Search results for: language loss
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6881

Search results for: language loss

281 Synthesis, Growth, Characterization and Quantum Chemical Investigations of an Organic Single Crystal: 2-Amino- 4-Methylpyridinium Quinoline- 2-Carboxylate

Authors: Anitha Kandasamy, Thirumurugan Ramaiah

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Interestingly, organic materials exhibit large optical nonlinearity with quick responses and having the flexibility of molecular tailoring using computational modelling and favourable synthetic methodologies. Pyridine based organic compounds and carboxylic acid contained aromatic compounds play a crucial role in crystal engineering of NCS complexes that displays admirable optical nonlinearity with fast response and favourable physicochemical properties such as low dielectric constant, wide optical transparency and large laser damage threshold value requires for optoelectronics device applications. Based on these facts, it was projected to form an acentric molecule of π-conjugated system interaction with appropriately replaced electron donor and acceptor groups for achieving higher SHG activity in which quinoline-2-carboyxlic acid is chosen as an electron acceptor and capable of acting as an acid as well as a base molecule, while 2-amino-4-methylpyridine is used as an electron donor and previously employed in numerous proton transfer complexes for synthesis of NLO materials for optoelectronic applications. 2-amino-4-mehtylpyridinium quinoline-2-carboxylate molecular complex (2AQ) is having π-donor-acceptor groups in which 2-amino-4-methylpyridine donates one of its electron to quinoline -2-carboxylic acid thereby forming a protonated 2-amino-4-methyl pyridinium moiety and mono ionized quinoline-2-carboxylate moiety which are connected via N-H…O intermolecular interactions with non-centrosymmetric crystal packing arrangement at microscopic scale is accountable to the enhancement of macroscopic second order NLO activity. The 2AQ crystal was successfully grown by a slow evaporation solution growth technique and its structure was determined in orthorhombic crystal system with acentric, P212121, space group. Hirshfeld surface analysis reveals that O…H intermolecular interactions primarily contributed with 31.0 % to the structural stabilization of 2AQ. The molecular structure of title compound has been confirmed by 1H and 13C NMR spectral studies. The vibrational modes of functional groups present in 2AQ have been assigned by using FTIR and FT-Raman spectroscopy. The grown 2AQ crystal exhibits high optical transparency with lower cut-off wavelength (275 nm) within the region of 275-1500 nm. The laser study confirmed that 2AQ exhibits high SHG efficiency of 12.6 times greater than that of KDP. TGA-DTA analysis revealed that 2AQ crystal had a thermal stability of 223 °C. The low dielectric constant and low dielectric loss at higher frequencies confirmed good crystalline nature with fewer defects of grown 2AQ crystal. The grown crystal exhibits soft material and positive photoconduction behaviour. Mulliken atomic distribution and FMOs analysis suggested that the strong intermolecular hydrogen bonding which lead to the enhancement of NLO activity. These properties suggest that 2AQ crystal is a suitable material for optoelectronic and laser frequency conversion applications.

Keywords: crystal growth, NLO activity, proton transfer complex, quantum chemical investigation

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280 New Recipes of Communication in the New Linguistic World Order: End of Road for Aged Pragmatics

Authors: Shailendra Kumar Singh

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With the rise of New Linguistic World Order in the 21st century, the Aged Pragmatics is palpitating on the edge of theoretical irrelevance. What appears to be a new sociolinguistic reality is that the enlightening combination of alternative west, inclusive globalization and techno-revolution is adding novel recipes to communicative actions, style and gain among new linguistic breed which is being neither dominated nor powered by the western supremacy. The paper has the following main, interrelated, aims: it is intended to introduce the concept of alternative pragmatics that can offer what exactly is needed for our emerging societal realities; it asserts as to how the basic pillar of linguistic success in the new linguistic world order rests upon linguistic temptation and calibration of all; and it also reviews an inevitability of emerging economies in shaping the communication trends at a time when the western world is struggling to maintain the same control on the others exercised in the past. In particular, the paper seeks answers for the following questions: (a) Do we need an alternative pragmatics, one with alternativist leaning in an era of inclusive globalization and alternative west? (b) What are the pulses of shift which are encapsulating emergence of new communicative behavior among the new linguistic breed by breaking yesterday’s linguistic rigidity? (c) Or, what are those shifts which are making linguistic shift more perceptible? (d) Is New Linguistic World Order succeeding in reversing linguistic priorities of `who speaks, what language, where, how, why, to whom and in which condition’ with no parallel in the history? (e) What is explicit about the contemporary world of 21st century which makes linguistic world all exciting and widely celebrative phenomenon and that is also forced into our vision? (f) What factors will hold key to the future of yesterday’s `influential languages’ and today’s `emerging languages’ as world is in the paradigm transition? (g) Is the collapse of Aged Pragmatics good for the 21st century for understanding the difference between pragmatism of old linguistic world and new linguistic world order? New Linguistic world Order today, unlike in the past, is about a branding of new world with liberal world view for a particular form of ideal to be imagined in the 21st century. At this time without question it is hope that a new set of ideals with popular vocabulary will become the implicit pragmatic model as one of benign majoritarianism in all aspects of sociolinguistic reality. It appears to be a reality that we live in an extraordinary linguistic world with no parallel in the past. In particular, the paper also highlights the paradigm shifts: Demographic, Social-psychological, technological and power. These shifts are impacting linguistic shift which is unique in itself. The paper will highlight linguistic shift in details in which alternative west plays a major role without challenging the west because it is an era of inclusive globalization in which almost everyone takes equal responsibility.

Keywords: inclusive globalization, new linguistic world order, linguistic shift, world order

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279 The Markers -mm and dämmo in Amharic: Developmental Approach

Authors: Hayat Omar

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Languages provide speakers with a wide range of linguistic units to organize and deliver information. There are several ways to verbally express the mental representations of events. According to the linguistic tools they have acquired, speakers select the one that brings out the most communicative effect to convey their message. Our study focuses on two markers, -mm and dämmo, in Amharic (Ethiopian Semitic language). Our aim is to examine, from a developmental perspective, how they are used by speakers. We seek to distinguish the communicative and pragmatic functions indicated by means of these markers. To do so, we created a corpus of sixty narrative productions of children from 5-6, 7-8 to 10-12 years old and adult Amharic speakers. The experimental material we used to collect our data is a series of pictures without text 'Frog, Where are you?'. Although -mm and dämmo are each used in specific contexts, they are sometimes analyzed as being interchangeable. The suffix -mm is complex and multifunctional. It marks the end of the negative verbal structure, it is found in the relative structure of the imperfect, it creates new words such as adverbials or pronouns, it also serves to coordinate words, sentences and to mark the link between macro-propositions within a larger textual unit. -mm was analyzed as marker of insistence, topic shift marker, element of concatenation, contrastive focus marker, 'bisyndetic' coordinator. On the other hand, dämmo has limited function and did not attract the attention of many authors. The only approach we could find analyzes it in terms of 'monosyndetic' coordinator. The paralleling of these two elements made it possible to understand their distinctive functions and refine their description. When it comes to marking a referent, the choice of -mm or dämmo is not neutral, depending on whether the tagged argument is newly introduced, maintained, promoted or reintroduced. The presence of these morphemes explains the inter-phrastic link. The information is seized by anaphora or presupposition: -mm goes upstream while dämmo arrows downstream, the latter requires new information. The speaker uses -mm or dämmo according to what he assumes to be known to his interlocutors. The results show that -mm and dämmo, although all the speakers use them both, do not always have the same scope according to the speaker and vary according to the age. dämmo is mainly used to mark a contrastive topic to signal the concomitance of events. It is more commonly used in young children’s narratives (F(3,56) = 3,82, p < .01). Some values of -mm (additive) are acquired very early while others are rather late and increase with age (F(3,56) = 3,2, p < .03). The difficulty is due not only because of its synthetic structure but primarily because it is multi-purpose and requires a memory work. It highlights the constituent on which it operates to clarify how the message should be interpreted.

Keywords: acquisition, cohesion, connection, contrastive topic, contrastive focus, discourse marker, pragmatics

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278 R Statistical Software Applied in Reliability Analysis: Case Study of Diesel Generator Fans

Authors: Jelena Vucicevic

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Reliability analysis represents a very important task in different areas of work. In any industry, this is crucial for maintenance, efficiency, safety and monetary costs. There are ways to calculate reliability, unreliability, failure density and failure rate. This paper will try to introduce another way of calculating reliability by using R statistical software. R is a free software environment for statistical computing and graphics. It compiles and runs on a wide variety of UNIX platforms, Windows and MacOS. The R programming environment is a widely used open source system for statistical analysis and statistical programming. It includes thousands of functions for the implementation of both standard and new statistical methods. R does not limit user only to operation related only to these functions. This program has many benefits over other similar programs: it is free and, as an open source, constantly updated; it has built-in help system; the R language is easy to extend with user-written functions. The significance of the work is calculation of time to failure or reliability in a new way, using statistic. Another advantage of this calculation is that there is no need for technical details and it can be implemented in any part for which we need to know time to fail in order to have appropriate maintenance, but also to maximize usage and minimize costs. In this case, calculations have been made on diesel generator fans but the same principle can be applied to any other part. The data for this paper came from a field engineering study of the time to failure of diesel generator fans. The ultimate goal was to decide whether or not to replace the working fans with a higher quality fan to prevent future failures. Seventy generators were studied. For each one, the number of hours of running time from its first being put into service until fan failure or until the end of the study (whichever came first) was recorded. Dataset consists of two variables: hours and status. Hours show the time of each fan working and status shows the event: 1- failed, 0- censored data. Censored data represent cases when we cannot track the specific case, so it could fail or success. Gaining the result by using R was easy and quick. The program will take into consideration censored data and include this into the results. This is not so easy in hand calculation. For the purpose of the paper results from R program have been compared to hand calculations in two different cases: censored data taken as a failure and censored data taken as a success. In all three cases, results are significantly different. If user decides to use the R for further calculations, it will give more precise results with work on censored data than the hand calculation.

Keywords: censored data, R statistical software, reliability analysis, time to failure

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277 Integration of an Innovative Complementary Approach Inspired by Clinical Hypnosis into Oncology Care: Nurses’ Perception of Comfort Talk

Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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276 Investigation of the Possible Beneficial and Protective Effects of an Ethanolic Extract from Sarcopoterium spinosum Fruits

Authors: Hawraa Zbeeb, Hala Khalifeh, Mohamad Khalil, Francesca Storace, Francesca Baldini, Giulio Lupidi, Laura Vergani

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Sarcopoterium spinosum, a widely distributed spiny shrub belonging to the Rosaceae family, is rich in essential and beneficial constituents. In fact, S. spinosum fruits and roots are traditionally used as herbal medicine in the eastern Mediterranean landscape, and this shrub is mentioned as a medicinal plant in a large number of ethnobotanical surveys. Aqueous root extracts from S. spinosum are used by traditional medicinal practitioners for weight loss treatment of diabetes and pain. Moreover, the anti-diabetic activity of S. spinosum root extract has been reported in different studies, but the beneficial effects of aerial parts, especially fruits, have not been elucidated yet. The aim of the present study was to investigate the in vitro antioxidant and lipid-lowering properties of an ethanolic extract from S. spinosum fruits using both hepatic (FaO) and endothelial (HECV) cells in an attempt to evaluate its possible employment as a nutraceutical supplement. First of all, in vitro spectrophotometric assays were employed to characterize the extract. The total phenol content (TPC) was evaluated by Folin–Ciocalteu spectrophotometric method and the radical scavenging activity was tested by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2, 2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assays. After that, the beneficial effects of the extract were tested on cells. FaO cells treated for 3 hours with 0.75 mM oleate/palmitate mix (1:2 molar ratio) mimic in vitro a moderate hepato-steatosis. HECV cells exposed for 1 hour to 100 µM H₂O₂ mimic an oxidative insult leading to oxidative stress conditions. After the metabolic and oxidative insult, both cell lines were treated with increasing concentrations of the S. spinosum extract (1, 10, 25 µg/mL) for 24 hours. The results showed the S. spinosum ethanolic extract is rather rich in phenols (TPC of 18.6 mgGAE/g dry extracts). Moreover, the extract showed a good scavenging ability in vitro (IC₅₀ 15.9 µg/ml and 10.9 µg/ml measured by DPPH and ABTS assays, respectively). When the extract was tested on cells, the results showed that it could ameliorate some markers of cell dysfunction. The three concentrations of the extract led to a significant decrease in the intracellular triglyceride (TG) content in steatotic FaO cells measured by spectrophotometric assay. On the other hand, HECV cells treated with increasing concentrations of the extract did not result in a significant decrease in both lipid peroxidation measured by the Thiobarbituric Acid Reactive Substances (TBARS) assay, and in reactive oxygen species (ROS) production measured by fluorometric analysis after DCF staining. Interestingly, the ethanolic extract was able to accelerate the wound repair of confluent HECV cells with respect to H₂O₂-insulted cells as measured by T-scratch assay. Taken together, these results seem to indicate that the ethanol extract from S. spinosum fruits is rich in phenol compounds and plays considerable lipid-lowering activity in vitro on steatotic hepatocytes and accelerates wound healing repair on endothelial cells. In light of that, the ethanolic extract from S. spinosum fruits could be a potential candidate for nutraceutical applications.

Keywords: antioxidant activity, ethanolic extract, lipid-lowering activity, phenolic compounds, Sarcopoterium spinosum fruits

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275 “Teacher, You’re on Mute!”: Teachers as Cultivators of Trans-Literacies

Authors: Efleda Preclaro Tolentino

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Research indicates that an educator’s belief system is reflected in the way they structure the learning environment. Their values and belief system have the potential to positively impact school readiness through an understanding of children’s development and the creation of a stable, motivating environment. Based on the premise that the social environment influences the development of social skills, knowledge construct, and shared values of young children, this study examined verbal and nonverbal exchanges between early childhood teachers and their preschool students within the context of remote learning. Using the qualitative method of data collection, the study determined the nature of interactions between preschoolers and their teachers within a remote learning environment at a preschool in Southeast Asia that utilized the Mother Tongue-based Multilingual Education (MTBMLE) Approach. From the lens of sociocultural theory, the study investigated preschoolers’ use of literacies to convey meaning and to interact within a remote learning environment. Using a Strengths Perspective, the study revealed the creativity and resourcefulness of preschoolers in expressing themselves through trans-literacies that were made possible by the use of online mode of learning within cultural and subcultural norms. The study likewise examined how social skills acquired by young children were transmitted (verbally or nonverbally) in their interactions with peers during Zoom meetings. By examining the dynamics of social exchanges between teachers and children, the findings of the study underscore the importance of providing support for preschool students as they apply acquired values and shared practices within a remote learning environment. The potential of distance learning in the early years will be explored, specifically in supporting young children’s language and literacy development. At the same time, the study examines the role of teachers as cultivators of trans-literacies. The teachers’ skillful use of technology in facilitating young children’s learning, as well as in supporting interactions with families, will be examined. The findings of this study will explore the potential of distance learning in early childhood education to establish continuity in learning, supporting young children’s social and emotional transitions, and nurturing trans-literacies that transcend prevailing definitions of learning contexts. The implications of teachers and parents working collaboratively to support student learning will be examined. The importance of preparing teachers to be resourceful, adaptable, and innovative to ensure that learning takes place across a variety of modes and settings will be discussed.

Keywords: transliteracy, preschoolers, remote learning, strengths perspective

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274 Nanoscale Photo-Orientation of Azo-Dyes in Glassy Environments Using Polarized Optical Near-Field

Authors: S. S. Kharintsev, E. A. Chernykh, S. K. Saikin, A. I. Fishman, S. G. Kazarian

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Recent advances in improving information storage performance are inseparably linked with circumvention of fundamental constraints such as the supermagnetic limit in heat assisted magnetic recording, charge loss tolerance in solid-state memory and the Abbe’s diffraction limit in optical storage. A substantial breakthrough in the development of nonvolatile storage devices with dimensional scaling has been achieved due to phase-change chalcogenide memory, which nowadays, meets the market needs to the greatest advantage. A further progress is aimed at the development of versatile nonvolatile high-speed memory combining potentials of random access memory and archive storage. The well-established properties of light at the nanoscale empower us to use them for recording optical information with ultrahigh density scaled down to a single molecule, which is the size of a pit. Indeed, diffraction-limited optics is able to record as much information as ~1 Gb/in2. Nonlinear optical effects, for example, two-photon fluorescence recording, allows one to decrease the extent of the pit even more, which results in the recording density up to ~100 Gb/in2. Going beyond the diffraction limit, due to the sub-wavelength confinement of light, pushes the pit size down to a single chromophore, which is, on average, of ~1 nm in length. Thus, the memory capacity can be increased up to the theoretical limit of 1 Pb/in2. Moreover, the field confinement provides faster recording and readout operations due to the enhanced light-matter interaction. This, in turn, leads to the miniaturization of optical devices and the decrease of energy supply down to ~1 μW/cm². Intrinsic features of light such as multimode, mixed polarization and angular momentum in addition to the underlying optical and holographic tools for writing/reading, enriches the storage and encryption of optical information. In particular, the finite extent of the near-field penetration, falling into a range of 50-100 nm, gives the possibility to perform 3D volume (layer-to-layer) recording/readout of optical information. In this study, we demonstrate a comprehensive evidence of isotropic-to-homeotropic phase transition of the azobenzene-functionalized polymer thin film exposed to light and dc electric field using near-field optical microscopy and scanning capacitance microscopy. We unravel a near-field Raman dichroism of a sub-10 nm thick epoxy-based side-chain azo-polymer films with polarization-controlled tip-enhanced Raman scattering. In our study, orientation of azo-chromophores is controlled with a bias voltage gold tip rather than light polarization. Isotropic in-plane and homeotropic out-of-plane arrangement of azo-chromophores in glassy environment can be distinguished with transverse and longitudinal optical near-fields. We demonstrate that both phases are unambiguously visualized by 2D mapping their local dielectric properties with scanning capacity microscopy. The stability of the polar homeotropic phase is strongly sensitive to the thickness of the thin film. We make an analysis of α-transition of the azo-polymer by detecting a temperature-dependent phase jump of an AFM cantilever when passing through the glass temperature. Overall, we anticipate further improvements in optical storage performance, which approaches to a single molecule level.

Keywords: optical memory, azo-dye, near-field, tip-enhanced Raman scattering

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273 AI Applications in Accounting: Transforming Finance with Technology

Authors: Alireza Karimi

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Artificial Intelligence (AI) is reshaping various industries, and accounting is no exception. With the ability to process vast amounts of data quickly and accurately, AI is revolutionizing how financial professionals manage, analyze, and report financial information. In this article, we will explore the diverse applications of AI in accounting and its profound impact on the field. Automation of Repetitive Tasks: One of the most significant contributions of AI in accounting is automating repetitive tasks. AI-powered software can handle data entry, invoice processing, and reconciliation with minimal human intervention. This not only saves time but also reduces the risk of errors, leading to more accurate financial records. Pattern Recognition and Anomaly Detection: AI algorithms excel at pattern recognition. In accounting, this capability is leveraged to identify unusual patterns in financial data that might indicate fraud or errors. AI can swiftly detect discrepancies, enabling auditors and accountants to focus on resolving issues rather than hunting for them. Real-Time Financial Insights: AI-driven tools, using natural language processing and computer vision, can process documents faster than ever. This enables organizations to have real-time insights into their financial status, empowering decision-makers with up-to-date information for strategic planning. Fraud Detection and Prevention: AI is a powerful tool in the fight against financial fraud. It can analyze vast transaction datasets, flagging suspicious activities and reducing the likelihood of financial misconduct going unnoticed. This proactive approach safeguards a company's financial integrity. Enhanced Data Analysis and Forecasting: Machine learning, a subset of AI, is used for data analysis and forecasting. By examining historical financial data, AI models can provide forecasts and insights, aiding businesses in making informed financial decisions and optimizing their financial strategies. Artificial Intelligence is fundamentally transforming the accounting profession. From automating mundane tasks to enhancing data analysis and fraud detection, AI is making financial processes more efficient, accurate, and insightful. As AI continues to evolve, its role in accounting will only become more significant, offering accountants and finance professionals powerful tools to navigate the complexities of modern finance. Embracing AI in accounting is not just a trend; it's a necessity for staying competitive in the evolving financial landscape.

Keywords: artificial intelligence, accounting automation, financial analysis, fraud detection, machine learning in finance

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272 Status of Sensory Profile Score among Children with Autism in Selected Centers of Dhaka City

Authors: Nupur A. D., Miah M. S., Moniruzzaman S. K.

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Autism is a neurobiological disorder that affects physical, social, and language skills of a person. A child with autism feels difficulty for processing, integrating, and responding to sensory stimuli. Current estimates have shown that 45% to 96 % of children with Autism Spectrum Disorder demonstrate sensory difficulties. As autism is a worldwide burning issue, it has become a highly prioritized and important service provision in Bangladesh. The sensory deficit does not only hamper the normal development of a child, it also hampers the learning process and functional independency. The purpose of this study was to find out the prevalence of sensory dysfunction among children with autism and recognize common patterns of sensory dysfunction. A cross-sectional study design was chosen to carry out this research work. This study enrolled eighty children with autism and their parents by using the systematic sampling method. In this study, data were collected through the Short Sensory Profile (SSP) assessment tool, which consists of 38 items in the questionnaire, and qualified graduate Occupational Therapists were directly involved in interviewing parents as well as observing child responses to sensory related activities of the children with autism from four selected autism centers in Dhaka, Bangladesh. All item analyses were conducted to identify items yielding or resulting in the highest reported sensory processing dysfunction among those children through using SSP and Statistical Package for Social Sciences (SPSS) version 21.0 for data analysis. This study revealed that almost 78.25% of children with autism had significant sensory processing dysfunction based on their sensory response to relevant activities. Under-responsive sensory seeking and auditory filtering were the least common problems among them. On the other hand, most of them (95%) represented that they had definite to probable differences in sensory processing, including under-response or sensory seeking, auditory filtering, and tactile sensitivity. Besides, the result also shows that the definite difference in sensory processing among 64 children was within 100%; it means those children with autism suffered from sensory difficulties, and thus it drew a great impact on the children’s Daily Living Activities (ADLs) as well as social interaction with others. Almost 95% of children with autism require intervention to overcome or normalize the problem. The result gives insight regarding types of sensory processing dysfunction to consider during diagnosis and ascertaining the treatment. So, early sensory problem identification is very important and thus will help to provide appropriate sensory input to minimize the maladaptive behavior and enhance to reach the normal range of adaptive behavior.

Keywords: autism, sensory processing difficulties, sensory profile, occupational therapy

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271 A Case for Strategic Landscape Infrastructure: South Essex Estuary Park

Authors: Alexandra Steed

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Alexandra Steed URBAN was commissioned to undertake the South Essex Green and Blue Infrastructure Study (SEGBI) on behalf of the Association of South Essex Local Authorities (ASELA): a partnership of seven neighboring councils within the Thames Estuary. Located on London’s doorstep, the 70,000-hectare region is under extraordinary pressure for regeneration, further development, and economic expansion, yet faces extreme challenges: sea-level rise and inadequate flood defenses, stormwater flooding and threatened infrastructure, loss of internationally important habitats, significant existing community deprivation, and lack of connectivity and access to green space. The brief was to embrace these challenges in the creation of a document that would form a key part of ASELA’s Joint Strategic Framework and feed into local plans and master plans. Thus, helping to tackle climate change, ecological collapse, and social inequity at a regional scale whilst creating a relationship and awareness between urban communities and the surrounding landscapes and nature. The SEGBI project applied a ‘land-based’ methodology, combined with a co-design approach involving numerous stakeholders, to explore how living infrastructure can address these significant issues, reshape future planning and development, and create thriving places for the whole community of life. It comprised three key stages, including Baseline Review; Green and Blue Infrastructure Assessment; and the final Green and Blue Infrastructure Report. The resulting proposals frame an ambitious vision for the delivery of a new regional South Essex Estuary (SEE) Park – 24,000 hectares of protected and connected landscapes. This unified parkland system will drive effective place-shaping and “leveling up” for the most deprived communities while providing large-scale nature recovery and biodiversity net gain. Comprehensive analysis and policy recommendations ensure best practices will be embedded within planning documents and decisions guiding future development. Furthermore, a Natural Capital Account was undertaken as part of the strategy showing the tremendous economic value of the natural assets. This strategy sets a pioneering precedent that demonstrates how the prioritisation of living infrastructure has the capacity to address climate change and ecological collapse, while also supporting sustainable housing, healthier communities, and resilient infrastructures. It was only achievable through a collaborative and cross-boundary approach to strategic planning and growth, with a shared vision of place, and a strong commitment to delivery. With joined-up thinking and a joined-up region, a more impactful plan for South Essex was developed that will lead to numerous environmental, social, and economic benefits across the region, and enhancing the landscape and natural environs on the periphery of one of the largest cities in the world.

Keywords: climate change, green and blue infrastructure, landscape architecture, master planning, regional planning, social equity

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270 Cell-free Bioconversion of n-Octane to n-Octanol via a Heterogeneous and Bio-Catalytic Approach

Authors: Shanna Swart, Caryn Fenner, Athanasios Kotsiopoulos, Susan Harrison

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Linear alkanes are produced as by-products from the increasing use of gas-to-liquid fuel technologies for synthetic fuel production and offer great potential for value addition. Their current use as low-value fuels and solvents do not maximize this potential. Therefore, attention has been drawn towards direct activation of these aliphatic alkanes to more useful products such as alcohols, aldehydes, carboxylic acids and derivatives. Cytochrome P450 monooxygenases (P450s) can be used for activation of these aliphatic alkanes using whole-cells or cell-free systems. Some limitations of whole-cell systems include reduced mass transfer, stability and possible side reactions. Since the P450 systems are little studied as cell-free systems, they form the focus of this study. Challenges of a cell-free system include co-factor regeneration, substrate availability and enzyme stability. Enzyme immobilization offers a positive outlook on this dilemma, as it may enhance stability of the enzyme. In the present study, 2 different P450s (CYP153A6 and CYP102A1) as well as the relevant accessory enzymes required for electron transfer (ferredoxin and ferredoxin reductase) and co-factor regeneration (glucose dehydrogenase) have been expressed in E. coli and purified by metal affinity chromatography. Glucose dehydrogenase (GDH), was used as a model enzyme to assess the potential of various enzyme immobilization strategies including; surface attachment on MagReSyn® microspheres with various functionalities and on electrospun nanofibers, using self-assembly based methods forming Cross Linked Enzymes (CLE), Cross Linked Enzyme Aggregates (CLEAs) and spherezymes as well as in a sol gel. The nanofibers were synthesized by electrospinning, which required the building of an electrospinning machine. The nanofiber morphology has been analyzed by SEM and binding will be further verified by FT-IR. Covalent attachment based methods showed limitations where only ferredoxin reductase and GDH retained activity after immobilization which were largely attributed to insufficient electron transfer and inactivation caused by the crosslinkers (60% and 90% relative activity loss for the free enzyme when using 0.5% glutaraldehyde and glutaraldehyde/ethylenediamine (1:1 v/v), respectively). So far, initial experiments with GDH have shown the most potential when immobilized via their His-tag onto the surface of MagReSyn® microspheres functionalized with Ni-NTA. It was found that Crude GDH could be simultaneously purified and immobilized with sufficient activity retention. Immobilized pure and crude GDH could be recycled 9 and 10 times, respectively, with approximately 10% activity remaining. The immobilized GDH was also more stable than the free enzyme after storage for 14 days at 4˚C. This immobilization strategy will also be applied to the P450s and optimized with regards to enzyme loading and immobilization time, as well as characterized and compared with the free enzymes. It is anticipated that the proposed immobilization set-up will offer enhanced enzyme stability (as well as reusability and easy recovery), minimal mass transfer limitation, with continuous co-factor regeneration and minimal enzyme leaching. All of which provide a positive outlook on this robust multi-enzyme system for efficient activation of linear alkanes as well as the potential for immobilization of various multiple enzymes, including multimeric enzymes for different bio-catalytic applications beyond alkane activation.

Keywords: alkane activation, cytochrome P450 monooxygenase, enzyme catalysis, enzyme immobilization

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269 Psychotherapeutic Narratives and the Importance of Truth

Authors: Spencer Jay Knafelc

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Some mental health practitioners and theorists have suggested that we approach remedying psychological problems by centering and intervening upon patients’ narrations. Such theorists and their corresponding therapeutic approaches see persons as narrators of their lives, where the stories they tell constitute and reflect their sense-making of the world. Psychological problems, according to these approaches to therapy, are often the result of problematic narratives. The solution is the construction of more salubrious narratives through therapy. There is trouble lurking within the history of these narrative approaches. These thinkers tend to denigrate the importance of truth, insisting that narratives are not to be thought of as aiming at truth, and thus the truth of our self-narratives is not important. There are multiple motivations for the tendency to eschew truth’s importance within the tradition of narrative approaches to therapy. The most plausible and interesting motivation comes from the observation that, in general, all dominant approaches to therapy are equally effective. The theoretical commitments of each approach are quite different and are often ostensibly incompatible (psychodynamic therapists see psychological problems as resulting from unconscious conflict and repressed desires, Cognitive-Behavioral approaches see them as resulting from distorted cognitions). This strongly suggests that there must be some cases in which therapeutic efficacy does not depend on truth and that insisting that patient’s therapeutic narratives be true in all instances is a mistake. Lewis’ solution is to suggest that narratives are metaphors. Lewis’ account appreciates that there are many ways to tell a story and that many different approaches to mental health treatment can be appropriate without committing us to any contradictions, providing us with an ostensibly coherent way to treat narratives as non-literal, instead of seeing them as tools that can be more or less apt. Here, it is argued that Lewis’ metaphor approach fails. Narratives do not have the right kind of structure to be metaphors. Still, another way to understand Lewis’ view might be that self-narratives, especially when articulated in the language of any specific approach, should not be taken literally. This is an idea at the core of the narrative theorists’ tendency to eschew the importance of the ordinary understanding of truth. This very tendency will be critiqued. The view defended in this paper more accurately captures the nature of self-narratives. The truth of one’s self-narrative is important. Not only do people care about having the right conception of their abilities, who they are, and the way the world is, but self-narratives are composed of beliefs, and the nature of belief is to aim at truth. This view also allows the recognition of the importance of developing accurate representations of oneself and reality for one’s psychological well-being. It is also argued that in many cases, truth factors in as a mechanism of change over the course of therapy. Therapeutic benefit can be achieved by coming to have a better understanding of the nature of oneself and the world. Finally, the view defended here allows for the recognition of the nature of the tension between values: truth and efficacy. It is better to recognize this tension and develop strategies to navigate it as opposed to insisting that it doesn’t exist.

Keywords: philosophy, narrative, psychotherapy, truth

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268 An Elasto-Viscoplastic Constitutive Model for Unsaturated Soils: Numerical Implementation and Validation

Authors: Maria Lazari, Lorenzo Sanavia

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Mechanics of unsaturated soils has been an active field of research in the last decades. Efficient constitutive models that take into account the partial saturation of soil are necessary to solve a number of engineering problems e.g. instability of slopes and cuts due to heavy rainfalls. A large number of constitutive models can now be found in the literature that considers fundamental issues associated with the unsaturated soil behaviour, like the volume change and shear strength behaviour with suction or saturation changes. Partially saturated soils may either expand or collapse upon wetting depending on the stress level, and it is also possible that a soil might experience a reversal in the volumetric behaviour during wetting. Shear strength of soils also changes dramatically with changes in the degree of saturation, and a related engineering problem is slope failures caused by rainfall. There are several states of the art reviews over the last years for studying the topic, usually providing a thorough discussion of the stress state, the advantages, and disadvantages of specific constitutive models as well as the latest developments in the area of unsaturated soil modelling. However, only a few studies focused on the coupling between partial saturation states and time effects on the behaviour of geomaterials. Rate dependency is experimentally observed in the mechanical response of granular materials, and a viscoplastic constitutive model is capable of reproducing creep and relaxation processes. Therefore, in this work an elasto-viscoplastic constitutive model for unsaturated soils is proposed and validated on the basis of experimental data. The model constitutes an extension of an existing elastoplastic strain-hardening constitutive model capable of capturing the behaviour of variably saturated soils, based on energy conjugated stress variables in the framework of superposed continua. The purpose was to develop a model able to deal with possible mechanical instabilities within a consistent energy framework. The model shares the same conceptual structure of the elastoplastic laws proposed to deal with bonded geomaterials subject to weathering or diagenesis and is capable of modelling several kinds of instabilities induced by the loss of hydraulic bonding contributions. The novelty of the proposed formulation is enhanced with the incorporation of density dependent stiffness and hardening coefficients in order to allow the modeling of the pycnotropy behaviour of granular materials with a single set of material constants. The model has been implemented in the commercial FE platform PLAXIS, widely used in Europe for advanced geotechnical design. The algorithmic strategies adopted for the stress-point algorithm had to be revised to take into account the different approach adopted by PLAXIS developers in the solution of the discrete non-linear equilibrium equations. An extensive comparison between models with a series of experimental data reported by different authors is presented to validate the model and illustrate the capability of the newly developed model. After the validation, the effectiveness of the viscoplastic model is displayed by numerical simulations of a partially saturated slope failure of the laboratory scale and the effect of viscosity and degree of saturation on slope’s stability is discussed.

Keywords: PLAXIS software, slope, unsaturated soils, Viscoplasticity

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267 Awareness Creation of Benefits of Antitrypsin-Free Nutraceutical Biopowder for Increasing Human Serum Albumin Synthesis as Possible Adjunct for Management of MDRTB or MDRTB-HIV Patients

Authors: Vincent Oghenekevbe Olughor, Olusoji Mayowa Ige

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Except for a preexisting liver disease and malnutrition, there are no predilections for low serum albumin (SA) levels in humans. At normal reference levels (4.0-6.0g/dl) SA is a universal marker for mortality and morbidity risks assessments where depletion by 1.0g/dl increases mortality risk by 137% and morbidity by 89%.It has 40 known functions contributing significantly to the sustenance of human life. A depletion in SA to <2.2g/dl, in most clinical settings worldwide, leads to loss of oncotic pressure of blood causing clinical manifestations of bipedal Oedema, in which the patients remain conscious. SA also contributes significantly to buffering of blood to a life-sustaining pH of 7.35-7.45. A drop in blood pH to <6.9 will lead to instant coma and death, which can occur after SA continues to deplete after manifestations of bipedal Oedema. In an intervention study conducted in 2014 following the discovery that “SA is depleted during malaria fever”, a Nutraceutical formulated for use as treatment adjunct to prevent SA depletions during malaria to <2.4g/dl after Efficacy testing was found to be satisfactory. There are five known types of Malaria caused by Apicomplexan parasites, Plasmodium: the most lethal being that caused by Plasmodium falciparum causing malignant tertian malaria, in which the fever was occurring every 48 hours coincides with the dumping of malaria-toxins (Hemozoin) into blood, causing contamination: blood must remain sterile. Other Apicomplexan parasites, Toxoplasma and Cryptosporidium, are opportunistic infections of HIV. Separate studies showed SA depletions in MDRTB (multidrug resistant TB), and MDRTB-HIV patients by the same mechanism discovered with malaria and such depletions will be further complicated whenever Apicomplexan parasitic infections co-exist. Both Apicomplexan parasites and the TB parasite belong to the Obligate-group of Parasites, which are parasites that replicate only inside its host; and most of them have capacities to over-consume host nutrients during parasitaemia. In MDRTB patients the body attempts repeatedly to prevent depletions in SA to critical levels in the presence of adequate nutrients and only for a while in MDRTB-HIV patients. These groups of patients will, therefore, benefit from the already tested Nutraceutical in malaria patients. The Nutraceutical bio-Powder was formulated (to BP 1988 specification) from twelve nature-based food-grade nutrients containing all dedicated nutrients for ensuring improved synthesis of Albumin by the liver. The Nutraceutical was administered daily for 38±2days in 23 children, in a prospective phase-2 clinical trial, and its impact on body weight and core blood parameters were documented at the start and end of efficacy testing period. Sixteen children who did not experience malaria-induced depletions of SA had significant SA increase; seven children who experienced malaria-induced depletions of SA had insignificant SA decrease. The Packed Cell Volume Percentage (PCV %), a measure of the Oxygen carrying capacity of blood and the amount of nutrients the body can absorb, increased in both groups. The total serum proteins (SA+ Globulins) increased or decreased within the continuum of normal. In conclusion, MDRTB and MDRTB-HIV patients will benefit from a variant of this Nutraceutical when used as treatment adjunct.

Keywords: antitrypsin-free Nutraceutical, apicomplexan parasites, no predilections for low serum albumin, toxoplasmosis

Procedia PDF Downloads 266
266 Production Factor Coefficients Transition through the Lens of State Space Model

Authors: Kanokwan Chancharoenchai

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Economic growth can be considered as an important element of countries’ development process. For developing countries, like Thailand, to ensure the continuous growth of the economy, the Thai government usually implements various policies to stimulate economic growth. They may take the form of fiscal, monetary, trade, and other policies. Because of these different aspects, understanding factors relating to economic growth could allow the government to introduce the proper plan for the future economic stimulating scheme. Consequently, this issue has caught interest of not only policymakers but also academics. This study, therefore, investigates explanatory variables for economic growth in Thailand from 2005 to 2017 with a total of 52 quarters. The findings would contribute to the field of economic growth and become helpful information to policymakers. The investigation is estimated throughout the production function with non-linear Cobb-Douglas equation. The rate of growth is indicated by the change of GDP in the natural logarithmic form. The relevant factors included in the estimation cover three traditional means of production and implicit effects, such as human capital, international activity and technological transfer from developed countries. Besides, this investigation takes the internal and external instabilities into account as proxied by the unobserved inflation estimation and the real effective exchange rate (REER) of the Thai baht, respectively. The unobserved inflation series are obtained from the AR(1)-ARCH(1) model, while the unobserved REER of Thai baht is gathered from naive OLS-GARCH(1,1) model. According to empirical results, the AR(|2|) equation which includes seven significant variables, namely capital stock, labor, the imports of capital goods, trade openness, the REER of Thai baht uncertainty, one previous GDP, and the world financial crisis in 2009 dummy, presents the most suitable model. The autoregressive model is assumed constant estimator that would somehow cause the unbias. However, this is not the case of the recursive coefficient model from the state space model that allows the transition of coefficients. With the powerful state space model, it provides the productivity or effect of each significant factor more in detail. The state coefficients are estimated based on the AR(|2|) with the exception of the one previous GDP and the 2009 world financial crisis dummy. The findings shed the light that those factors seem to be stable through time since the occurrence of the world financial crisis together with the political situation in Thailand. These two events could lower the confidence in the Thai economy. Moreover, state coefficients highlight the sluggish rate of machinery replacement and quite low technology of capital goods imported from abroad. The Thai government should apply proactive policies via taxation and specific credit policy to improve technological advancement, for instance. Another interesting evidence is the issue of trade openness which shows the negative transition effect along the sample period. This could be explained by the loss of price competitiveness to imported goods, especially under the widespread implementation of free trade agreement. The Thai government should carefully handle with regulations and the investment incentive policy by focusing on strengthening small and medium enterprises.

Keywords: autoregressive model, economic growth, state space model, Thailand

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265 Climate Change Implications on Occupational Health and Productivity in Tropical Countries: Study Results from India

Authors: Vidhya Venugopal, Jeremiah Chinnadurai, Rebekah A. I. Lucas, Tord Kjellstrom, Bruno Lemke

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Introduction: The effects of climate change (CC) are largely discussed across the globe in terms of impacts on the environment and the general population, but the impacts on workers remain largely unexplored. The predicted rise in temperatures and heat events in the CC scenario have health implications on millions of workers in physically exerting jobs. The current health and productivity risks associated with heat exposures are characterized, future risk estimates as temperature rises and recommendations towards developing protective and preventive occupational health and safety guidelines for India are discussed. Methodology: Cross-sectional studies were conducted in several occupational sectors with workers engaged in moderate to heavy labor (n=1580). Quantitative data on heat exposures (WBGT°C), physiological heat strain indicators viz., Core temperature (CBT), Urine specific gravity (USG), Sweat rate (SwR) and qualitative data on heat-related health symptoms and productivity losses were collected. Data were analyzed for associations between heat exposures, health and productivity outcomes related to heat stress. Findings: Heat conditions exceeded the Threshold Limit Value (TLV) for safe manual work in 66% of the workers across several sectors (Avg.WBGT of 28.7°C±3.1°C). Widespread concerns about heat-related health outcomes (86%) were prevalent among workers exposed to high TLVs, with excessive sweating, fatigue and tiredness being commonly reported by workers. The heat stress indicators, core temperature (14%), Sweat rate (8%) and USG (9%), were above normal levels in the study population. A significant association was found between rise in Core Temperatures and WBGT exposures (p=0.000179) Elevated USG and SwR in the worker population indicate moderate dehydration, with potential risks of developing heat-related illnesses. In a steel industry with high heat exposures, an alarming 9% prevalence of kidney/urogenital anomalies was observed in a young workforce. Heat exposures above TLVs were associated with significantly increased odds of various adverse health outcomes (OR=2.43, 95% CI 1.88 to 3.13, p-value = <0.0001) and productivity losses (OR=1.79, 95% CI 1.32 to 2.4, p-value = 0.0002). Rough estimates for the number of workers who would be subjected to higher than TLV levels in the various RCP scenarios are RCP2.6 =79%, RCP4.5 & RCP6 = 81% and at RCP 8.5 = 85%. Rising temperatures due to CC has the capacity to further reduce already compromised health and productivity by subjecting the workers to increased heat exposures in the RCP scenarios are of concern for the country’s occupational health and economy. Conclusion: The findings of this study clearly identify that health protection from hot weather will become increasingly necessary in the Indian subcontinent and understanding the various adaptation techniques needs urgent attention. Further research with a multi-targeted approach to develop strategies for implementing interventions to protect the millions of workers is imperative. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the “Health in All Policies” approach to avert adverse health and productivity consequences as climate change proceeds.

Keywords: heat stress, occupational health, productivity loss, heat strain, adverse health outcomes

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264 Relationship between Illegal Wildlife Trade and Community Conservation: A Case Study of the Chepang Community in Nepal

Authors: Vasundhara H. Krishnani, Ajay Saini, Dibesh Karmacharya, Salit Kark

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Illegal Wildlife Trade is one of the most pressing global conservation challenges. Unregulated wildlife trade can threaten biodiversity, contribute to habitat loss, limit sustainable development efforts, and expedite species declines and extinctions. In low-income and middle-income countries, such as Nepal and other countries in Asia and Africa, many of the people engaged in the early stages of illegal wildlife trade, which includes the hunting and transportation of wildlife, belong to Indigenous tribes and local communities.These countries primarily rely on punitive measures to prevent and suppress Illegal Wildlife Trade. For example, in Nepal, people involved in wildlife crimes can often be sentenced to incarceration and a hefty fine and serve up to 15 years in prison. Despite these harsh punitive measures, illegal wildlife trade remains a significant conservation challenge in many countries. The aim of this study was to examine factors affecting the participation of Indigenous communities in Illegal Wildlife Trade while recording the experiences of members of the Indigenous Chepang community, some of whom were imprisoned for their alleged involvement in rhino poaching. Chepangs, belonging to traditionally a hunter-gatherer community, are often considered an isolated and marginalized Indigenous community, some of whom live around the Chitwan National Park in Nepal. Established in 1973, Chitwan National Park is situated in the Chitwan Valley of Nepal and was one of the first regions that was declared as a protected area in Nepal, aiming to protect the one-horned rhinoceros as a flagship species. Conducted over a period of three years, this study used semi-structured interviews and focus group discussions to collect data from Illegal Wildlife Trade offenders, family members of offenders, community Elders, NGO personnel, community forest representatives, Chepang community representatives, and Government school teachers from the region surrounding Chitwan National Park. The study also examined the social, cultural, health, and financial impacts that the imprisonment of offenders had on the families of the community members, especially women and children. The results suggest that involvement of the members of the Chepang community living around Chitwan National Park in the poaching of the one-horned rhinoceros (Rhinoceros unicornis) can be attributed to a range of factors, some of which include: lack of livelihood opportunities, lack of awareness regarding wildlife rules and regulations and poverty.This work emphasises the need for raising awareness and building programs to enhance alternative livelihood training and empower indigenous and marginalised communities that provide sustainable alternatives. Furthermore, the issue needs to be addressed as a community solution which includes all community members. We suggest this multi-pronged approach can benefit wildlife conservation by reducing illegal poaching and wildlife trade, as well as community conservation in regions with similar challenges. By actively involving and empowering local communities, the communities become key stakeholders in the conservation process. This involvement contributes to protecting wildlife and natural ecosystems while simultaneously providing sustainable livelihood options for local communities.

Keywords: alternative livelihoods, chepang community, illegal wildlife trade, low-and middle-income countries, nepal, one-horned rhinoceros

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263 Identification of Tangible and Intangible Heritage and Preparation of Conservation Proposal for the Historic City of Karanja Laad

Authors: Prachi Buche Marathe

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Karanja Laad is a city located in the Vidarbha region in the state of Maharashtra, India. It has a huge amount of tangible and intangible heritage in the form of monuments, precincts, a group of structures, festivals and procession route, which is neglected and lost with time. Three different religions Hinduism, Islam and Jainism along with associations of being a birthplace of Swami Nrusinha Saraswati, an exponent of Datta Sampradaya sect and the British colonial layer have shaped the culture and society of the place over the period. The architecture of the town Karanja Laad has enhanced its unique historic and cultural value with a combination of all these historic layers. Karanja Laad is also a traditional trading historic town with unique hybrid architectural style and has a good potential for developing as a tourist place along with the present image of a pilgrim destination of Datta Sampradaya. The aim of the research is to prepare a conservation proposal for the historic town along with the management framework. Objectives of the research are to study the evolution of Karanja town, to identify the cultural resources along with issues of the historic core of the city, to understand Datta sampradaya, and contribution of Saint Nrusinha Saraswati in the religious sect and his association as an important personality with Karanja. The methodology of the research is site visits to the Karanja city, making field surveys for documentation and discussions and questionnaires with the residents to establish heritage and identify potential and issues within the historic core thereby establishing a case for conservation. Field surveys are conducted for town level study of land use, open spaces, occupancy, ownership, traditional commodity and community, infrastructure, streetscapes, and precinct activities during the festival and non-festival period. Building level study includes establishing various typologies like residential, institutional commercial, religious, and traditional infrastructure from the mythological references like waterbodies (kund), lake and wells. One of the main issues is that the loss of the traditional footprint as well as the traditional open spaces which are getting lost due to the new illegal encroachments and lack of guidelines for the new additions to conserve the original fabric of the structures. Traditional commodities are getting lost since there is no promotion of these skills like pottery and painting. Lavish bungalows like Kannava mansion, main temple Wada (birthplace of the saint) have a huge potential to be developed as a museum by adaptive re-use which will, in turn, attract many visitors during festivals which will boost the economy. Festival procession routes can be identified and a heritage walk can be developed so as to highlight the traditional features of the town. Overall study has resulted in establishing a heritage map with 137 heritage structures identified as potential. Conservation proposal is worked out on the town level, precinct level and building level with interventions such as developing construction guidelines for further development and establishing a heritage cell consisting architects and engineers for the upliftment of the existing rich heritage of the Karanja city.

Keywords: built heritage, conservation, Datta Sampradaya, Karanja Laad, Swami Nrusinha Saraswati, procession route

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262 A Case Study of Psycho-Social Status of Rohingya Women Refugees Settled in Delhi

Authors: Fizza Saghir

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Rohingyas are an ethnic minority of predominantly Buddhist-Myanmar. Living in ghettos in Rakhine, one of the poorest states of Myanmar, for decades, they have been marginalized, discriminated, deprived of the basic amenities and have faced ghastly violations of their rights- politically, socially, economically and culturally. In 2012, in violence that, erupted between ethnic Rakhine Buddhists and Rohingya Muslims, hundreds of Rohingyas were slayed and many more displaced. The state does not recognize them as ‘citizens’ and the military and police have constantly persecuted and pushed them to either migrate to other countries like India, Bangladesh or else die of deprivation. Amidst the deadly violence, Rohingya women are the most vulnerable. Many of them have faced sexual abuse and gender-based violence. Minimalistic to insignificant studies have been done on the plight of Rohingya women refugees in context of India. Thus, this paper focuses on psycho-social status of Rohingya women refugees settled in Delhi, India. The research study used both quantitative and qualitative methods. It was explorative in nature and used non-probability sampling, purposive sampling, in particular. A sample size of 30 Rohingya women refugees was interviewed out of the universe of 45 Rohingya refugee families living in Kalindi Kunj Refugee Camp of Delhi. Case studies were developed. The paper explores the psychological and social status of the respondents along with a deep understanding of their issues and concerns. Moreover, it assesses the impact of violence and migration on respondents. It was found that Rohingya women refugees are deeply and severely affected by a violent past, an insecure present and an uncertain future. Major problems they face in Delhi, India are finding employment, lack of identity cards to avail government services, language barrier, lack of health and education facilities. All they desire is peace and shelter in India. Besides, recommendations and suggestions have been given to various stakeholders of the forced mass migration of Rohingya refugees which includes, Government of Myanmar, Government of India, other bordering nations of Myanmar, international NGOs and media and the Rohingya community, itself. Only an immediate, peaceful and continuous dialogue process can help resolve the issue of exodus of Rohingyas. Countries, including India, must come together to help the Rohingyas who are in need of urgent humanitarian aid and assistance.

Keywords: dialogue process, ethnic minority, forced mass migration, impact of violence and migration, psycho-social status, Rohingya women refugees, sexual abuse

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261 Metabolic Changes during Reprogramming of Wheat and Triticale Microspores

Authors: Natalia Hordynska, Magdalena Szechynska-Hebda, Miroslaw Sobczak, Elzbieta Rozanska, Joanna Troczynska, Zofia Banaszak, Maria Wedzony

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Albinism is a common problem encountered in wheat and triticale breeding programs, which require in vitro culture steps e.g. generation of doubled haploids via androgenesis process. Genetic factor is a major determinant of albinism, however, environmental conditions such as temperature and media composition influence the frequency of albino plant formation. Cold incubation of wheat and triticale spikes induced a switch from gametophytic to sporophytic development. Further, androgenic structures formed from anthers of the genotypes susceptible to androgenesis or treated with cold stress, had a pool of structurally primitive plastids, with small starch granules or swollen thylakoids. High temperature was a factor inducing andro-genesis of wheat and triticale, but at the same time, it was a factor favoring the formation of albino plants. In genotypes susceptible to albinism or after heat stress conditions, cells formed from anthers were vacuolated, and plastids were eliminated. Partial or complete loss of chlorophyll pigments and incomplete differentiation of chloroplast membranes result in formation of tissues or whole plant unable to perform photosynthesis. Indeed, susceptibility to the andro-genesis process was associated with an increase of total concentration of photosynthetic pigments in anthers, spikes and regenerated plants. The proper balance of the synthesis of various pigments, was the starting point for their proper incorporation into photosynthetic membranes. In contrast, genotypes resistant to the androgenesis process and those treated with heat, contained 100 times lower content of photosynthetic pigments. In particular, the synthesis of violaxanthin, zeaxanthin, lutein and chlorophyll b was limited. Furthermore, deregulation of starch and lipids synthesis, which led to the formation of very complex starch granules and an increased number of oleosomes, respectively, correlated with the reduction of the efficiency of androgenesis. The content of other sugars varied depending on the genotype and the type of stress. The highest content of various sugars was found for genotypes susceptible to andro-genesis, and highly reduced for genotypes resistant to androgenesis. The most important sugars seem to be glucose and fructose. They are involved in sugar sensing and signaling pathways, which affect the expression of various genes and regulate plant development. Sucrose, on the other hand, seems to have minor effect at each stage of the androgenesis. The sugar metabolism was related to metabolic activity of microspores. The genotypes susceptible to androgenesis process had much faster mitochondrium- and chloroplast-dependent energy conversion and higher heat production by tissues. Thus, the effectiveness of metabolic processes, their balance and the flexibility under the stress was a factor determining the direction of microspore development, and in the later stages of the androgenesis process, a factor supporting the induction of androgenic structures, chloroplast formation and the regeneration of green plants. The work was financed by Ministry of Agriculture and Rural Development within Program: ‘Biological Progress in Plant Production’, project no HOR.hn.802.15.2018.

Keywords: androgenesis, chloroplast, metabolism, temperature stress

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260 Adaptation of the Scenario Test for Greek-speaking People with Aphasia: Reliability and Validity Study

Authors: Marina Charalambous, Phivos Phylactou, Thekla Elriz, Loukia Psychogios, Jean-Marie Annoni

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Background: Evidence-based practices for the evaluation and treatment of people with aphasia (PWA) in Greek are mainly impairment-based. Functional and multimodal communication is usually under assessed and neglected by clinicians. This study explores the adaptation and psychometric testing of the Greek (GR) version of The Scenario Test. The Scenario Test assesses the everyday functional communication of PWA in an interactive multimodal communication setting with the support of an active communication facilitator. Aims: To define the reliability and validity of The Scenario Test GR and discuss its clinical value. Methods & Procedures: The Scenario Test-GR was administered to 54 people with chronic stroke (6+ months post-stroke): 32 PWA and 22 people with stroke without aphasia. Participants were recruited from Greece and Cyprus. All measures were performed in an interview format. Standard psychometric criteria were applied to evaluate reliability (internal consistency, test-retest, and interrater reliability) and validity (construct and known – groups validity) of the Scenario Test GR. Video analysis was performed for the qualitative examination of the communication modes used. Outcomes & Results: The Scenario Test-GR shows high levels of reliability and validity. High scores of internal consistency (Cronbach’s α = .95), test-retest reliability (ICC = .99), and interrater reliability (ICC = .99) were found. Interrater agreement in scores on individual items fell between good and excellent levels of agreement. Correlations with a tool measuring language function in aphasia (the Aphasia Severity Rating Scale of the Boston Diagnostic Aphasia Examination), a measure of functional communication (the Communicative Effectiveness Index), and two instruments examining the psychosocial impact of aphasia (the Stroke and Aphasia Quality of Life questionnaire and the Aphasia Impact Questionnaire) revealed good convergent validity (all ps< .05). Results showed good known – groups validity (Mann-Whitney U = 96.5, p < .001), with significantly higher scores for participants without aphasia compared to those with aphasia. Conclusions: The psychometric qualities of The Scenario Test-GR support the reliability and validity of the tool for the assessment of functional communication for Greek-speaking PWA. The Scenario Test-GR can be used to assess multimodal functional communication, orient aphasia rehabilitation goal setting towards the activity and participation level, and be used as an outcome measure of everyday communication. Future studies will focus on the measurement of sensitivity to change in PWA with severe non-fluent aphasia.

Keywords: the scenario test GR, functional communication assessment, people with aphasia (PWA), tool validation

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259 The Relationship between the Competence Perception of Student and Graduate Nurses and Their Autonomy and Critical Thinking Disposition

Authors: Zülfiye Bıkmaz, Aytolan Yıldırım

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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.

Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis

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258 Runoff Estimates of Rapidly Urbanizing Indian Cities: An Integrated Modeling Approach

Authors: Rupesh S. Gundewar, Kanchan C. Khare

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Runoff contribution from urban areas is generally from manmade structures and few natural contributors. The manmade structures are buildings; roads and other paved areas whereas natural contributors are groundwater and overland flows etc. Runoff alleviation is done by manmade as well as natural storages. Manmade storages are storage tanks or other storage structures such as soakways or soak pits which are more common in western and European countries. Natural storages are catchment slope, infiltration, catchment length, channel rerouting, drainage density, depression storage etc. A literature survey on the manmade and natural storages/inflow has presented percentage contribution of each individually. Sanders et.al. in their research have reported that a vegetation canopy reduces runoff by 7% to 12%. Nassif et el in their research have reported that catchment slope has an impact of 16% on bare standard soil and 24% on grassed soil on rainfall runoff. Infiltration being a pervious/impervious ratio dependent parameter is catchment specific. But a literature survey has presented a range of 15% to 30% loss of rainfall runoff in various catchment study areas. Catchment length and channel rerouting too play a considerable role in reduction of rainfall runoff. Ground infiltration inflow adds to the runoff where the groundwater table is very shallow and soil saturates even in a lower intensity storm. An approximate percent contribution through this inflow and surface inflow contributes to about 2% of total runoff volume. Considering the various contributing factors in runoff it has been observed during a literature survey that integrated modelling approach needs to be considered. The traditional storm water network models are able to predict to a fair/acceptable degree of accuracy provided no interaction with receiving water (river, sea, canal etc), ground infiltration, treatment works etc. are assumed. When such interactions are significant then it becomes difficult to reproduce the actual flood extent using the traditional discrete modelling approach. As a result the correct flooding situation is very rarely addressed accurately. Since the development of spatially distributed hydrologic model the predictions have become more accurate at the cost of requiring more accurate spatial information.The integrated approach provides a greater understanding of performance of the entire catchment. It enables to identify the source of flow in the system, understand how it is conveyed and also its impact on the receiving body. It also confirms important pain points, hydraulic controls and the source of flooding which could not be easily understood with discrete modelling approach. This also enables the decision makers to identify solutions which can be spread throughout the catchment rather than being concentrated at single point where the problem exists. Thus it can be concluded from the literature survey that the representation of urban details can be a key differentiator to the successful understanding of flooding issue. The intent of this study is to accurately predict the runoff from impermeable areas from urban area in India. A representative area has been selected for which data was available and predictions have been made which are corroborated with the actual measured data.

Keywords: runoff, urbanization, impermeable response, flooding

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257 Effects of an Envious Experience on Schadenfreude and Economic Decisions Making

Authors: Pablo Reyes, Vanessa Riveros Fiallo, Cesar Acevedo, Camila Castellanos, Catalina Moncaleano, Maria F. Parra, Laura Colmenares

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Social emotions are physiological, cognitive and behavioral phenomenon that intervene in the mechanisms of adaptation of individuals and their context. These are mediated by interpersonal relationship and language. Such emotions are subdivided into moral and comparison. The present research emphasizes two comparative emotions: Envy and Schadenfreude. Envy arises when a person lack of quality, possessions or achievements and these are superior in someone else. The Schadenfreude (SC) expresses the pleasure that someone experienced by the misfortune of the other. The relationship between both emotions has been questioned before. Hence there are reports showing that envy increases and modulates SC response. Other documents suggest that envy causes SC response. However, the methodological approach of the topic has been made through self-reports, as well as the hypothetical scenarios. Given this problematic, the neuroscience social framework provides an alternative and demonstrates that social emotions have neurophysiological correlates that can be measured. This is relevant when studying social emotions that are reprehensible like envy or SC are. When tested, the individuals tend to report low ratings due to social desirability. In this study, it was drawn up a proposal in research's protocol and the progress on its own piloting. The aim is to evaluate the effect of feeling envy and Schadenfreude has on the decision-making process, as well as the cooperative behavior in an economic game. To such a degree, it was proposed an experimental model that will provoke to feel envious by performing games against an unknown opponent. The game consists of asking general knowledge questions. The difficulty level in questions and the strangers' facial response have been manipulated in order to generate an ecological comparison framework and be able to arise both envy and SC emotions. During the game, an electromyography registry will be made for two facial muscles that have been associated with the expressiveness of envy and SC emotions. One of the innovations of the current proposal is the measurement of the effect that emotions have on a specific behavior. To that extent, it was evaluated the effect of each condition on the dictators' economic game. The main intention is to evaluate if a social emotion can modulate actions that have been associated with social norms, in the literacy. The result of the evaluation of a pilot model (without electromyography record and self-report) have shown an association between envy and SC, in a way that as the individuals report a greater sense of envy, the greater the chance to experience SC. The results of the economic game show a slight tendency towards profit maximization decisions. It is expected that at the time of using real cash this behavior will be strengthened and also to correlate with the responses of electromyography.

Keywords: envy, schadenfreude, electromyography, economic games

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256 Differentially Expressed Genes in Atopic Dermatitis: Bioinformatics Analysis Of Pooled Microarray Gene Expression Datasets In Gene Expression Omnibus

Authors: Danna Jia, Bin Li

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Background: Atopic dermatitis (AD) is a chronic and refractory inflammatory skin disease characterized by relapsing eczematous and pruritic skin lesions. The global prevalence of AD ranges from 1~ 20%, and its incidence rates are increasing. It affects individuals from infancy to adulthood, significantly impacting their daily lives and social activities. Despite its major health burden, the precise mechanisms underlying AD remain unknown. Understanding the genetic differences associated with AD is crucial for advancing diagnosis and targeted treatment development. This study aims to identify candidate genes of AD by using bioinformatics analysis. Methods: We conducted a comprehensive analysis of four pooled transcriptomic datasets (GSE16161, GSE32924, GSE130588, and GSE120721) obtained from the Gene Expression Omnibus (GEO) database. Differential gene expression analysis was performed using the R statistical language. The differentially expressed genes (DEGs) between AD patients and normal individuals were functionally analyzed using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Furthermore, a protein-protein interaction (PPI) network was constructed to identify candidate genes. Results: Among the patient-level gene expression datasets, we identified 114 shared DEGs, consisting of 53 upregulated genes and 61 downregulated genes. Functional analysis using GO and KEGG revealed that the DEGs were mainly associated with the negative regulation of transcription from RNA polymerase II promoter, membrane-related functions, protein binding, and the Human papillomavirus infection pathway. Through the PPI network analysis, we identified eight core genes: CD44, STAT1, HMMR, AURKA, MKI67, and SMARCA4. Conclusion: This study elucidates key genes associated with AD, providing potential targets for diagnosis and treatment. The identified genes have the potential to contribute to the understanding and management of AD. The bioinformatics analysis conducted in this study offers new insights and directions for further research on AD. Future studies can focus on validating the functional roles of these genes and exploring their therapeutic potential in AD. While these findings will require further verification as achieved with experiments involving in vivo and in vitro models, these results provided some initial insights into dysfunctional inflammatory and immune responses associated with AD. Such information offers the potential to develop novel therapeutic targets for use in preventing and treating AD.

Keywords: atopic dermatitis, bioinformatics, biomarkers, genes

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255 Pivoting to Fortify our Digital Self: Revealing the Need for Personal Cyber Insurance

Authors: Richard McGregor, Carmen Reaiche, Stephen Boyle

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Cyber threats are a relatively recent phenomenon and offer cyber insurers a dynamic and intelligent peril. As individuals en mass become increasingly digitally dependent, Personal Cyber Insurance (PCI) offers an attractive option to mitigate cyber risk at a personal level. This abstract proposes a literature review that conceptualises a framework for siting Personal Cyber Insurance (PCI) within the context of cyberspace. The lack of empirical research within this domain demonstrates an immediate need to define the scope of PCI to allow cyber insurers to understand personal cyber risk threats and vectors, customer awareness, capabilities, and their associated needs. Additionally, this will allow cyber insurers to conceptualise appropriate frameworks allowing effective management and distribution of PCI products and services within a landscape often in-congruent with risk attributes commonly associated with traditional personal line insurance products. Cyberspace has provided significant improvement to the quality of social connectivity and productivity during past decades and allowed enormous capability uplift of information sharing and communication between people and communities. Conversely, personal digital dependency furnish ample opportunities for adverse cyber events such as data breaches and cyber-attacksthus introducing a continuous and insidious threat of omnipresent cyber risk–particularly since the advent of the COVID-19 pandemic and wide-spread adoption of ‘work-from-home’ practices. Recognition of escalating inter-dependencies, vulnerabilities and inadequate personal cyber behaviours have prompted efforts by businesses and individuals alike to investigate strategies and tactics to mitigate cyber risk – of which cyber insurance is a viable, cost-effective option. It is argued that, ceteris parabus, the nature of cyberspace intrinsically provides characteristic peculiarities that pose significant and bespoke challenges to cyber insurers, often in-congruent with risk attributes commonly associated with traditional personal line insurance products. These challenges include (inter alia) a paucity of historical claim/loss data for underwriting and pricing purposes, interdependencies of cyber architecture promoting high correlation of cyber risk, difficulties in evaluating cyber risk, intangibility of risk assets (such as data, reputation), lack of standardisation across the industry, high and undetermined tail risks, and moral hazard among others. This study proposes a thematic overview of the literature deemed necessary to conceptualise the challenges to issuing personal cyber coverage. There is an evident absence of empirical research appertaining to PCI and the design of operational business models for this business domain, especially qualitative initiatives that (1) attempt to define the scope of the peril, (2) secure an understanding of the needs of both cyber insurer and customer, and (3) to identify elements pivotal to effective management and profitable distribution of PCI - leading to an argument proposed by the author that postulates that the traditional general insurance customer journey and business model are ill-suited for the lineaments of cyberspace. The findings of the review confirm significant gaps in contemporary research within the domain of personal cyber insurance.

Keywords: cyberspace, personal cyber risk, personal cyber insurance, customer journey, business model

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254 Cai Guo-Qiang: A Chinese Artist at the Cutting-Edge of Global Art

Authors: Marta Blavia

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Magiciens de la terre, organized in 1989 by the Centre Pompidou, became 'the first worldwide exhibition of contemporary art' by presenting artists from Western and non-Western countries, including three Chinese artists. For the first time, West turned its eyes to other countries not as exotic sources of inspiration, but as places where contemporary art was also being created. One year later, Chine: demain pour hier was inaugurated as the first Chinese avant-garde group-exhibition in Occident. Among the artists included was Cai Guo-Qiang who, like many other Chinese artists, had left his home country in the eighties in pursuit of greater creative freedom. By exploring artistic non-Western perspectives, both landmark exhibitions questioned the predominance of the Eurocentric vision in the construction of history art. But more than anything else, these exhibitions laid the groundwork for the rise of the so-called phenomenon 'global contemporary art'. All the same time, 1989 also was a turning point in Chinese art history. Because of the Tiananmen student protests, The Chinese government undertook a series of measures to cut down any kind of avant-garde artistic activity after a decade of a relative openness. During the eighties, and especially after the Tiananmen crackdown, some important artists began to leave China to move overseas such as Xu Bing and Ai Weiwei (USA); Chen Zhen and Huang Yong Ping (France); or Cai Guo-Qiang (Japan). After emigrating abroad, Chinese overseas artists began to develop projects in accordance with their new environments and audiences as well as to appear in numerous international exhibitions. With their creations, that moved freely between a variety of Eastern and Western art sources, these artists were crucial agents in the emergence of global contemporary art. As other Chinese artists overseas, Cai Guo-Qiang’s career took off during the 1990s and early 2000s right at the same moment in which Western art world started to look beyond itself. Little by little, he developed a very personal artistic language that redefines Chinese ideas, symbols, and traditional materials in a new world order marked by globalization. Cai Guo-Qiang participated in many of the exhibitions that contributed to shape global contemporary art: Encountering the Others (1992); the 45th Venice Biennale (1993); Inside Out: New Chinese Art (1997), or the 48th Venice Biennale (1999), where he recreated the Chinese monumental social realist work Rent Collection Courtyard that earned him the Golden Lion Award. By examining the different stages of Cai Guo-Qiang’s artistic path as well as the transnational dimensions of his creations, this paper aims at offering a comprehensive survey on the construction of the discourse of global contemporary art.

Keywords: Cai Guo-Qiang, Chinese artists overseas, emergence global art, transnational art

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253 Memories of Lost Fathers: The Unfinished Transmission of Generational Values in Hungarian Cinema by Peter Falanga

Authors: Peter Falanga

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During the process of de-Stalinization that began in 1956 with the Twentieth Congress of the Soviet Communist Party, many filmmakers in Hungary chose to explore their country’s political discomforts by using Socialist Realism as a negative model against which they could react to the dominating ideology. A renewed national film industry and a more permissive political regime would allow filmmakers to take to task the plight of the preceding generation who had experienced the fatal political turmoil of both World Wars and the purges of Stalin. What follows is no longer the multigenerational unity found in Socialist Realism wherein both the old and the young embrace Stalin’s revolutionary optimism; instead, the protagonists are parentless, and thus their connection to the previous generation is partially severed. In these films, violent historical forces leave one generation to search for both a connection with their family’s past, and for moral guidance to direct their future. István Szabó’s Father (1966), Márta Mészáros Diary for My Children (1984), and Pál Gábor’s Angi Vera (1978) each consider the fraught relationship between successive generations through the lens of postwar youth. A characteristic each of their protagonist’s share is that they are all missing one or both parents, and cope with familial loss either through recalling memories of their parents in dream-like sequences, or, in the case of Angi Vera, through embracing the surrogate paternalism that the Communist Party promises to provide. This paper considers the argument these films present about the progress of Hungarian history, and how this topic is explored in more recent films that similarly focus on the transmission of generational values. Scholars such as László Strausz and John Cunningham have written on the continuous concern with the transmission of generational values in more recent films such as István Szabó’s Sunshine (1999), Béla Tarr’s Werckmeister Harmonies (2000), György Pálfi’s Taxidermia (2006), Ágnes Kocsis’ Pál Adrienn (2010), and Kornél Mundruczó’s Evolution (2021). These films, they argue, make intimate portrayals of the various sweeping political changes in Hungary’s history and question how these epochs or events have impacted Hungarian identities. If these films attempt to personalize historical shifts of Hungary, then what is the significance of featuring characters who have lost one or both parents? An attempt to understand this coherent trend in Hungarian cinema will profit from examining the earlier, celebrated films of Szabó, Mészáros, and Gábor, who inaugurated this preoccupation with generational values. The pervasive interplay of dreams and memory in their films invites an additional element to their argument concerning historical progression. This paper incorporates Richard Teniman’s notion of the “dialectics of memory” in which memory is in a constant process of negation and reinvention to explain why these Directors prefer to explore Hungarian identity through the disarranged form of psychological realism over the linear causality structure of historical realism.

Keywords: film theory, Eastern European Studies, film history, Eastern European History

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252 The Risk of Bleeding in Knee or Shoulder Injections in Patients on Warfarin Treatment

Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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