Euripides have been published, not to mention several adaptations of Homer’s two epic poems. This paper proposes a comparative analysis of two such works: Grace Passô’s 2017 play Mata teu Pai [Kill your father, in English] and Marcia Lima’s 2019 play Medeia Negra [Black Medea, in English] from the perspective of Classical Reception Studies in an intersection with feminist literary criticism. The paper intends to look at the endurance of Euripides’ character in contemporary Brazilian literature with a focus on how the character seems to have acquired special relevance to the treatment of pressing issues of the twenty-first century. Whereas Grace Passô’s play sets Medea at the center of a group of immigrant women, Marcia Limma has the character enact the dilemmas of incarcerated women in Brazil. The hypothesis that this research aims at testing is that both artists preserve the pathos of Euripides’s original character at the same time that they recreate his Medea in concrete circumstances of Brazilian contemporary social reality. At the end, the research aims at stating the significance of the Medea theme to contemporary Brazilian literature.

Keywords: Euripides, Medea, Grace Passô, Marcia Limma, Brazilian literature

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Authors: Stephen Rulisa, Aimee Nyiramahirwe

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Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda, but the unmet need for family planning remains high. Women in the postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners in the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali for a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted six weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptives taken (long-acting vs. short-acting), controlling for male companionship during the antenatal period. A Chi-square test was used and a p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with a mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, and 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for four antenatal visits, and 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at a health center or district hospital, cesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short-acting contraceptives. Conclusions: Our study demonstrates a positive association between male companionship during antenatal care, labor and delivery with the uptake of postpartum family planning. Our study suggests more sensitization to involve the male partners, improving the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period.

Keywords: postpartum, family planning, contraception, male partner, uptake

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Authors: Maarja Karbus, Elsbet Lippmaa, Kadri Kööp, Mare Tupits

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Aim: The aim is to describe the experiences and needs of mothers of children with cancer in coping with the child's illness. Background: Cancer affects different life areas. Especially if it is a child, in this case the whole family is involved. Loved ones are mentally affected, there are limitations, and life changes need to be made to make the whole treatment regimen and recovery as comfortable as possible. Also, the whole process is expensive and time consuming. The research is part of a larger project that covers the experiences and needs of parents of children with chronic illness and coping strategies related to the child's illness. Design: Qualitative, empirical, descriptive research. Method: Semi-structured interviews were used to collect data and inductive content analysis was used to analyze the data. The interviews were conducted in the autumn of 2020, 5 respondents participated in the research. Results and Conclusions: The research revealed that the mothers' experiences of coping with a child's disease included health-related experiences, material aspects, changes in lifestyle, support systems and contact with professionals. Regarding the organizational and material aspects of life, the subjects presented experiences with economic problems, adaptation of changes in lifestyle, access to information and changes in the treatment process. With regard to health, the respondents identified experiences with the mother's physical and mental health and experiences with the health of an ill child. The experience of different support systems was related to the support of family, friends, acquaintances, various organizations and specialists. Experiences with specialist support included experiences with family relationships and positive and negatiive experiences with staff. The mothers' needs in dealing with the child's disease included the mother's emotional needs, the support of other family members, and the need for various support systems and services. The needs of coping with the child were the need for understanding, support, confidence, the need to be strong and courageous, the need to ignore one's own needs, and the need for personal time and rest. The needs of other family members included the needs of an ill child and the need to pay attention to other children in the family. The needs of different supporters and services were related to different helpers and different services.

Keywords: cancer, mother, coping, child, need, experience, illness

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Authors: Levicatus Mugenyi, Joaniter Nankabirwa, Emmanuel Arinaitwe, John Rek, Niel Hens, Moses Kamya, Grant Dorsey

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Background: Indoor residual spraying (IRS) reduces vector densities and malaria transmission, however, the most effective spraying intervals for IRS have not been well established. We aim to estimate the optimal timing interval for IRS using a modeling approach. Methods: We use a generalized additive model to estimate the optimal timing interval for IRS using the predicted malaria incidence. The model is applied to post IRS cohort clinical data from children aged 0.5–10 years in selected households in Tororo, historically a high malaria transmission setting in Uganda. Six rounds of IRS were implemented in Tororo during the study period (3 rounds with bendiocarb: December 2014 to December 2015, and 3 rounds with actellic: June 2016 to July 2018). Results: Monthly incidence of malaria from October 2014 to February 2019 decreased from 3.25 to 0.0 per person-years in the children under 5 years, and 1.57 to 0.0 for 5-10 year-olds. The optimal time interval for IRS differed between bendiocarb and actellic and by IRS round. It was estimated to be 17 and 40 weeks after the first round of bendiocarb and actellic, respectively. After the third round of actellic, 36 weeks was estimated to be optimal. However, we could not estimate from the data the optimal time after the second and third rounds of bendiocarb and after the second round of actellic. Conclusion: We conclude that to sustain the effect of IRS in a high-medium transmission setting, the second rounds of bendiocarb need to be applied roughly 17 weeks and actellic 40 weeks after the first round, and the timing differs for subsequent rounds. The amount of rainfall did not influence the trend in malaria incidence after IRS, as well as the IRS timing intervals. Our results suggest that shorter intervals for the IRS application can be more effective compared to the current practice, which is about 24 weeks for bendiocarb and 48 weeks for actellic. However, when considering our findings, one should account for the cost and drug resistance associated with IRS. We also recommend that the timing and incidence should be monitored in the future to improve these estimates.

Keywords: incidence, indoor residual spraying, generalized additive model, malaria

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Authors: Fatemeh Moosavi, Tumelo Franck Nkoshwane

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Peter Drucker the renowned management guru once said, “The best way to predict the future is to create it.” Mr. Drucker is also the man who placed human capital as the most vital resource of any institution. As such any institution bent on creating a better future, requires a competent human capital, one that is able to execute with efficiency and effectiveness the objective a society aspires to. Technology today is accelerating the rate at which many societies transition to knowledge based societies. In this accelerated paradigm, it is imperative that those in leadership establish a platform capable of sustaining the planned future; intellectual capital. The capitalist economy going into the future will not just be sustained by dollars and cents, but by individuals who possess the creativity to enterprise, innovate and create wealth from ideas. This calls for cities of the future, to have this premise at the heart of their future plan, if the objective of designing sustainable and liveable future cities will be realised. The knowledge economy, now transitioning to the creative economy, requires cities of the future to be ‘gardens’ of inspiration, to be places where knowledge, creativity, and innovation can thrive as these instruments are becoming critical assets for creating wealth in the new economic system. Developing nations must accept that learning is a lifelong process that requires keeping abreast with change and should invest in teaching people how to keep learning. The need to continuously update one’s knowledge, turn these cities into vibrant societies, where new ideas create knowledge and in turn enriches the quality of life of the residents. Cities of the future must have as one of their objectives, the ability to motivate their citizens to learn, share knowledge, evaluate the knowledge and use it to create wealth for a just society. The five functional factors suggested by Kevin Lynch;-vitality, meaning/sense, adaptability, access, control, and monitoring should form the basis on which policy makers and urban designers base their plans for future cities. The authors of this paper believe that developing nations “creative economy clusters”, cities where creative industries drive the need for constant new knowledge creating sustainable learning creative cities. Obviously the form, shape and size of these districts should be cognisant of the environmental, cultural and economic characteristics of each locale. Gaborone city in the republic of Botswana is presented as the case study for this paper.

Keywords: learning city, sustainable creative city, creative industry, good city form

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Authors: Yelba Maria Carrillo

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The focus of this research study was to explore barriers, if any, faced by parents or legal guardians who are of Latinx background and speak Spanish as a primary language or are bilingual speakers of Spanish and English; barriers that limit their understanding of and involvement in their gifted child’s academic life. This study was guided by a qualitative case study design. The primary investigator hosted focus group interviews at a Magnet Middle School in Southern California. The groups consisted of 25 parents, or legal guardians of bilingual (English/Spanish) or former English learner students enrolled in a school serving 6th-8th grades. The primary investigator interviewed Latinx Spanish-speaking parents or legal guardians of gifted students regarding their perception of their child’s giftedness, parental involvement in schools, and fostering their child’s exceptional abilities. Parents and legal guardians described children as creative, intellectual, and highly intelligent. Key themes such as student performance, language proficiency, socio-emotional, and general intellectual ability were strong indicators of giftedness. Barriers such as language and education inhibited parent and legal guardian ability to understand their child’s giftedness, which resulted in their inability to adequately contribute to the development of their children’s talents and advocate for the appropriate services for their children. However, they recognized the importance of being involved in their child’s academic life and the importance of nurturing their ‘dón’ or ‘gift.’ La Familia is the foundation and core of Latinx culture; and, without a strong foundation, children lack guidance, confidence, and awareness to tap into their gifted abilities. Providing Latinx parents with the proper tools and resources to appropriately identify gifted characteristics and traits could lead to early identification and intervention for students in schools and at home.

Keywords: gifted education, gifted Latino students, Latino parent involvement, high ability students

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Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

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Background: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are: 1) What studies have been published on concept mapping in undergraduate medical education? 2) What was the impact of CMs on students’ critical thinking? 3) How and why have these interventions had an educational impact? Methods: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles, and abstracts, and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the structured approach to the reporting in healthcare education of evidence synthesis statement and BEME guidance. Results: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students’ knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both teaching and learning methods. Conclusions: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increase our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

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Authors: Paola Leon, Hugo Garcia, Adan Leon, Samuel Munoz

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The enhanced oil recovery by steam injection was considered a process that only generated physical recovery mechanisms. However, there is evidence of the occurrence of a series of chemical reactions, which are called aquathermolysis, which generates hydrogen sulfide, carbon dioxide, methane, and lower molecular weight hydrocarbons. These reactions can be favored by the addition of a catalyst during steam injection; in this way, it is possible to generate the original oil in situ upgrading through the production increase of molecules of lower molecular weight. This additional effect could increase the oil recovery factor and reduce costs in transport and refining stages. Therefore, this research has focused on the experimental evaluation of the catalytic aquathermolysis on a Colombian heavy oil with 12,8°API. The effects of three different catalysts, reaction time, and temperature were evaluated in a batch microreactor. The changes in the Colombian heavy oil were quantified through nuclear magnetic resonance 1H-NMR. The relaxation times interpretation and the absorption intensity allowed to identify the distribution of the functional groups in the base oil and upgraded oils. Additionally, the average number of aliphatic carbons in alkyl chains, the number of substituted rings, and the aromaticity factor were established as average structural parameters in order to simplify the samples' compositional analysis. The first experimental stage proved that each catalyst develops a different reaction mechanism. The aromaticity factor has an increasing order of the salts used: Mo > Fe > Ni. However, the upgraded oil obtained with iron naphthenate tends to form a higher content of mono-aromatic and lower content of poly-aromatic compounds. On the other hand, the results obtained from the second phase of experiments suggest that the upgraded oils have a smaller difference in the length of alkyl chains in the range of 240º to 270°C. This parameter has lower values at 300°C, which indicates that the alkylation or cleavage reactions of alkyl chains govern at higher reaction temperatures. The presence of condensation reactions is supported by the behavior of the aromaticity factor and the bridge carbons production between aromatic rings (RCH₂). Finally, it is observed that there is a greater dispersion in the aliphatic hydrogens, which indicates that the alkyl chains have a greater reactivity compared to the aromatic structures.

Keywords: catalyst, upgrading, aquathermolysis, steam

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Authors: A. G. Cunha, M. Inácio, M. C. Freitas, C. Antunes, T. Silva, C. Andrade, V. Lopes

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Saltmarshes are essential ecosystems both from an ecological and biological point of view. Furthermore, they constitute an important social niche, providing valuable economic and protection functions. Thus, understanding their rates and patterns of sedimentation is critical for functional management and rehabilitation, especially in an SLR scenario. The Sado estuary is located 40 km south of Lisbon. It is a bar built estuary, separated from the sea by a large sand spit: the Tróia barrier. Caldeira de Tróia is located on the free edge of this barrier, and encompasses a salt marsh with ca. 21,000 m². Sediment cores were collected in the high and low marshes and in the mudflat area of the North bank of Caldeira de Tróia. From the low marsh core, fifteen samples were chosen for ²¹⁰Pb and ¹³⁷Cs determination at University of Geneva. The cores from the high marsh and the mudflat are still being analyzed. A sedimentation rate of 2.96 mm/year was derived from ²¹⁰Pb using the Constant Flux Constant Sedimentation model. The ¹³⁷Cs profile shows a peak in activity (1963) between 15.50 and 18.50 cm, giving a 3.1 mm/year sedimentation rate for the past 53 years. The adopted sea level rise scenario was based on a model built with the initial rate of SLR of 2.1 mm/year in 2000 and an acceleration of 0.08 mm/year². Based on the harmonic analysis of Setubal-Tróia tide gauge of 2005 data, the tide model was estimated and used to build the tidal tables to the period 2000-2016. With these tables, the average mean water levels were determined for the same time span. A digital terrain model was created from LIDAR scanning with 2m horizontal resolution (APA-DGT, 2011) and validated with altimetric data obtained with a DGPS-RTK. The response model calculates a new elevation for each pixel of the DTM for 2050 and 2100 based on the sedimentation rates specific of each environment. At this stage, theoretical values were chosen for the high marsh and the mudflat (respectively, equal and double the low marsh rate – 2.92 mm/year). These values will be rectified once sedimentation rates are determined for the other environments. For both projections, the total surface of the marsh decreases: 2% in 2050 and 61% in 2100. Additionally, the high marsh coverage diminishes significantly, indicating a regression in terms of maturity.

Keywords: ¹³⁷Cs, ²¹⁰Pb, saltmarsh, sea level rise, response model

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Authors: Mohamed Elkashouty, Mohamed Elkammar, Mohamed Gomma, Menal Elminiami

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Lake Bardawil is considered as one of the major morphological features of northern Sinai. It represents the largest fish production lake for export in Egypt. Nineteen and thirty one samples were collected from lake water during winter and summer (2005). TDS, cations, anions, Cd, Cu, Fe, Mn, Zn, Ni, Co and Pb concentrations were measured within winter and summer seasons. During summer, in the eastern sector of the lake, TDS concentration is decreased due northeastern part (38000 ppm), it is attributed to dilution from seawater through Boughaz II. The TDS concentration increased generally in the central and southern parts of the lake (44000 and 42000 ppm, respectively). It is caused by they are far from dilution from seawater, disconnected water body, shallow depth (mean 2 m), and high evaporation rate. In the western sector, the TDS content ranged from low (38000 ppm) in the northeastern part to high (50000 ppm) in the western part. Generally, the TDS concentration in the western sector is higher than those in the eastern. It is attributed to low volume of water body for the former, high evaporation rate, and therefore increase in TDS content in the lake water.During winter season, in the eastern sector, the wind velocity is high which enhance the water current to inflow into the lake through Boughaz I and II. The resultant water lake is diluted by seawater and rainfall in the winter season. The TDS concentration increased due southern part of the lake (42000 ppm) and declined in the northern part (36000 ppm). The concentration of Co, Ni, Pb, Fe, Cd, Zn, Cu, Mn and Pb within winter and summery seasons, in lake water are low, which considered as background concentrations with respect to seawater. Therefore, there are no industrial, agricultural and sanitary wastewaters dump into the lake. This confirms the statement that has been written at the entrance of Lake Bardawil at El-Telool area "Lake Bardawil, one of the purest lakes in the world". It indicate that the Lake Bardawil is excellent area for fish production for export (current state) and is the second main fish source in Egypt after the Mediterranean Sea after the illness of Lake Manzala.

Keywords: lake Bardawil, water quality, major ions, toxic metals

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Authors: Esshili Awatef, Manitz Marie-Pierre, Eßlinger Manuela, Gerhardt Alexandra, Plümper Jennifer, Wachholz Simone, Friebe Astrid, Juckel Georg

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Maternal immune activation (MIA) resulting from maternal viral infection during pregnancy is a known risk factor for schizophrenia. The neural mechanisms by which maternal infections increase the risk for schizophrenia remain unknown, although the prevailing hypothesis argues that an activation of the maternal immune system induces changes in the maternal-fetal environment that might interact with fetal brain development. It may lead to an activation of fetal microglia inducing long-lasting functional changes of these cells. Based on post-mortem analysis showing an increased number of activated microglial cells in patients with schizophrenia, it can be hypothesized that these cells contribute to disease pathogenesis and may actively be involved in gray matter loss observed in such patients. In the present study, we hypothesize that prenatal treatment with the inflammatory agent Poly(I:C) during embryogenesis at contributes to microglial activation in the offspring, which may, therefore, represent a contributing factor to the pathogenesis of schizophrenia and underlines the need for new pharmacological treatment options. Pregnant rats were treated with intraperitoneal injections a single dose of Poly(I:C) or saline on gestation day 17. Brains of control and Poly(I:C) offspring, were removed and into 20-μm-thick coronal sections were cut by using a Cryostat. Brain slices were fixed and immunostained with ba1 antibody. Subsequently, Iba1-immunoreactivity was detected using a secondary antibody, goat anti-rabbit. The sections were viewed and photographed under microscope. The immunohistochemical analysis revealed increases in microglia cell number in the prefrontal cortex, in offspring of poly(I:C) treated-rats as compared to the controls injected with NaCl. However, no significant differences were observed in microglia activation in the cerebellum among the groups. Prenatal immune challenge with Poly(I:C) was able to induce long-lasting changes in the offspring brains. This lead to a higher activation of microglia cells in the prefrontal cortex, a brain region critical for many higher brain functions, including working memory and cognitive flexibility. which might be implicated in possible changes in cortical neuropil architecture in schizophrenia. Further studies will be needed to clarify the association between microglial cells activation and schizophrenia-related behavioral alterations.

Keywords: Microglia, neuroinflammation, PolyI:C, schizophrenia

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Authors: Stefano Fantin

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The present analysis outcomes from the research undertaken in the course of the European-funded project EUNITY, which targets the gaps in research and development on cybersecurity and privacy between Europe and Japan. Under these auspices, the research presents a study on the policy approach of Japan, the EU and a number of Member States of the Union with regard to the handling and discovery of software vulnerabilities, with the aim of identifying methodological differences and similarities. This research builds upon a functional comparative analysis of both public policies and legal instruments from the identified jurisdictions. The result of this analysis is based on semi-structured interviews with EUNITY partners, as well as by the participation of the researcher to a recent report from the Center for EU Policy Study on software vulnerability. The European Union presents a rather fragmented legal framework on software vulnerabilities. The presence of a number of different legislations at the EU level (including Network and Information Security Directive, Critical Infrastructure Directive, Directive on the Attacks at Information Systems and the Proposal for a Cybersecurity Act) with no clear focus on such a subject makes it difficult for both national governments and end-users (software owners, researchers and private citizens) to gain a clear understanding of the Union’s approach. Additionally, the current data protection reform package (general data protection regulation), seems to create legal uncertainty around security research. To date, at the member states level, a few efforts towards transparent practices have been made, namely by the Netherlands, France, and Latvia. This research will explain what policy approach such countries have taken. Japan has started implementing a coordinated vulnerability disclosure policy in 2004. To date, two amendments can be registered on the framework (2014 and 2017). The framework is furthermore complemented by a series of instruments allowing researchers to disclose responsibly any new discovery. However, the policy has started to lose its efficiency due to a significant increase in reports made to the authority in charge. To conclude, the research conducted reveals two asymmetric policy approaches, time-wise and content-wise. The analysis therein will, therefore, conclude with a series of policy recommendations based on the lessons learned from both regions, towards a common approach to the security of European and Japanese markets, industries and citizens.

Keywords: cybersecurity, vulnerability, European Union, Japan

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Authors: Alexandru Grigorescu, Alexandra Protesanu

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Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.

Keywords: cancer pain, opioids, medical oncology, palliative care

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Authors: Sathvika Reddy, Devi Revathi

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Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Ghirmay Teklemicheal, Samsom Mehari, Sara Tesfay

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Objectives: A total of 1074 suspected chikungunya cases were reported in Tesseney Province, Gash Barka region, Eritrea, during an outbreak. This study was aimed to assess the possible association of chikungunya severity among ABO blood groups and other potential determinants. Methods: A sex-matched and age-matched case-control study was conducted during the outbreak. For each case, one control subject had been selected from the mild Chikungunya cases. Along the same line of argument, a second control subject had also been designated through which neighborhood of cases were analyzed, scrutinized, and appeared to the scheme of comparison. Time is always the most sacrosanct element in pursuance of any study. According to the temporal calculation, this study was pursued from October 15, 2018, to November 15, 2018. Coming to the methodological dependability, calculating odds ratios (ORs) and conditional (fixed-effect) logistic regression methods were being applied. As a consequence of this, the data was analyzed and construed on the basis of the aforementioned methodological systems. Results: In this outbreak, 137 severe suspected chikungunya cases and 137 mild chikungunya suspected patients, and 137 controls free of chikungunya from the neighborhood of cases were analyzed. Non-O individuals compared to those with O blood group indicated as significant with a p-value of 0.002. Separate blood group comparison among A and O blood groups reflected as significant with a p-value of 0.002. However, there was no significant difference in the severity of chikungunya among B, AB, and O blood groups with a p-value of 0.113 and 0.708, respectively, and a strong association of chikungunya severity was found with hypertension and diabetes (p-value of < 0.0001); whereas, there was no association between chikungunya severity and asthma with a p-value of 0.695 and also no association with pregnancy (p-value =0.881), ventilator (p-value =0.181), air conditioner (p-value = 0.247), and didn’t use latrine and pit latrine (p-value = 0.318), among individuals using septic and pit latrine (p-value = 0.567) and also among individuals using flush and pit latrine (p-value = 0.194). Conclusions: Non- O blood groups were found to be at risk more than their counterpart O blood group individuals with severe form of chikungunya disease. By the same token, individuals with chronic disease were more prone to severe forms of the disease in comparison with individuals without chronic disease. Prioritization is recommended for patients with chronic diseases and non-O blood group since they are found to be susceptible to severe chikungunya disease. Identification of human cell surface receptor(s) for CHIKV is quite necessary for further understanding of its pathophysiology in humans. Therefore, molecular and functional studies will necessarily be helpful in disclosing the association of blood group antigens and CHIKV infections.

Keywords: Chikungunya, Chikungunya virus, disease outbreaks, case-control studies, Eritrea

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Authors: Rajesh Kumar Suman, Ipseeta Ray Mohanty, Manjusha K. Borde, Ujjawala maheswari, Y. A. Deshmukh

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Background: Metabolic syndrome encompasses cluster of risk factors for cardiovascular disease which includes abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. The incidence of metabolic syndrome is on the rise globally. Objective: The present study was designed to develop a unique animal model that will mimic the pathological features seen in a large pool of individuals with diabetes and metabolic syndrome; suitable for pharmacological screening of drugs beneficial in this condition. Material and Methods: A combination of high fat diet (HFD) and low dose of streptozotocin (STZ) at 30, 35 and 40 mg/kg was used to induce metabolic syndrome co-existing with diabetes mellitus in Wistar rats. Results: The 40 mg/kg STZ produced sustained hyperglycemia and the dose was thus selected for our study to induce diabetes mellitus. Rat fed HFD (HF-DC) group showed significant (p < 0.001) increase in body weight on 4th and 7th week as compared with NC (Normal Control) group rats. However, the increase in body weight of HF-DC group rats was not sustained at the end of 10th weeks. Various components of metabolic syndrome such as dyslipidemia {(Increased Triglyceride, total Cholesterol, LDL Cholesterol and decreased HDL Cholesterol)}, diabetes mellitus (Blood Glucose, HbA1c, Serum Insulin, C-peptide), hypertension {Systolic Blood pressure (p < 0.001)} were mimicked in the developed model of metabolic syndrome co existing with diabetes mellitus. In addition significant cardiac injury as indicated by CPK-MB levels, artherogenic index, hs-CRP. The decline in hepatic function {(p < 0.01) increase in the level of SGPT (U/L)} and renal function {(increase in creatinine levels (p < 0.01)} when compared to NC group rats. The histopathological assessment confirmed presence of edema, necrosis and inflammation in Heart, Pancreas, Liver and Kidney of HFD-DC group as compared to NC. Conclusion: The present study has developed a unique rodent model of metabolic syndrome; with diabetes as an essential component.

Keywords: diabetes, metabolic syndrome, high fat diet, streptozotocin, rats

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Authors: Doua AlSaad, Ahmed Awaisu, Samah Elsalem, Palli Valapila Abdulrouf, Binny Thomas, Moza AlHail

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Background: It has been suggested that pyridoxine has an anti-lactogenic effect. Studies of the efficacy of pyridoxine in suppressing lactation have reported conflicting results. The aim of this review is to evaluate the effectiveness and safety of high-dose pyridoxine in postpartum lactation inhibition. Methods: This systematic review included published trials that compared the efficacy and/or safety of pyridoxine to placebo or to other pharmacological agents for the inhibition of postpartum lactation. We searched PubMed, Embase, ScienceDirect, CINAHL, AMED, the Cochrane library, and the clinical trials registry to identify relevant literature. No limit was imposed on the year of publication of the studies, and the review included studies published until 15 January 2016. Two reviewers independently extracted data and assessed the risk of bias. Results: Seven studies were included, with a total of 1155 women, of which 471 women received pyridoxine. Three studies were randomized controlled trials, while the remaining four studies were non-randomized controlled trials. All of the included studies were relatively small (n = 18 – 482). The studies compared pyridoxine with placebo, bromocriptine, and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450 – 600 mg for 5 to 7 days. Two trials (n = 349 participants) indicated that pyridoxine was effective in inhibiting lactation in approximately 95% of the enrolled patients. All other studies failed to demonstrate pyridoxine efficacy through either clinical assessment or prolactin level measurements. Pyridoxine safety was assessed by two trials in which no serious untoward side-effects were reported. Overall, the risk of bias for most of the studies was low to moderate. Conclusion: Current evidence supporting the effectiveness of high dose pyridoxine in the inhibition of postpartum lactation is inconsistent and insufficient. Larger randomized trials are needed to confirm the efficacy of pyridoxine in postpartum lactation inhibition. Acknowledgment: This review received a grant from the Medical Research Center of Hamad Medical Corporation in Qatar (grant number: 15100/15).

Keywords: pyridoxine, safety, effectiveness, lactation inhibition

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Authors: Yu Chen, Xiaoguang Yang, Lin Lin

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Traffic engineering construction is an important infrastructure for economic and social development. In the process of construction and operation, the ability to make a correct evaluation of the project's environmental impact appears to be crucial to the rational operation of existing transportation projects, the correct development of transportation engineering construction and the adoption of corresponding measures to scientifically carry out environmental protection work. Most of the existing research work on ecological and environmental impact assessment is limited to individual aspects of the environment and less to the overall evaluation of the environmental system; in terms of research conclusions, there are more qualitative analyses from the technical and policy levels, and there is a lack of quantitative research results and quantitative and operable evaluation models. In this paper, a comprehensive analysis of the ecological and environmental impacts of transportation construction projects is conducted, and factors such as the accessibility of data and the reliability of calculation results are comprehensively considered to extract indicators that can reflect the essence and characteristics. The qualitative evaluation indicators were screened using the expert review method, the qualitative indicators were measured using the fuzzy statistics method, the quantitative indicators were screened using the principal component analysis method, and the quantitative indicators were measured by both literature search and calculation. An environmental impact evaluation index system with the general objective layer, sub-objective layer and indicator layer was established, dividing the environmental impact of the transportation construction project into two periods: the construction period and the operation period. On the basis of the evaluation index system, the index weights are determined using the hierarchical analysis method, and the individual indicators to be evaluated are dimensionless, eliminating the influence of the original background and meaning of the indicators. Finally, the thesis uses the above research results, combined with the actual engineering practice, to verify the correctness and operability of the evaluation method.

Keywords: transportation construction projects, ecological and environmental impact, analysis and evaluation, indicator evaluation system

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Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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