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Authors: Baikuntha Prasad Acharya, Elizabeth Halpenny

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Small tourism enterprises (STEs) are primary providers of services and attractions in many destinations of less developed countries; they are considered the lifeblood of tourism sector. Furthermore, in rural community destinations of such countries including Nepal, STEs are regarded as alternative tools for advancing economic and sociocultural transformations. Many families in rural Nepali destinations are venturing into small tourism entrepreneurship so that their poverty can be reduced and they can live a sustained life. Most these communities are utilizing their lifestyles and natural and cultural heritages as tourism attractions. This study aimed to understand the sustainability of the STEs in rural destinations by synthesizing observations from Ghalegaon and Ghandruk of the Annapurna Conservation Area in western Nepal. Ghalegaon has community-based homestays and Ghandruk has independently owned and operated small tourism businesses such as cafes, tea houses, lodges, guest houses, and hotels, etc. The community-based homestays of Ghalegaon are compared with the independently owned and operated STEs of Ghandruk. The data were collected through multiple sources: 1) survey of tourists (n=112) and households (n=191); 2) interviews (n=14) with the locals, 3) group discussions (n=10) with different local groups including that of regional tourism players, experts and policy makers, 4) observations, and 5) document analysis. The STEs of both communities were first analyzed by understanding their level of sustainability as businesses, and then were explored how they were impacting on respective communities’ sustainability. The survey indicators and guidelines for interviews and group discussions were adapted to the Nepalese context based on four pillars of sustainability: economic, social, cultural and environmental; an additional dimension of management was also included, particularly for the STEs. The findings have shown a weaker economic and management dimensions of Ghalegaon’s Homestay than that of Ghandruk’s STEs. Some interesting social complexities of rural tourism and entrepreneurship were also revealed. This study’s findings do not much resonate to what Nepal government’s current rural tourism strategies that have been envisioned and prioritized for, particularly that the rural homestay tourism opportunities enhance inclusiveness of women and other deprived communities by spreading the benefits to the grassroots level. The study has highlighted several important applied implications to the local tourism management committees, tourism operators and associations, and regional and national tourism authorities. Further studies are advisable in other similar contexts in Nepal and in other countries to see whether there are variances in the findings.

Keywords: Nepal, rural tourism communities, small tourism enterprises, sustainability

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Authors: I. Cerrillo, A. Carrillo-Vico, M. A. Ortega, B. Escudero-López, N. Álvarez-Sánchez, F. Martín, M. S. Fernández-Pachón

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Melatonin is a bioactive compound involved in multiple biological activities such as glucose tolerance, circadian rhythm regulation, antioxidant defense or immune system action. In elderly subjects the intake of foods and drinks rich in melatonin is very important due to its endogenous level decreases with age. Alcoholic fermentation is a process carried out in fruits, vegetables and legumes to obtain new products with improved bioactive compounds profile in relation to original substrates. Alcoholic fermentation process carried out by Saccharomycetaceae var. Pichia kluyveri induces an important synthesis of melatonin in orange juice. A novel beverage derived of fermented orange juice could be a promising source of this bioactive compound. The aim of the present study was to determine whether the acute intake of fermented orange juice increase the levels of urinary 6-sulfatoxymelatonin in healthy humans. Nine healthy volunteers (7 women and 2 men), aged between 20 and 25 years old and BMI of 21.1  2.4 kg/m2, were recruited. On the study day, participants ingested 500 mL of fermented orange juice. The first urine collection was made before fermented orange juice consumption (basal). The rest of urine collections were made in the following time intervals after fermented orange juice consumption: 0-2, 2-5, 5-10, 10- 15 and 15-24 hours. During the experimental period only the consumption of water was allowed. At lunch time a meal was provided (60 g of white bread, two slices of ham, a slice of cheese, 125 g of sweetened natural yoghurt and water). The subjects repeated the protocol with orange juice following a 2-wk washout period between both types of beverages. The levels of 6-sulfatoxymelatonin (6-SMT) were measured in urine recollected at different time points using the Melatonin-Sulfate Urine ELISA (IBL International GMBH, Hamburg, Germany). Levels of 6-SMT were corrected to those of creatinine for each sample. A significant (p < 0.05) increase in urinary 6-SMT levels was observed between 2-5 hours after fermented orange juice ingestion with respect to basal values (increase of 67,8 %). The consumption of orange juice did not induce any significant change in urinary 6-SMT levels. In addition, urinary 6-SMT levels obtained between 2-5 hours after fermented orange juice ingestion (115,6 ng/mg) were significantly different (p < 0.05) from those of orange juice (42,4 ng/mg). The enhancement of urinary 6-SMT after the ingestion of 500 mL of fermented orange juice in healthy humans compared to orange juice could be an important advantage of this novel product as an excellent source of melatonin. Fermented orange juice could be a new functional food, and its consumption could exert a potentially positive effect on health in both the maintenance of health status and the prevention of chronic diseases.

Keywords: fermented orange juice, functional beverage, healthy human, melatonin

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Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

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Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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Authors: Melanie Schinnerl, Dorothea Greiling

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In the context of the 2020 strategy, poverty and its fight returned to the center of national political efforts. This served as motivation for an Austrian research grant-funded project to focus on the under-researched local government level with the aim to identify municipal best-practice cases and to derive policy implications for Austria. Designing effective poverty reduction strategies is a complex challenge which calls for an integrated multi-actor in approach. Cities are increasingly confronted to combat poverty, even in rich EU-member states. By doing so cities face substantial demographic, cultural, economic and social challenges as well as changing welfare state regimes. Furthermore, there is a low willingness of (right-wing) governments to support the poor. Against this background, the research questions are: 1. How do local governments define poverty? 2. Who are the main risk groups and what are the most pressing problems when fighting urban poverty? 3. What is regarded as successful anti-poverty initiatives? 4. What is the underlying welfare state concept? To address the research questions a multi-method approach was chosen, consisting of a systematic literature analysis, a comprehensive document analysis, and expert interviews. For interpreting the data the project follows the qualitative-interpretive paradigm. Municipal approaches for reducing poverty are compared based on deductive, as well as inductive identified criteria. In addition to an intensive literature analysis, interviews (40) were conducted in Austria since the project started in March 2018. From the other countries, 14 responses have been collected, providing a first insight. Regarding the definition of poverty the EU SILC-definition as well as counting the persons who receive need-based minimum social benefits, the Austrian form of social welfare, are the predominant approaches in Austria. In addition to homeless people, single-parent families, un-skilled persons, long-term unemployed persons, migrants (first and second generation), refugees and families with at least 3 children were frequently mentioned. The most pressing challenges for Austrian cities are: expected reductions of social budgets, a great insecurity of the central government's social policy reform plans, the growing number of homeless people and a lack of affordable housing. Together with affordable housing, old-age poverty will gain more importance in the future. The Austrian best practice examples, suggested by interviewees, focused primarily on homeless, children and young people (till 25). Central government’s policy changes have already negative effects on programs for refugees and elderly unemployed. Social Housing in Vienna was frequently mentioned as an international best practice case, other growing cities can learn from. The results from Austria indicate a change towards the social investment state, which primarily focuses on children and labour market integration. The first insights from the other countries indicate that affordable housing and labor market integration are cross-cutting issues. Inherited poverty and old-age poverty seems to be more pressing outside Austria.

Keywords: anti-poverty policies, European cities, empirical study, social investment

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Authors: Zhao Luqian, Wang Yafei

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Participation in music activities is beneficial for enhancing wellbeing, especially for aged people (Creech, 2013). Looking at percussion group in particular, it can facilitate a sense of belonging, relaxation, energy, and productivity, learning, enhanced mood, humanising, seems of accomplishment, escape from trauma, and emotional expression (Newman, 2015). In health literatures, group drumming is effective in reducing stress and improving multiple domains of social-motional behaviors (Ho et al., 2011; Maschi et al., 2010) because it offers a creative and mutual learning space that allows patients to establish a positive peer interaction (Mungas et al., 2014; Perkins, 2016). However, very few studies have investigated the effect of group drumming from the aspect of patients’ needs. Therefore, this study focuses on the discussion of patients' specific needs within mental health and explores how group percussion may meet their needs. Seligman’s (2011) five core elements of mental health were applied as patients’ needs in this study: (1) Positive emotions; (2) Engagement; (3) Relationships; (4) Meaning and (5) Accomplishment. 12 participants aged 57- 80 years were interviewed individually. The researcher also had observation in four drumming groups simultaneously. The results reveal that group drumming could improve participants’ mental wellbeing. First, it created a therapeutic health care environment extending beyond the elimination of boredom, and patients could focus on positive emotions during the session of group drumming. Secondly, it was effective in satisfying patients’ level of engagement. Thirdly, this study found that joining a percussion group would require patients to work on skills such as turn-taking and sharing. This equal relationship is helpful for releasing patients’ negative mood and thus forming tighter relationships between and among them. Fourthly, group drumming was found to meet patients’ meaning needs through offering them a place of belonging and a place for sharing. Its leaner-oriented approach engaged patients by a sense of belonging, accepting, connecting, and ownership. Finally, group drumming could meet patients’ needs for accomplishment through the learning process. The inclusive learning process, which indicates there is no right or wrong throughout the process, allowed patients to make their own decisions. In conclusion, it is difficult for patients to achieve positive emotions, engagement, relationships, meanings, and accomplishments in a hospital setting. Drumming can be practiced for enhancement in terms of reducing patients’ negative emotions and improving their experiences in a hospital through enriched social interaction and sense of accomplishment. Also, it can help patients to enhance social skills in a controlled environment.

Keywords: group drumming, hospital, mental health, music psychology

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Authors: Elena Bellini, Daniele Mugnaini, Michele Boschetto

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People with an Autistic Spectrum Disorder and an Intellectual Disability who need to attend a Hospital Emergency Waiting Room frequently present high levels of discomfort and challenging behaviors due to stress-related hyperarousal, sensory sensitivity, novelty-anxiety, communication and self-regulation difficulties. Increased agitation and acting out also disturb the diagnostic and therapeutic processes, and the emergency room climate. Architectural design disciplines aimed at reducing distress in hospitals or creating autism-friendly environments are called for to find effective answers to this particular need. A growing number of researchers are considering the physical environment as an important point of intervention for people with autism. It has been shown that providing the right setting can help enhance confidence and self-esteem and can have a profound impact on their health and wellbeing. Environmental psychology has evaluated the perceived quality of care, looking at the design of hospital rooms, paths and circulation, waiting rooms, services and devices. Furthermore, many studies have investigated the influence of the hospital environment on patients, in terms of stress-reduction and therapeutic intervention’ speed, but also on health professionals and their work. Several services around the world are organizing autism-friendly hospital environments which involve the architecture and the specific staff training. In Italy, the association Spes contra spem has promoted and published, in 2013, the ‘Chart of disabled people in the hospital’. It stipulates that disabled people should have equal rights to accessible and high-quality care. There are a few Italian examples of therapeutic programmes for autistic people as the Dama project in Milan and the recent experience of Children and Autism Foundation in Pordenone. Careggi’s Emergency Waiting Room in Florence has been built to satisfy this challenge. This project of research comes from a collaboration between the technical staff of Careggi Hospital, the Center for autism PAMAPI and some architects expert in the sensory environment. The methodology of focus group involved architects, psychologists and professionals through a transdisciplinary research, centered on the links between the spatial characteristics and clinical state of people with ASD. The relationship between architectural space and quality of life is studied to pay maximum attention to users’ needs and to support the medical staff in their work by a specific program of training. The result of this research is a sum of criteria used to design the emergency waiting room, that will be illustrated. A protected room, with a clear space design, maximizes comprehension and predictability. The multisensory environment is thought to help sensory integration and relaxation. Visual communication through Ipad allows an anticipated understanding of medical procedures, and a specific technological system supports requests, choices and self-determination in order to fit sensory stimulation to personal preferences, especially for hypo and hypersensitive people. All these characteristics should ensure a better regulation of the arousal, less behavior problems, improving treatment accessibility, safety, and effectiveness. First results about patient-satisfaction levels will be presented.

Keywords: accessibility of care, autism-friendly architecture, personalized therapeutic process, sensory environment

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Authors: Tunde Ope-Davies

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Transmediality and platformization as online content-sharing protocols have continued to accentuate the growing impact of the unprecedented digital revolution across the world. The rapid transformation across all sectors as a result of this revolution has continued to spotlight the increasing importance of new media technologies in redefining and reshaping the rhythm and dynamics of our private and public discursive practices. Equally, social and political activities are being impacted daily through the creation and transmission of political discourse content through multi-channel platforms such as mobile telephone communication, social media networks and the internet. It has been observed that digital platforms have become central to the production, processing, and distribution of multimodal social data and cultural content. The platformization paradigm thus underpins our understanding of how digital platforms enhance the production and heterogenous distribution of media and cultural content through these platforms and how this process facilitates socioeconomic and political activities. The use of multiple digital platforms to share and transmit political discourse material synchronously and asynchronously has gained some exciting momentum in the last few years. Nigeria’s 2023 general elections amplified the usage of social media and other online platforms as tools for electioneering campaigns, socio-political mobilizations and civic engagement. The study, therefore, focuses on transmedia and platformed political discourse as a new strategy to promote political candidates and their manifesto in order to mobilize support and woo voters. This innovative transmedia digital discourse model involves a constellation of online texts and images transmitted through different online platforms almost simultaneously. The data for the study was extracted from the 2023 general elections campaigns in Nigeria between January- March 2023 through media monitoring, manual download and the use of software to harvest the online electioneering campaign material. I adopted a discursive-analytic qualitative technique with toolkits drawn from a computer-mediated multimodal discourse paradigm. The study maps the progressive development of digital political discourse in this young democracy. The findings also demonstrate the inevitable transformation of modern democratic practice through platform-dependent and transmedia political discourse. Political actors and media practitioners now deploy layers of social media network platforms to convey messages and mobilize supporters in order to aggregate and maximize the impact of their media campaign projects and audience reach.

Keywords: social media, digital humanities, political discourse, platformized discourse, multimodal discourse

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Authors: Filip Majetić, Dražen Šimleša, Jelena Puđak, Anita Bušljeta Tonković, Svitlana Pinchuk

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This paper focuses on the self-sustainability aspect of social entrepreneurship (SE). We define SE as a form of entrepreneurship that is social/ecological mission oriented. It means SE organizations start and run businesses and use them to accomplish their social/ecological missions i.e. to solve social/ecological problems or fulfill social/ecological needs. Self-sustainability is defined as the capability of an SE organization to operate by relying on the money earned through trading its products in the free market. For various reasons, the achievement of self-sustainability represents a fundamental (business) challenge for many SE organizations. Those that are not able to operate using the money made through commercial activities, in order to remain active, rely on alternative, non-commercial streams of income such as grants, donations, and public subsidies. Starting from this widespread (business) challenge, we are interested in exploring elements that (could) influence the self-sustainability in SE organizations. Therefore, the research goal is to empirically investigate some of the self-sustainability factors of two notable SE organizations from different socio-economic contexts. A qualitative research, using the multiple case study approach, was conducted. ACT Group Čakovec (ACT) from Croatia was selected for the first case because it represents one of the leading and most self-sustainable SE organization in the region (in 2015 55% of the organization’s budget came from commercial activities); Friskis&Svettis Stockholm (F&S) from Sweden was selected for the second case because it is a rare example of completely self-sustainable SE organization in Europe (100% of the organization’s budget comes from commercial activities). The data collection primarily consists of conducting in-depth interviews. Additionally, the content of some of the organizations' official materials are analyzed (e.g. business reports, marketing materials). The interviewees are selected purposively and include: six highly ranked F&S members who represent five different levels in the hierarchy of their organization; five highly ranked ACT members who represent three different levels in the hierarchy of the organization. All of the interviews contain five themes: a) social values of the organization, b) organization of work, c) non-commercial income sources, d) marketing/collaborations, and e) familiarity with the industry characteristics and trends. The gathered data is thematically analyzed through the coding process for which Atlas.ti software for qualitative data analysis is used. For the purpose of creating thematic categories (codes), the open coding is used. The research results intend to provide new theoretical insights on factors of SE self-sustainability and, preferably, encourage practical improvements in the field.

Keywords: Friskis&Svettis, self-sustainability factors, social entrepreneurship, Stockholm

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Authors: Karin Eines, Riki Tesler

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Introduction: The Mamanet Cachibol League (MCL) is a community-based model developed in Israel to promote physical activity (PA) and amateur team sports among women. team sports are not just groups in the context of specific sport activity but also incorporated into a person’s sense of self and become influencing factor on sport-related behavior among the players. While in the non-Arabic sector, sport venues are available for the local authority population, the Arabic sector authorities face limited access sport facilities, with 168 sport venues and authorities with no venues at all. Within the Arab community, women participation in sports has traditionally been limited and, even more so for participation in team sports. Aims: The purpose of the study was to explore attributes of women MCL activity via: (1) assess differences between participants in the MCL and non-participants among Arab women regarding well-being level; (2) to examine among MCL participants the relationship between health maintenance characteristics and the likelihood of participating in the MCL; and (3) Use qualitative approach to shed light over the question why Arabic women participate in MCL and continue their engagement in PA. Methods: An explanatory sequential mixed-method design was employed to gain a deeper understanding of the advantages and motivations among women participating in community-based team sports. A cross-sectional survey was conducted among Israeli Arab women aged 25–59. Demographic characteristics, well-being (SRH and psychosomatic symptoms), eating habits, and social support were analyzed using two-way analyses of covariance and multiple regression models with a sequential entry of the variables. Quantitative results were further explored in qualitative in-depth interviews among 30 of the MCL participants, which shed light on additional reasons for participation in PA. Results: MCL participants reported better self-reported health (p < 0.001) and lower rates of psychosomatic symptoms (p < 0.001) compared to non-participants. Participation in MCL was also related to higher levels of well-being and healthy eating habits. Women who participated also experienced a profound sense of belonging, leading to enhanced social interactions and positivity in their personal and professional lives. They were dedicated to the group and felt empowered by the reciprocal commitment. The group promoted equality, making the women feel valued and respected, resulting in community admiration. Their involvement positively impacted their families, justifying their time commitment.

Keywords: wellbeing, obesity, community based sports, healthy eating habits, arab women

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Authors: Sanjay Shukla, A. Nayak, R. K. Sharma, A. P. Singh, S. P. Tiwari

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Excessive use of antibiotics is a major problem in the treatment of wounds and other chronic infections, and antibiotic treatment is frequently non-curative, thus alternative treatment is necessary. Phage therapy is considered one of the most promising approaches to treat multi-drug resistant bacterial pathogens. Infections caused by Staphylococcus aureus are very efficiently controlled with phage cocktails, containing a different individual phages lysate infecting a majority of known pathogenic S. aureus strains. The aim of the present study was to evaluate the efficacy of a purified phage cocktail for prophylactic as well as therapeutic application in mouse model and in large animals with chronic septic infection of wounds. A total of 150 sewage samples were collected from various livestock farms. These samples were subjected for the isolation of bacteriophage by the double agar layer method. A total of 27 sewage samples showed plaque formation by producing lytic activity against S. aureus in the double agar overlay method out of 150 sewage samples. In TEM, recovered isolates of bacteriophages showed hexagonal structure with tail fiber. In the bacteriophage (ØVS) had an icosahedral symmetry with the head size 52.20 nm in diameter and long tail of 109 nm. Head and tail were held together by connector and can be classified as a member of the Myoviridae family under the order of Caudovirale. Recovered bacteriophage had shown the antibacterial activity against the S. aureus in vitro. Cocktail (ØVS1, ØVS5, ØVS9, and ØVS 27) of phage lysate were tested to know in vivo antibacterial activity as well as the safety profile. Result of mice experiment indicated that the bacteriophage lysate were very safe, did not show any appearance of abscess formation, which indicates its safety in living system. The mice were also prophylactically protected against S. aureus when administered with cocktail of bacteriophage lysate just before the administration of S. aureuswhich indicates that they are good prophylactic agent. The S. aureusinoculated mice were completely recovered by bacteriophage administration with 100% recovery, which was very good as compere to conventional therapy. In the present study, ten chronic cases of the wound were treated with phage lysate, and follow up of these cases was done regularly up to ten days (at 0, 5, and 10 d). The result indicated that the six cases out of ten showed complete recovery of wounds within 10 d. The efficacy of bacteriophage therapy was found to be 60% which was very good as compared to the conventional antibiotic therapy in chronic septic wounds infections. Thus, the application of lytic phage in single dose proved to be innovative and effective therapy for the treatment of septic chronic wounds.

Keywords: phage therapy, S aureus, antimicrobial resistance, lytic phage, and bacteriophage

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Authors: Prema Basargekar

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Facilitating the subject ‘Entrepreneurship Education’ in higher education, such as management studies, can be exhilarating as well as challenging. It is a multi-disciplinary and ever-evolving subject. Capturing entrepreneurship as a phenomenon in a holistic manner is a daunting task as it requires covering various dimensions such as new ideas generation, entrepreneurial traits, business opportunities scanning, the role of policymakers, value creation, etc., to name a few. Implicit entrepreneurship theory and effectuation are two different theories that focus on engaging the participants to create content by using their own experiences, perceptions, and belief systems. It helps in understanding the phenomenon holistically. The assumption here is that all of us are part of the entrepreneurial ecosystem, and effective learning can come through active engagement and peer learning by all the participants together. The present study is an attempt to use these theories in the class assignment given to the students at the beginning of the course to build the course content and understand entrepreneurship as a phenomenon in a better way through peer learning. The assignment was given to three batches of MBA post-graduate students doing the program in one of the private business schools in India. The subject of ‘Entrepreneurship Management’ is facilitated in the third trimester of the first year. At the beginning of the course, the students were given the assignment to submit a brief write-up/ collage/picture/poem or in any other format about “What entrepreneurship means to you?” They were asked to give their candid opinions about entrepreneurship as a phenomenon as they perceive it. Nearly 156 students doing post-graduate MBA submitted the assignment. These assignments were further used to find answers to two research questions. – 1) Are students able to use divergent and innovative forms to express their opinions, such as poetry, illustrations, videos, etc.? 2) What are various dimensions of entrepreneurship which are emerging to understand the phenomenon in a better way? The study uses the Brawn and Clark framework of reflective thematic analysis for qualitative analysis. The study finds that students responded to this assignment enthusiastically and expressed their thoughts in multiple ways, such as poetry, illustration, personal narrative, videos, etc. The content analysis revealed that there could be seven dimensions to looking at entrepreneurship as a phenomenon. They are 1) entrepreneurial traits, 2) entrepreneurship as a journey, 3) value creation by entrepreneurs in terms of economic and social value, 4) entrepreneurial role models, 5) new business ideas and innovations, 6) personal entrepreneurial experiences and aspirations, and 7) entrepreneurial ecosystem. The study concludes that an implicit approach to facilitate entrepreneurship education helps in understanding it as a live phenomenon. It also encourages students to apply divergent and convergent thinking. It also helps in triggering new business ideas or stimulating the entrepreneurial aspirations of the students. The significance of the study lies in the application of implicit theories in the classroom to make higher education more engaging and effective.

Keywords: co-creation of content, divergent thinking, entrepreneurship education, implicit theory

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Authors: Mohamed El Fares Djellatou, Fracoise Filion

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The Ashukin program that means bridge in Naskapi or Atikamekw language, has been designed to offer a partnership between nursing students and an indigenous community. The students design a health promotion project tailored to the needs of the community. The issues of intimidation in primary school and cyber-dependence in high school were some concerns in a rural Atikamekw community. The goal of the project was to have a conversation with indigenous youths, aged 10-16 years old, on the challenges presented by intimidation and cyber dependence as well as promoting healthy relationships online and within the community. Methods: Multiple progressive inquiry questions (PIQs) were used to assess the feasibility and importance of this project for the Atikamekw nation, and to determine a plan to follow. The theoretical foundations to guide the conception of the project were the Population Health Promotion Model (PHPM), the First Nations Holistic Lifelong Learning Model, and the Medicine Wheel. A broad array of social determinants of health were addressed, including healthy childhood development, personal health practices, and coping skills, and education. The youths were encouraged to participate in interactive educational sessions, using PowerPoint presentations and pamphlets as the main effective strategies. Additional tools such as cultural artworks and physical activities were introduced to strengthen the inter-relational and team spirit within the Indigenous population. A quality assurance tool (QAT) was developed specifically to determine the appropriateness of these health promotion tools. Improvements were guided by the feedback issued by the indigenous schools’ teachers and social workers who filled the QATs. Post educational sessions, quantitative results have shown that 93.48% of primary school students were able to identify the different types of intimidation, 72.65% recognized more than two strategies, and 52.1% were able to list at least four resources to diffuse intimidation. On the other hand, around 75% of the adolescents were able to name at least three negative effects, and 50% listed three strategies to reduce cyber-dependence. This project was meant to create a bridge with the First Nation through health promotion, a population that is known to be disadvantaged due to systemic health inequity and disparities. Culturally safe care was proposed to deal with the two identified priority issues, and an educational toolkit was given to both schools to ensure the sustainability of the project. The project was self-financed through fundraising activities, and it yielded better results than expected.

Keywords: indigenous, first nation, bullying, cyber-dependence, internet addiction, intimidation, youth, adolescents, school, community nursing, health promotion

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Authors: S.K. Bhandari, E. Veneklaas, L. McCaw, R. Mazanec, K. Whitford, M. Renton

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Eucalyptus marginata, E. diversicolor and Corymbia calophylla form widespread forests in south-west Western Australia (SWWA). These forests have economic and ecological importance, and therefore, tree growth and sustainable management are of high priority. This paper aimed to analyse and model the growth of these species at both stand and individual levels, but this presentation will focus on predicting the growth of E. Marginata at the individual tree level. More specifically, the study wanted to investigate how well individual E. marginata tree growth could be predicted by considering the diameter and height of the tree at the start of the growth period, and whether this prediction could be improved by also accounting for the competition from neighbouring trees in different ways. The study also wanted to investigate how many neighbouring trees or what neighbourhood distance needed to be considered when accounting for competition. To achieve this aim, the Pearson correlation coefficient was examined among competition indices (CIs), between CIs and dbh growth, and selected the competition index that can best predict the diameter growth of individual trees of E. marginata forest managed under different thinning regimes at Inglehope in SWWA. Furthermore, individual tree growth models were developed using simple linear regression, multiple linear regression, and linear mixed effect modelling approaches. Individual tree growth models were developed for thinned and unthinned stand separately. The developed models were validated using two approaches. In the first approach, models were validated using a subset of data that was not used in model fitting. In the second approach, the model of the one growth period was validated with the data of another growth period. Tree size (diameter and height) was a significant predictor of growth. This prediction was improved when the competition was included in the model. The fit statistic (coefficient of determination) of the model ranged from 0.31 to 0.68. The model with spatial competition indices validated as being more accurate than with non-spatial indices. The model prediction can be optimized if 10 to 15 competitors (by number) or competitors within ~10 m (by distance) from the base of the subject tree are included in the model, which can reduce the time and cost of collecting the information about the competitors. As competition from neighbours was a significant predictor with a negative effect on growth, it is recommended including neighbourhood competition when predicting growth and considering thinning treatments to minimize the effect of competition on growth. These model approaches are likely to be useful tools for the conservations and sustainable management of forests of E. marginata in SWWA. As a next step in optimizing the number and distance of competitors, further studies in larger size plots and with a larger number of plots than those used in the present study are recommended.

Keywords: competition, growth, model, thinning

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Authors: Weikang Gong, Chunhua Li

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Dynamics plays an essential role in function exertion of proteins. Elastic network model (ENM), a harmonic potential-based and cost-effective computational method, is a valuable and efficient tool for characterizing the intrinsic dynamical properties encoded in biomacromolecule structures and has been widely used to detect the large-amplitude collective motions of proteins. Gaussian network model (GNM) and anisotropic network model (ANM) are the two often-used ENM models. In recent years, many ENM variants have been proposed. Here, we propose a small but effective modification (denoted as modified mENM) to the multiscale ENM (mENM) where fitting weights of Kirchhoff/Hessian matrixes with the least square method (LSM) is modified since it neglects the details of pairwise interactions. Then we perform its comparisons with the original mENM, traditional ENM, and parameter-free ENM (pfENM) on reproducing dynamical properties for the six representative proteins whose molecular dynamics (MD) trajectories are available in http://mmb.pcb.ub.es/MoDEL/. In the results, for B-factor prediction, mENM achieves the best performance among the four ENM models. Additionally, it is noted that with the weights of the multiscale Kirchhoff/Hessian matrixes modified, interestingly, the modified mGNM/mANM still has a much better performance than the corresponding traditional ENM and pfENM models. As to dynamical cross-correlation map (DCCM) calculation, taking the data obtained from MD trajectories as the standard, mENM performs the worst while the results produced by the modified mENM and pfENM models are close to those from MD trajectories with the latter a little better than the former. Generally, ANMs perform better than the corresponding GNMs except for the mENM. Thus, pfANM and the modified mANM, especially the former, have an excellent performance in dynamical cross-correlation calculation. Compared with GNMs (except for mGNM), the corresponding ANMs can capture quite a number of positive correlations for the residue pairs nearly largest distances apart, which is maybe due to the anisotropy consideration in ANMs. Furtherly, encouragingly the modified mANM displays the best performance in capturing the functional motional modes, followed by pfANM and traditional ANM models, while mANM fails in all the cases. This suggests that the consideration of long-range interactions is critical for ANM models to produce protein functional motions. Based on the analyses, the modified mENM is a promising method in capturing multiple dynamical characteristics encoded in protein structures. This work is helpful for strengthening the understanding of the elastic network model and provides a valuable guide for researchers to utilize the model to explore protein dynamics.

Keywords: elastic network model, ENM, multiscale ENM, molecular dynamics, parameter-free ENM, protein structure

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Authors: Wedad Albalawi

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The mathematical inequalities have been the core of mathematical study and used in almost all branches of mathematics as well in various areas of science and engineering. The inequalities by Hardy, Littlewood and Polya were the first significant composition of several science. This work presents fundamental ideas, results and techniques, and it has had much influence on research in various branches of analysis. Since 1934, various inequalities have been produced and studied in the literature. Furthermore, some inequalities have been formulated by some operators; in 1989, weighted Hardy inequalities have been obtained for integration operators. Then, they obtained weighted estimates for Steklov operators that were used in the solution of the Cauchy problem for the wave equation. They were improved upon in 2011 to include the boundedness of integral operators from the weighted Sobolev space to the weighted Lebesgue space. Some inequalities have been demonstrated and improved using the Hardy–Steklov operator. Recently, a lot of integral inequalities have been improved by differential operators. Hardy inequality has been one of the tools that is used to consider integrity solutions of differential equations. Then, dynamic inequalities of Hardy and Coposon have been extended and improved by various integral operators. These inequalities would be interesting to apply in different fields of mathematics (functional spaces, partial differential equations, mathematical modeling). Some inequalities have been appeared involving Copson and Hardy inequalities on time scales to obtain new special version of them. A time scale is an arbitrary nonempty closed subset of the real numbers. Then, the dynamic inequalities on time scales have received a lot of attention in the literature and has become a major field in pure and applied mathematics. There are many applications of dynamic equations on time scales to quantum mechanics, electrical engineering, neural networks, heat transfer, combinatorics, and population dynamics. This study focuses on Hardy and Coposon inequalities, using Steklov operator on time scale in double integrals to obtain special cases of time-scale inequalities of Hardy and Copson on high dimensions. The advantage of this study is that it uses the one-dimensional classical Hardy inequality to obtain higher dimensional on time scale versions that will be applied in the solution of the Cauchy problem for the wave equation. In addition, the obtained inequalities have various applications involving discontinuous domains such as bug populations, phytoremediation of metals, wound healing, maximization problems. The proof can be done by introducing restriction on the operator in several cases. The concepts in time scale version such as time scales calculus will be used that allows to unify and extend many problems from the theories of differential and of difference equations. In addition, using chain rule, and some properties of multiple integrals on time scales, some theorems of Fubini and the inequality of H¨older.

Keywords: time scales, inequality of hardy, inequality of coposon, steklov operator

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Authors: K. O'Malley

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Background: The emergence and rapid evolution of large language models (LLMs) (i.e., models of generative artificial intelligence, or AI) has been unprecedented. ChatGPT is one of the most widely used LLM platforms. Using natural language processing technology, it generates customized responses to user prompts, enabling it to mimic human conversation. Responses are generated using predictive modeling of vast internet text and data swathes and are further refined and reinforced through user feedback. The popularity of LLMs is increasing, with a growing number of students utilizing these platforms for study and revision purposes. Notwithstanding its many novel applications, LLM technology is inherently susceptible to bias and error. This poses a significant challenge in the educational setting, where academic integrity may be undermined. This study aims to evaluate the performance of the latest iteration of ChatGPT (ChatGPT4.0) in standardized state medical licensing examinations. Methods: A considered search strategy was used to interrogate the PubMed electronic database. The keywords ‘ChatGPT’ AND ‘medical education’ OR ‘medical school’ OR ‘medical licensing exam’ were used to identify relevant literature. The search included all peer-reviewed literature published in the past five years. The search was limited to publications in the English language only. Eligibility was ascertained based on the study title and abstract and confirmed by consulting the full-text document. Data was extracted into a Microsoft Excel document for analysis. Results: The search yielded 345 publications that were screened. 225 original articles were identified, of which 11 met the pre-determined criteria for inclusion in a narrative synthesis. These studies included performance assessments in national medical licensing examinations from the United States, United Kingdom, Saudi Arabia, Poland, Taiwan, Japan and Germany. ChatGPT 4.0 achieved scores ranging from 67.1 to 88.6 percent. The mean score across all studies was 82.49 percent (SD= 5.95). In all studies, ChatGPT exceeded the threshold for a passing grade in the corresponding exam. Conclusion: The capabilities of ChatGPT in standardized academic assessment in medicine are robust. While this technology can potentially revolutionize higher education, it also presents several challenges with which educators have not had to contend before. The overall strong performance of ChatGPT, as outlined above, may lend itself to unfair use (such as the plagiarism of deliverable coursework) and pose unforeseen ethical challenges (arising from algorithmic bias). Conversely, it highlights potential pitfalls if users assume LLM-generated content to be entirely accurate. In the aforementioned studies, ChatGPT exhibits a margin of error between 11.4 and 32.9 percent, which resonates strongly with concerns regarding the quality and veracity of LLM-generated content. It is imperative to highlight these limitations, particularly to students in the early stages of their education who are less likely to possess the requisite insight or knowledge to recognize errors, inaccuracies or false information. Educators must inform themselves of these emerging challenges to effectively address them and mitigate potential disruption in academic fora.

Keywords: artificial intelligence, ChatGPT, generative ai, large language models, licensing exam, medical education, medicine, university

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Authors: L. M. H. Mustonen, S. A. Heikkilä

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The focus of the paper is to describe team teaching as a HAMK’s pedagogical method, and its impacts to the teachers work. Background: Traditionally it is thought that teaching is a job where one mostly works alone. More and more teachers feel that their work is getting more stressful. Solutions to these problems have been sought in Häme University of Applied sciences’ (From now on referred to as HAMK). HAMK has made a strategic change to move to the group oriented working of teachers. Instead of isolated study courses, there are now larger 15 credits study modules. Implementation: As examples of the method, two cases are presented: technical project module and summer studies module, which was integrated into the EU development project called Energy Efficiency with Precise Control. In autumn 2017, technical project will be implemented third time. There are at least three teachers involved in it and it is the first module of the new students. Main focus is to learn the basic skills of project working. From communicational viewpoint, they learn the basics of written and oral reporting and the basics of video reporting skills. According to our quality control system, the need for the development is evaluated in the end of the module. There are always some differences in each implementation but the basics are the same. The other case summer studies 2017 is new and part of a larger EU project. For the first time, we took a larger group of first to third year students from different study programmes to the summer studies. The students learned professional skills and also skills from different fields of study, international cooperation, and communication skills. Benefits and challenges: After three years, it is possible to consider what the changes mean in the everyday work of the teachers - and of course – what it means to students and the learning process. The perspective is HAMK’s electrical and automation study programme: At first, the change always means more work. The routines born after many years and the course material used for years may not be valid anymore. Teachers are teaching in modules simultaneously and often with some subjects overlapping. Finding the time to plan the modules together is often difficult. The essential benefit is that the learning outcomes have improved. This can be seen in the feedback given by both the teachers and the students. Conclusions: A new type of working environment is being born. A team of teachers designs a module that matches the objectives and ponders the answers to such questions as what are the knowledge-based targets of the module? Which pedagogical solutions will achieve the desired results? At what point do multiple teachers instruct the class together? How is the module evaluated? How can the module be developed further for the next execution? The team discusses openly and finds the solutions. Collegiate responsibility and support are always present. These are strengthening factors of the new communal university teaching culture. They are also strong sources of pleasure of work.

Keywords: pedagogical development, summer studies, team teaching, well-being at work

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Authors: B. Gonzalez-Yebra, H. Barajas, P. Palomares, M. Hernandez, O. Torres, M. Ayala, A. L. González, G. Vazquez-Ortiz, M. L. Guzman

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Leukemia arises by molecular alterations of the normal hematopoietic stem cell (HSC) transforming it into a leukemic stem cell (LSC) with high cell proliferation, self-renewal, and cell differentiation. Chronic myeloid leukemia (CML) originates from an LSC-leading to elevated proliferation of myeloid cells and acute lymphoblastic leukemia (ALL) originates from an LSC development leading to elevated proliferation of lymphoid cells. In both cases, LSC can be identified by multicolor flow cytometry using several antibodies. However, to date, LSC levels in peripheral blood (PB) are not established well enough in ALL and CML patients. On the other hand, the detection of the minimal residue disease (MRD) in leukemia is mainly based on the identification of the mRNA bcr-abl gene in CML patients and some other genes in ALL patients. There is no a properly biomarker to detect MDR in both types of leukemia. The objective of this study was to determine mRNA bcr-abl and the percentage of LSC in peripheral blood of patients with CML and ALL and identify a possible association between the amount of LSC in PB and clinical data. We included in this study 19 patients with Leukemia. A PB sample was collected per patient and leukocytes were obtained by Ficoll gradient. The immunophenotype for LSC CD34+ was done by flow cytometry analysis with CD33, CD2, CD14, CD16, CD64, HLA-DR, CD13, CD15, CD19, CD10, CD20, CD34, CD38, CD71, CD90, CD117, CD123 monoclonal antibodies. In addition, to identify the presence of the mRNA bcr-abl by RT-PCR, the RNA was isolated using TRIZOL reagent. Molecular (presence of mRNA bcr-abl and LSC CD34+) and clinical results were analyzed with descriptive statistics and a multiple regression analysis was performed to determine statistically significant association. In total, 19 patients (8 patients with ALL and 11 patients with CML) were analyzed, 9 patients with de novo leukemia (ALL = 6 and CML = 3) and 10 under treatment (ALL = 5 and CML = 5). The overall frequency of mRNA bcr-abl was 31% (6/19), and it was negative in ALL patients and positive in 80% in CML patients. On the other hand, LSC was determined in 16/19 leukemia patients (%LSC= 0.02-17.3). The Novo patients had higher percentage of LSC (0.26 to 17.3%) than patients under treatment (0 to 5.93%). The amount of LSC was significantly associated with the amount of LSC were: absence of treatment, the absence of splenomegaly, and a lower number of leukocytes, negative association for the clinical variables age, sex, blasts, and mRNA bcr-abl. In conclusion, patients with de novo leukemia had a higher percentage of circulating LSC than patients under treatment, and it was associated with clinical parameters as lack of treatment, absence of splenomegaly and a lower number of leukocytes. The mRNA bcr-abl detection was only possible in the series of patients with CML, and molecular detection of LSC could be identified in the peripheral blood of all leukemia patients, we believe the identification of circulating LSC may be used as biomarker for the detection of the MRD in leukemia patients.

Keywords: stem cells, leukemia, biomarkers, flow cytometry

Procedia PDF Downloads 357

Authors: Clara Voyvodic

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

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

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Authors: Sree Sanyal

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Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.

Keywords: morbidity, multi-morbidity, prevalence, social ties

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Authors: Jamuna Loganath

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Education is the key to the development of any individual’s personality. Today’s students will be tomorrow’s citizens of the global society. The education of the student is the edifice on which his/her future will be built. Schools therefore should provide an all-round development of students so as to foster a healthy society. The behaviors and the attitude of the students in school play an essential role for the success of the education process. Frequent reports of misbehaviors such as clowning, harassing classmates, verbal insults are becoming common in schools today. If this issue is left unattended, it may develop a negative attitude and increase the delinquent behavior. So, the need of the hour is to find a solution to this problem. To solve this issue, it is important to monitor the students’ behaviors in school and give necessary feedback and mentor them to develop a positive attitude and help them to become a successful grownup. Nevertheless, measuring students’ behavior and attitude is extremely challenging. None of the present technology has proven to be effective in this measurement process because actions, reactions, interactions, response of the students are rarely used in the course of the data due to complexity. The purpose of this proposal is to recommend an effective supervising system after carrying out a feasibility study by measuring the behavior of the Students. This can be achieved by equipping schools with CCTV cameras. These CCTV cameras installed in various schools of the world capture the facial expressions and interactions of the students inside and outside their classroom. The real time raw videos captured from the CCTV can be uploaded to the cloud with the help of a network. The video feeds get scooped into various nodes in the same rack or on the different racks in the same cluster in Hadoop HDFS. The video feeds are converted into small frames and analyzed using various Pattern recognition algorithms and MapReduce algorithm. Then, the video frames are compared with the bench marking database (good behavior). When misbehavior is detected, an alert message can be sent to the counseling department which helps them in mentoring the students. This will help in improving the effectiveness of the education process. As Video feeds come from multiple geographical areas (schools from different parts of the world), BIG DATA helps in real time analysis as it analyzes computationally to reveal patterns, trends, and associations, especially relating to human behavior and interactions. It also analyzes data that can’t be analyzed by traditional software applications such as RDBMS, OODBMS. It has also proven successful in handling human reactions with ease. Therefore, BIG DATA could certainly play a vital role in handling this issue. Thus, effectiveness of the education process can be enhanced with the help of video analytics using the latest BIG DATA technology.

Keywords: big data, cloud, CCTV, education process

Procedia PDF Downloads 240

Authors: Helen Nelly Naiga, Jane Frances Zalwango, Saudah N. Kizito, Brian Agaba, Brenda N Simbwa, Maria Goretti Zalwango, Richard Migisha, Benon Kwesiga, Daniel Kadobera, Alex Ario Riolexus, Sarah Paige, Julie R. Harris

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Background: Traditional community beliefs and practices can facilitate the spread of Ebola virus during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022. Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically. Results: Frequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently first consulted traditional healers or spiritual leaders before seeking formal healthcare, and noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials. Conclusion: Multiple community beliefs and practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Engaging traditional and spiritual healers early during similar outbreaks through risk communication and community engagement efforts could facilitate outbreak control. Targeted community messaging, including clear biological explanations for clusters of deaths and information on the dangers of exhuming bodies of SVD patients, could similarly facilitate improved control in future outbreaks in Uganda.

Keywords: Ebola, Sudan virus, outbreak, beliefs, traditional

Procedia PDF Downloads 55

Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove

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It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.

Keywords: collaboration, joint commissioning, service delivery, service improvement

Procedia PDF Downloads 111

Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

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Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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Authors: Michela Quadrini

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Chord diagrams occur in mathematics, from the study of RNA to knot theory. They are widely used in theory of knots and links for studying the finite type invariants, whereas in molecular biology one important motivation to study chord diagrams is to deal with the problem of RNA structure prediction. An RNA molecule is a linear polymer, referred to as the backbone, that consists of four types of nucleotides. Each nucleotide is represented by a point, whereas each chord of the diagram stands for one interaction for Watson-Crick base pairs between two nonconsecutive nucleotides. A chord diagram is an oriented circle with a set of n pairs of distinct points, considered up to orientation preserving diffeomorphisms of the circle. A linear chord diagram (LCD) is a special kind of graph obtained cutting the oriented circle of a chord diagram. It consists of a line segment, called its backbone, to which are attached a number of chords with distinct endpoints. There is a natural fattening on any linear chord diagram; the backbone lies on the real axis, while all the chords are in the upper half-plane. Each linear chord diagram has a natural genus of its associated surface. To each chord diagram and linear chord diagram, it is possible to associate the intersection graph. It consists of a graph whose vertices correspond to the chords of the diagram, whereas the chord intersections are represented by a connection between the vertices. Such intersection graph carries a lot of information about the diagram. Our goal is to define an LCD equivalence class in terms of identity of intersection graphs, from which many chord diagram invariants depend. For studying these invariants, we introduce a new representation of Linear Chord Diagrams based on a set of appropriate topological operators that permits to model LCD in terms of the relations among chords. Such set is composed of: crossing, nesting, and concatenations. The crossing operator is able to generate the whole space of linear chord diagrams, and a multiple context free grammar able to uniquely generate each LDC starting from a linear chord diagram adding a chord for each production of the grammar is defined. In other words, it allows to associate a unique algebraic term to each linear chord diagram, while the remaining operators allow to rewrite the term throughout a set of appropriate rewriting rules. Such rules define an LCD equivalence class in terms of the identity of intersection graphs. Starting from a modelled RNA molecule and the linear chord, some authors proposed a topological classification and folding. Our LCD equivalence class could contribute to the RNA folding problem leading to the definition of an algorithm that calculates the free energy of the molecule more accurately respect to the existing ones. Such LCD equivalence class could be useful to obtain a more accurate estimate of link between the crossing number and the topological genus and to study the relation among other invariants.

Keywords: chord diagrams, linear chord diagram, equivalence class, topological language

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Authors: Nasra Idilbi, Jalal Tarabeia, Layalleh Masalha, Heiam Shoufani Kassis, Gizell Green

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Background: Healthcare professionals working in underground facilities face unique challenges affecting their physical and mental health and team effectiveness. We aimed to examine how an underground work environment affects the physical and mental health and effectiveness of a multi-professional medical team in a medical center under continuous war threats and the contribution of various demographic and professional characteristics. Methods: A cross-sectional survey was disseminated electronically. The questionnaire assessed team effectiveness, the quality of the work, and the health symptoms reported by the team while working in the underground complex. Results: In total, 270 healthcare workers (mean age 40 years, 75.6% females, 88.4% nurses) completed the questionnaire. Women reported statistically significantly higher mean scores of physical strain, fatigue, and eye irritation associated with the work environment compared to men. Multiple regression analysis revealed that psychological distress, noise, and lighting in the underground compound significantly influenced team effectiveness. The qualitative analysis revealed two key themes: the mental health impact of working in an underground environment and the effects of noise and lighting on staff performance. Nurses reported feelings of suffocation, claustrophobia, and difficulty concentrating due to the enclosed space, with some expressing heightened stress levels that impaired their ability to work effectively and safely. Female staff reported more pronounced symptoms of physical strain, fatigue, and eye irritation. Additionally, the underground complex’s poor noise absorption created a highly disruptive work environment, while inadequate lighting hindered accurate patient assessments, leading to potential errors. These challenges were exacerbated by physical symptoms like headaches and nausea, which further impacted job performance. The findings underscore the significant role of environmental factors in influencing both mental health and operational effectiveness, aligning with quantitative data on the predictors of team performance. Conclusions: The underground work environment is crucial in influencing healthcare team effectiveness, with psychological distress, noise, and lighting as key factors. The study highlights the importance of creating a comfortable work environment to foster team efficiency. The findings provide valuable insights for managers in underground healthcare facilities to optimize team performance and well-being.

Keywords: team effectiveness, underground settings, healthcare, environmental factors, a mixed-methods study

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Authors: Rafael do Amaral Teodoro, Leandro Augusto da Silva

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Originated from graphite, graphene is a two-dimensional (2D) material that promises to revolutionize technology in many different areas, such as energy, telecommunications, civil construction, aviation, textile, and medicine. This is possible because its structure, formed by carbon bonds, provides desirable optical, thermal, and mechanical characteristics that are interesting to multiple areas of the market. Thus, several research and development centers are studying different manufacturing methods and material applications of graphene, which are often compromised by the scarcity of more agile and accurate methodologies to characterize the material – that is to determine its composition, shape, size, and the number of layers and crystals. To engage in this search, this study proposes a computational methodology that applies deep learning to identify graphene oxide crystals in order to characterize samples by crystal sizes. To achieve this, a fully convolutional neural network called U-net has been trained to segment SEM graphene oxide images. The segmentation generated by the U-net is fine-tuned with a standard deviation technique by classes, which allows crystals to be distinguished with different labels through an object delimitation algorithm. As a next step, the characteristics of the position, area, perimeter, and lateral measures of each detected crystal are extracted from the images. This information generates a database with the dimensions of the crystals that compose the samples. Finally, graphs are automatically created showing the frequency distributions by area size and perimeter of the crystals. This methodological process resulted in a high capacity of segmentation of graphene oxide crystals, presenting accuracy and F-score equal to 95% and 94%, respectively, over the test set. Such performance demonstrates a high generalization capacity of the method in crystal segmentation, since its performance considers significant changes in image extraction quality. The measurement of non-overlapping crystals presented an average error of 6% for the different measurement metrics, thus suggesting that the model provides a high-performance measurement for non-overlapping segmentations. For overlapping crystals, however, a limitation of the model was identified. To overcome this limitation, it is important to ensure that the samples to be analyzed are properly prepared. This will minimize crystal overlap in the SEM image acquisition and guarantee a lower error in the measurements without greater efforts for data handling. All in all, the method developed is a time optimizer with a high measurement value, considering that it is capable of measuring hundreds of graphene oxide crystals in seconds, saving weeks of manual work.

Keywords: characterization, graphene oxide, nanomaterials, U-net, deep learning

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Authors: Bangun F., Crevits B., Bellet T., Banet A., Boy G. A., Katili I.

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This paper seeks the incoherencies in cognitive process during an accident of Powered Two Wheelers (PTW) by understanding the factual sequences of events and causal relations for each case of accident. The principle of this approach is undertaking in-depth investigations on case per case of PTW accidents based on elaborate data acquisitions on accident sites that officially stamped in Police Crash Report (PCRs) 2012 of Medan with criteria, involved at least one PTW and resulted in serious injury and fatalities. The analysis takes into account four modules: accident chronologies, perpetrator, and victims, injury surveillance, vehicles and road infrastructures, comprising of traffic facilities, road geometry, road alignments and weather. The proposal for improvement could have provided a favorable influence on the chain of functional processes and events leading to collision. Decision Aiding Processes (DAP) assists in structuring different entities at different decisional levels, as each of these entities has its own objectives and constraints. The entities (A) are classified into 6 groups of accidents: solo PTW accidents; PTW vs. PTW; PTW vs. pedestrian; PTW vs. motor-trishaw; and PTW vs. other vehicles and consecutive crashes. The entities are also distinguished into 4 decisional levels: level of road users and street systems; operational level (crash-attended police officers or CAPO and road engineers), tactical level (Regional Traffic Police, Department of Transportation, and Department of Public Work), and strategic level (Traffic Police Headquarters (TCPHI)), parliament, Ministry of Transportation and Ministry of Public Work). These classifications will lead to conceptualization of Problem Situations (P) and Problem Formulations (I) in DAP context. The DAP concerns the sequences process of the incidents until the time the accident occurs, which can be modelled in terms of five activities of procedural rationality: identification on initial human features (IHF), investigation on proponents attributes (PrAT), on Injury Surveillance (IS), on the interaction between IHF and PrAt and IS (intercorrelation), then unravel the sequences of incidents; filtering and disclosure, which include: what needs to activate, modify or change or remove, what is new and what is priority. These can relate to the activation or modification or new establishment of law. The PrAt encompasses the problems of environmental, road infrastructure, road and traffic facilities, and road geometry. The evaluation model (MP) is generated to bridge P and I since MP is produced by the intercorrelations among IHF, PrAT and IS extracted from the PCRs 2012 of Medan. There are 7 findings of incoherences: lack of knowledge and awareness on the traffic regulations and the risks of accidents, especially when riding between 0 < x < 10 km from house, riding between 22 p.m.–05.30 a.m.; lack of engagements on procurement of IHF Data by CAPO; lack of competency of CAPO on data procurement in accident-sites; no intercorrelation among IHF and PrAt and IS in the database systems of PCRs; lack of maintenance and supervision on the availabilities and the capacities of traffic facilities and road infrastructure; instrumental bias with wash-back impacts towards the TCPHI; technical robustness with wash-back impacts towards the CAPO and TCPHI.

Keywords: decision aiding processes, evaluation model, PTW accidents, police crash reports

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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