Search results for: middle war and post war architecture
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7460

Search results for: middle war and post war architecture

830 Efficacy of Single-Dose Azithromycin Therapy for the Treatment of Chlamydia trachomatis in Patients Evaluated for Child Sexual Abuse in an Urban Health Center 2006-16

Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann

Abstract:

Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.

Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms

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829 Vertical Village Buildings as Sustainable Strategy to Re-Attract Mega-Cities in Developing Countries

Authors: M. J. Eichner, Y. S. Sarhan

Abstract:

Overall study purpose has been the evaluation of ‘Vertical Villages’ as a new sustainable building typology, reducing significantly negative impacts of rapid urbanization processes in third world capital cities. Commonly in fast-growing cities, housing and job supply, educational and recreational opportunities, as well as public transportation infrastructure, are not accommodating rapid population growth, exposing people to high noise and emission polluted living environments with low-quality neighborhoods and a lack of recreational areas. Like many others, Egypt’s capital city Cairo, according to the UN facing annual population growth rates of up to 428.000 people, is struggling to address the general deterioration of urban living conditions. New settlements typologies and urban reconstruction approach hardly follow sustainable urbanization principles or socio-ecologic urbanization models with severe effects not only for inhabitants but also for the local environment and global climate. The authors prove that ‘Vertical Village’ buildings can offer a sustainable solution for increasing urban density with at the same time improving the living quality and urban environment significantly. Inserting them within high-density urban fabrics the ecologic and socio-cultural conditions of low-quality neighborhoods can be transformed towards districts, considering all needs of sustainable and social urban life. This study analyzes existing building typologies in Cairo’s «low quality - high density» districts Ard el Lewa, Dokki and Mohandesen according to benchmarks for sustainable residential buildings, identifying major problems and deficits. In 3 case study design projects, the sustainable transformation potential through ‘Vertical Village’ buildings are laid out and comparative studies show the improvement of the urban microclimate, safety, social diversity, sense of community, aesthetics, privacy, efficiency, healthiness and accessibility. The main result of the paper is that the disadvantages of density and overpopulation in developing countries can be converted with ‘Vertical Village’ buildings into advantages, achieving attractive and environmentally friendly living environments with multiple synergies. The paper is documenting based on scientific criteria that mixed-use vertical building structures, designed according to sustainable principles of low rise housing, can serve as an alternative to convert «low quality - high density» districts in megacities, opening a pathway for governments to achieve sustainable urban transformation goals. Neglected informal urban districts, home to millions of the poorer population groups, can be converted into healthier living and working environments.

Keywords: sustainable, architecture, urbanization, urban transformation, vertical village

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828 Men’s Attendance in Labour and Birth Room: A Choice and Coercion in Childbirth

Authors: A/Prof Marjan Khajehei

Abstract:

In the last century, the role of fathers in the birth has changed exponentially. Before the 1970s, the principal view was that birth was a female business and not a man’s place. Changing cultural and professional attitudes around the emotional bond between a man and a woman, family structure and the more proactive involved role of men in the family have encouraged fathers’ attendance at birth. There is evidence that fathers’ support can make birthing less traumatic for some women and can make couples closer. This has made some clinicians to believe the fathers should be more involved throughout the birth process. Some clinicians even go further and ask the fathers to watch the medical procedures, such as inserting vaginal speculum, forceps or vacuum, episiotomy and stitches. Although birth can unfold like a beautiful picture captured by birth photographers, with fathers massaging women’s backs by candle light and the miraculous moment of birth, it can be overshadowed by less attractive images of cervical mucous, emptying bowels and the invasive medical procedures. What happens in the birth room and the fathers’ reaction to the graphic experience of birthing can be unpredictable. Despite the fact that most men are absolutely thrilled to be in the delivery room, for some men, a very intimate body part can become completely desexualised, and they can experience psychological and sexual scarring. They see someone they cherish dramatically sliced open and can then associate their partners with a disturbing scene, and it can dramatically affect their relationships. While most women want the expectant fathers by their side for this life-changing event, not all of them may be happy for their partners to watch the perineum to be cut or stitched or when large blades of forceps are inserted inside the vagina. Anecdotal reports have shown that consent is not sought from the labouring women as to whether they want their partners to watch these procedures. The majority of research1, 2, 3 focuses on men’s and women’s retrospective attitudes towards their birth experience. However, the effect of witnessing invasive procedures during childbirth on a man's attraction to his partner, while she is most vulnerable, and also an increased risk of post-traumatic stress disorder in fathers have not been widely investigated. There is a lack of sufficient research investigating whether women need to be asked for their consent before inviting their partners to closely watch medical procedures during childbirth. Future research is required to provide a basis for better awareness and involve the consumers to understanding the men’s and women’s experience and their expectations for labour and birth.

Keywords: birth, childbirth, father, labour, men, women

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827 Development and Evaluation of a Calcium Rich Plant-Based Supplement on Bone Turnover of Peri and Post Menopausal Women

Authors: Gayathri.G, Hemamalini.A.J, Chandrasekaran.A

Abstract:

Problem statement: Nutritional deficiency, especially calcium, may lead to poor bone formation and mineralization. Although there are plenty of synthetic supplements available, it is essential to make a calcium rich food supplement accessible to combat calcium deficiency that could be readily prepared at the household level. Thus the current study aimed to formulate and standardize an indigenous low-cost calcium-rich food supplement and to study the impact of supplementation on the bone resorption and formation markers. Methods: A Randomized controlled trial was conducted with 60 subjects distributed equally in control and experimental groups, including perimenopausal and postmenopausal women. A plant-based calcium-rich product was developed and supplemented in form of balls as a midmorning and evening snack by addition of optimized proportions of leaves of Sesbania Grandiflora, seeds of Sesamum indicum, Eleusine coracana, Glycine max, Vigna mungo for a period of 6 months. Postmenopausal and perimenopausal women received 1200mg and 800mg of calcium per day from the supplemented, respectively. Outcome measures like serum calcium; betacrosslaps (bone resorption marker) and total P1NP (bone absorption marker) were assessed after 3 months and after 6 months. Results: There were no significant changes seen in the serum calcium and total P1NP levels (bone formation marker) among the subjects during the supplementation period. The bone resorption marker (betacrosslaps) reduced in all the groups and the reduction (0.32 ± 0.130 ng/ml to 0.25 ± 0.130 ng/ml) was found to be statistically highly significant (p < 0.01) in experimental group of perimenopausal subjects and significant (p < 0.05) in experimental group of postmenopausal subjects (1.11 ± 0.290 ng/ml to 0.42 ± 0.263 ng/ml). Conclusion: With the current severe calcium deficiency in the Indian population, integrating low-cost, calcium-rich native foods that could be readily prepared at household level would be useful in raising the nutritional consumption of calcium, which would, in turn, decrease bone turnover.

Keywords: calcium, sesbania grandiflora, sesamum indicum, eleusine coracana, glycine max, vigna mungo, postmenopause, perimenopause, bone resorption, bone absorption, betacrosslaps, total P1NP

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826 Mesenteric Ischemia Presenting as Acalculous Cholecystitis: A Case Review of a Rare Complication and Aberrant Anatomy

Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

Abstract:

Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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825 Estimates of (Co)Variance Components and Genetic Parameters for Body Weights and Growth Efficiency Traits in the New Zealand White Rabbits

Authors: M. Sakthivel, A. Devaki, D. Balasubramanyam, P. Kumarasamy, A. Raja, R. Anilkumar, H. Gopi

Abstract:

The genetic parameters of growth traits in the New Zealand White rabbits maintained at Sheep Breeding and Research Station, Sandynallah, The Nilgiris, India were estimated by partitioning the variance and covariance components. The (co)variance components of body weights at weaning (W42), post-weaning (W70) and marketing (W135) age and growth efficiency traits viz., average daily gain (ADG), relative growth rate (RGR) and Kleiber ratio (KR) estimated on a daily basis at different age intervals (1=42 to 70 days; 2=70 to 135 days and 3=42 to 135 days) from weaning to marketing were estimated by restricted maximum likelihood, fitting six animal models with various combinations of direct and maternal effects. Data were collected over a period of 15 years (1998 to 2012). A log-likelihood ratio test was used to select the most appropriate univariate model for each trait, which was subsequently used in bivariate analysis. Heritability estimates for W42, W70 and W135 were 0.42 ± 0.07, 0.40 ± 0.08 and 0.27 ± 0.07, respectively. Heritability estimates of growth efficiency traits were moderate to high (0.18 to 0.42). Of the total phenotypic variation, maternal genetic effect contributed 14 to 32% for early body weight traits (W42 and W70) and ADG1. The contribution of maternal permanent environmental effect varied from 6 to 18% for W42 and for all the growth efficiency traits except for KR2. Maternal permanent environmental effect on most of the growth efficiency traits was a carryover effect of maternal care during weaning. Direct maternal genetic correlations, for the traits in which maternal genetic effect was significant, were moderate to high in magnitude and negative in direction. Maternal effect declined as the age of the animal increased. The estimates of total heritability and maternal across year repeatability for growth traits were moderate and an optimum rate of genetic progress seems possible in the herd by mass selection. The estimates of genetic and phenotypic correlations among body weight traits were moderate to high and positive; among growth efficiency traits were low to high with varying directions; between body weights and growth efficiency traits were very low to high in magnitude and mostly negative in direction. Moderate to high heritability and higher genetic correlation in body weight traits promise good scope for genetic improvement provided measures are taken to keep the inbreeding at the lowest level.

Keywords: genetic parameters, growth traits, maternal effects, rabbit genetics

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824 Comparison of Iodine Density Quantification through Three Material Decomposition between Philips iQon Dual Layer Spectral CT Scanner and Siemens Somatom Force Dual Source Dual Energy CT Scanner: An in vitro Study

Authors: Jitendra Pratap, Jonathan Sivyer

Abstract:

Introduction: Dual energy/Spectral CT scanning permits simultaneous acquisition of two x-ray spectra datasets and can complement radiological diagnosis by allowing tissue characterisation (e.g., uric acid vs. non-uric acid renal stones), enhancing structures (e.g. boost iodine signal to improve contrast resolution), and quantifying substances (e.g. iodine density). However, the latter showed inconsistent results between the 2 main modes of dual energy scanning (i.e. dual source vs. dual layer). Therefore, the present study aimed to determine which technology is more accurate in quantifying iodine density. Methods: Twenty vials with known concentrations of iodine solutions were made using Optiray 350 contrast media diluted in sterile water. The concentration of iodine utilised ranged from 0.1 mg/ml to 1.0mg/ml in 0.1mg/ml increments, 1.5 mg/ml to 4.5 mg/ml in 0.5mg/ml increments followed by further concentrations at 5.0 mg/ml, 7mg/ml, 10 mg/ml and 15mg/ml. The vials were scanned using Dual Energy scan mode on a Siemens Somatom Force at 80kV/Sn150kV and 100kV/Sn150kV kilovoltage pairing. The same vials were scanned using Spectral scan mode on a Philips iQon at 120kVp and 140kVp. The images were reconstructed at 5mm thickness and 5mm increment using Br40 kernel on the Siemens Force and B Filter on Philips iQon. Post-processing of the Dual Energy data was performed on vendor-specific Siemens Syngo VIA (VB40) and Philips Intellispace Portal (Ver. 12) for the Spectral data. For each vial and scan mode, the iodine concentration was measured by placing an ROI in the coronal plane. Intraclass correlation analysis was performed on both datasets. Results: The iodine concentrations were reproduced with a high degree of accuracy for Dual Layer CT scanner. Although the Dual Source images showed a greater degree of deviation in measured iodine density for all vials, the dataset acquired at 80kV/Sn150kV had a higher accuracy. Conclusion: Spectral CT scanning by the dual layer technique has higher accuracy for quantitative measurements of iodine density compared to the dual source technique.

Keywords: CT, iodine density, spectral, dual-energy

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823 Literary Theatre and Embodied Theatre: A Practice-Based Research in Exploring the Authorship of a Performance

Authors: Rahul Bishnoi

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Theatre, as Ann Ubersfld calls it, is a paradox. At once, it is both a literary work and a physical representation. Theatre as a text is eternal, reproducible, and identical while as a performance, theatre is momentary and never identical to the previous performances. In this dual existence of theatre, who is the author? Is the author the playwright who writes the dramatic text, or the director who orchestrates the performance, or the actor who embodies the text? From the poststructuralist lens of Barthes, the author is dead. Barthes’ argument of discrete temporality, i.e. the author is the before, and the text is the after, does not hold true for theatre. A published literary work is written, edited, printed, distributed and then gets consumed by the reader. On the other hand, theatrical production is immediate; an actor performs and the audience witnesses it instantaneously. Time, so to speak, does not separate the author, the text, and the reader anymore. The question of authorship gets further complicated in Augusto Boal’s “Theatre of the Oppressed” movement where the audience is a direct participant like the actors in the performance. In this research, through an experimental performance, the duality of theatre is explored with the authorship discourse. And the conventional definition of authorship is subjected to additional complexity by erasing the distinction between an actor and the audience. The design/methodology of the experimental performance is as follows: The audience will be asked to produce a text under an anonymous virtual alias. The text, as it is being produced, will be read and performed by the actor. The audience who are also collectively “authoring” the text, will watch this performance and write further until everyone has contributed with one input each. The cycle of writing, reading, performing, witnessing, and writing will continue until the end. The intention is to create a dynamic system of writing/reading with the embodiment of the text through the actor. The actor is giving up the power to the audience to write the spoken word, stage instruction and direction while still keeping the agency of interpreting that input and performing in the chosen manner. This rapid conversation between the actor and the audience also creates a conversion of authorship. The main conclusion of this study is a perspective on the nature of dynamic authorship of theatre containing a critical enquiry of the collaboratively produced text, an individually performed act, and a collectively witnessed event. Using practice as a methodology, this paper contests the poststructuralist notion of the author as merely a ‘scriptor’ and breaks it further by involving the audience in the authorship as well.

Keywords: practice based research, performance studies, post-humanism, Avant-garde art, theatre

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822 Structural Analysis of a Composite Wind Turbine Blade

Authors: C. Amer, M. Sahin

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The design of an optimised horizontal axis 5-meter-long wind turbine rotor blade in according with IEC 61400-2 standard is a research and development project in order to fulfil the requirements of high efficiency of torque from wind production and to optimise the structural components to the lightest and strongest way possible. For this purpose, a research study is presented here by focusing on the structural characteristics of a composite wind turbine blade via finite element modelling and analysis tools. In this work, first, the required data regarding the general geometrical parts are gathered. Then, the airfoil geometries are created at various sections along the span of the blade by using CATIA software to obtain the two surfaces, namely; the suction and the pressure side of the blade in which there is a hat shaped fibre reinforced plastic spar beam, so-called chassis starting at 0.5m from the root of the blade and extends up to 4 m and filled with a foam core. The root part connecting the blade to the main rotor differential metallic hub having twelve hollow threaded studs is then modelled. The materials are assigned as two different types of glass fabrics, polymeric foam core material and the steel-balsa wood combination for the root connection parts. The glass fabrics are applied using hand wet lay-up lamination with epoxy resin as METYX L600E10C-0, is the unidirectional continuous fibres and METYX XL800E10F having a tri-axial architecture with fibres in the 0,+45,-45 degree orientations in a ratio of 2:1:1. Divinycell H45 is used as the polymeric foam. The finite element modelling of the blade is performed via MSC PATRAN software with various meshes created on each structural part considering shell type for all surface geometries, and lumped mass were added to simulate extra adhesive locations. For the static analysis, the boundary conditions are assigned as fixed at the root through aforementioned bolts, where for dynamic analysis both fixed-free and free-free boundary conditions are made. By also taking the mesh independency into account, MSC NASTRAN is used as a solver for both analyses. The static analysis aims the tip deflection of the blade under its own weight and the dynamic analysis comprises normal mode dynamic analysis performed in order to obtain the natural frequencies and corresponding mode shapes focusing the first five in and out-of-plane bending and the torsional modes of the blade. The analyses results of this study are then used as a benchmark prior to modal testing, where the experiments over the produced wind turbine rotor blade has approved the analytical calculations.

Keywords: dynamic analysis, fiber reinforced composites, horizontal axis wind turbine blade, hand-wet layup, modal testing

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821 Hybrid Living: Emerging Out of the Crises and Divisions

Authors: Yiorgos Hadjichristou

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The paper will focus on the hybrid living typologies which are brought about due to the Global Crisis. Mixing of the generations and the groups of people, mingling the functions of living with working and socializing, merging the act of living in synergy with the urban realm and its constituent elements will be the springboard of proposing an essential sustainable housing approach and the respective urban development. The thematic will be based on methodologies developed both on the academic, educational environment including participation of students’ research and on the practical aspect of architecture including case studies executed by the author in the island of Cyprus. Both paths of the research will deal with the explorative understanding of the hybrid ways of living, testing the limits of its autonomy. The evolution of the living typologies into substantial hybrid entities, will deal with the understanding of new ways of living which include among others: re-introduction of natural phenomena, accommodation of the activity of work and services in the living realm, interchange of public and private, injections of communal events into the individual living territories. The issues and the binary questions raised by what is natural and artificial, what is private and what public, what is ephemeral and what permanent and all the in-between conditions are eloquently traced in the everyday life in the island. Additionally, given the situation of Cyprus with the eminent scar of the dividing ‘Green line’ and the waiting of the ‘ghost city’ of Famagusta to be resurrected, the conventional way of understanding the limits and the definitions of the properties is irreversibly shaken. The situation is further aggravated by the unprecedented phenomenon of the crisis on the island. All these observations set the premises of reexamining the urban development and the respective sustainable housing in a synergy where their characteristics start exchanging positions, merge into each other, contemporarily emerge and vanish, changing from permanent to ephemeral. This fluidity of conditions will attempt to render a future of the built- and unbuilt realm where the main focusing point will be redirected to the human and the social. Weather and social ritual scenographies together with ‘spontaneous urban landscapes’ of ‘momentary relationships’ will suggest a recipe for emerging urban environments and sustainable living. Thus, the paper will aim at opening a discourse on the future of the sustainable living merged in a sustainable urban development in relation to the imminent solution of the division of island, where the issue of property became the main obstacle to be overcome. At the same time, it will attempt to link this approach to the global need for a sustainable evolution of the urban and living realms.

Keywords: social ritual scenographies, spontaneous urban landscapes, substantial hybrid entities, re-introduction of natural phenomena

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820 Nursing Education in Estonia During the Years of Occupation: Paternalism and Ideology

Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits

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Background data. In 1940–1941 and 1945–1991 Estonia was occupied by Soviet Union. Paternalism was a common principle in Soviet social policy, including health care. The Soviet government, not the individuals themselves, decided on achieving a person’s quality of life. With the help of Soviet ideology, the work culture of nurses was constructed and the education system was also reshaped according to the ideology. The “new period of awakening” was initiated under Gorbachev’s perestroika and glasnost (1985–1991), leading to democratization. Aim. The qualitative study aimed to analyze nursing education in Soviet Estonia in the conditions of paternalistic orientation and ideological pressure. Method. The research was conducted in 2021 and 2023. Senior nurses (aged 69–87) who had worked for at least 20 years during the Soviet era were surveyed. Thematic interviews were conducted in written form and orally (13 interviewees), followed by a focus group interview (8 interviewees). A thematic content analysis was performed. Results. Nursing is part of society’s culture and in this sense, in - terviews with nurses provide us with critical information about the functioning of society and cultural identity at a given time. During the Soviet era the training of nurses occured within vocational training institutions. The curricula underwent a shift towards a Soviet-oriented approach. A significant portion of lessons were dedicated to imparting knowledge on the principles and tenets of Communist-Marxist ideology. Therefore, practical subjects and nursing theory were frequently allocated limited space. A paternalistic orientation prevailed in health care: just as the state regulated how to cure, spread hygiene, and healthy lifestyles propaganda, training was also determined by the management of the institution, thereby limiting the person´s autonomy to decide what kind of training was needed. The research is of significant value in the context of the history of nursing, as it helps to understand the difficulties and complexity of the development of nursing on the timeline. The Soviet era still affects Estonian society today and will continue to do so in the future. The same type of developments occurred in other post-Soviet countries.

Keywords: Estonian SSR, nursing education, paternalism, senior nurse, Soviet ideology

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819 Over Expression of Mapk8ip3 Patient Variants in Zebrafish to Establish a Spectrum of Phenotypes in a Rare-Neurodevelopmental Disorder

Authors: Kinnsley Travis, Camerron M. Crowder

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Mapk8ip3 (Mitogen-Activated Protein Kinase 8 Interacting Protein 3) is a gene that codes for the JIP3 protein, which is a part of the JIP scaffolding protein family. This protein is involved in axonal vesicle transport, elongation and regeneration. Variants in the Mapk8ip3 gene are associated with a rare-genetic condition that results in a neurodevelopmental disorder that can cause a range of phenotypes including global developmental delay and intellectual disability. Currently, there are 18 known individuals diagnosed to have sequenced confirmed Mapk8ip3 genetic disorders. This project focuses on examining the impact of a subset of missense patient variants on the Jip3 protein function by overexpressing the mRNA of these variants in a zebrafish knockout model for Jip3. Plasmids containing cDNA with individual missense variants were reverse transcribed, purified, and injected into single-cell zebrafish embryos (Wild Type, Jip3 -/+, and Jip3 -/-). At 6-days post mRNA microinjection, morphological, behavioral, and microscopic phenotypes were examined in zebrafish larvae. Morphologically, we compared the size and shape of the zebrafish during their development over a 5-day period. Total locomotive activity was assessed using the Microtracker assay and patterns of movement over time were examined using the DanioVision assay. Lastly, we used confocal microscopy to examine sensory axons for swelling and shortened length, which are phenotypes observed in the loss-of-function knockout Jip3 zebrafish model. Using these assays during embryonic development, we determined the impact of various missense variants on Jip3 protein function, compared to knockout and wild-type zebrafish embryo models. Variants in the gene Mapk8ip3 cause rare-neurodevelopmental disorders due to an essential role in axonal vesicle transport, elongation and regeneration. A subset of missense variants was examined by overexpressing the mRNA of these variants in a Jip3 knock-out zebrafish. Morphological, behavioral, and microscopic phenotypes were examined in zebrafish larvae. Using these assays, the spectrum of disorders can be phenotypically determined and the impact of variant location can be compared to knockout and wild-type zebrafish embryo models.

Keywords: rare disease, neurodevelopmental disorders, mrna overexpression, zebrafish research

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818 Optimizing the Field Emission Performance of SiNWs-Based Heterostructures: Controllable Synthesis, Core-Shell Structure, 3D ZnO/Si Nanotrees and Graphene/SiNWs

Authors: Shasha Lv, Zhengcao Li

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Due to the CMOS compatibility, silicon-based field emission (FE) devices as potential electron sources have attracted much attention. The geometrical arrangement and dimensional features of aligned silicon nanowires (SiNWs) have a determining influence on the FE properties. We discuss a multistep template replication process of Ag-assisted chemical etching combined with polystyrene (PS) spheres to fabricate highly periodic and well-aligned silicon nanowires, then their diameter, aspect ratio and density were further controlled via dry oxidation and post chemical treatment. The FE properties related to proximity and aspect ratio were systematically studied. A remarkable improvement of FE propertiy was observed with the average nanowires tip interspace increasing from 80 to 820 nm. On the basis of adjusting SiNWs dimensions and morphology, addition of a secondary material whose properties complement the SiNWs could yield a combined characteristic. Three different nanoheterostructures were fabricated to control the FE performance, they are: NiSi/Si core-shell structures, ZnO/Si nanotrees, and Graphene/SiNWs. We successfully fabricated the high-quality NiSi/Si heterostructured nanowires with excellent conformality. First, nickle nanoparticles were deposited onto SiNWs, then rapid thermal annealing process were utilized to form NiSi shell. In addition, we demonstrate a new and simple method for creating 3D nanotree-like ZnO/Si nanocomposites with a spatially branched hierarchical structure. Compared with the as-prepared SiNRs and ZnO NWs, the high-density ZnO NWs on SiNRs have exhibited predominant FE characteristics, and the FE enhancement factors were attributed to band bending effect and geometrical morphology. The FE efficiency from flat sheet structure of graphene is low. We discussed an effective approach towards full control over the diameter of uniform SiNWs to adjust the protrusions of large-scale graphene sheet deposited on SiNWs. The FE performance regarding the uniformity and dimensional control of graphene protrusions supported on SiNWs was systematically clarified. Therefore, the hybrid SiNWs/graphene structures with protrusions provide a promising class of field emission cathodes.

Keywords: field emission, silicon nanowires, heterostructures, controllable synthesis

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817 An Analysis of Emmanuel Macron's Campaign Discourse

Authors: Robin Turner

Abstract:

In the context of the strengthening conservative movements such as “Brexit” and the election of US President Donald Trump, the global political stage was shaken up by the election of Emmanuel Macron to the French presidency, defeating the far-right candidate Marine Le Pen. The election itself was a first for the Fifth Republic in which neither final candidate was from the traditional two major political parties: the left Parti Socialiste (PS) and the right Les Républicains (LR). Macron, who served as the Minister of Finance under his predecessor, founded the centrist liberal political party En Marche! in April 2016 before resigning from his post in August to launch his bid for the presidency. Between the time of the party’s creation to the first round of elections a year later, Emmanuel Macron and En Marche! had garnered enough support to make it to the run-off election, finishing far ahead of many seasoned national political figures. Now months into his presidency, the youngest President of the Republic shows no sign of losing fuel anytime soon. His unprecedented success raises a lot of questions with respect to international relations, economics, and the evolving relationship between the French government and its citizens. The effectiveness of Macron’s campaign, of course, relies on many factors, one of which is his manner of communicating his platform to French voters. Using data from oral discourse and primary material from Macron and En Marche! in sources such as party publications and Twitter, the study categorizes linguistic instruments – address, lexicon, tone, register, and syntax – to identify prevailing patterns of speech and communication. The linguistic analysis in this project is two-fold. In addition to these findings’ stand-alone value, these discourse patterns are contextualized by comparable discourse of other 2017 presidential candidates with high emphasis on that of Marine Le Pen. Secondly, to provide an alternative approach, the study contextualizes Macron’s discourse using those of two immediate predecessors representing the traditional stronghold political parties, François Hollande (PS) and Nicolas Sarkozy (LR). These comparative methods produce an analysis that gives insight to not only a contributing factor to Macron’s successful 2017 campaign but also provides insight into how Macron’s platform presents itself differently to previous presidential platforms. Furthermore, this study extends analysis to supply data that contributes to a wider analysis of the defeat of “traditional” French political parties by the “start-up” movement En Marche!.

Keywords: Emmanuel Macron, French, discourse analysis, political discourse

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816 From Government-Led to Collective Action: A Case Study of the Transformation of Urban Renewal Governance in Nanjing, China

Authors: Hanjun Hu, Jinxiang Zhang

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With the decline of "growthism", China's urbanization process has shifted from the stage of spatial expansion to the stage of optimization of built-up spaces, and urban renewal has gradually become a new wave of China's urban movement in recent years. The ongoing urban renewal movement in China not only needs to generate new motivation for urban development but also solve the backlog of social problems caused by rapid urbanization, which provides an opportunity for the transformation of China's urban governance model. Unlike previous approaches that focused on physical space and functional renewal, such as urban reconstruction, redevelopment, and reuse, the key challenge of urban renewal in the post-growth era lies in coordinating the complex interest relationships between multiple stakeholders. The traditional theoretical frameworks that focus on the structural relations between social groups are insufficient to explain the behavior logic and mutual cooperation mechanism of various groups and individuals in the current urban renewal practices. Therefore, based on the long-term tracking of the urban renewal practices in the Old City of Nanjing (OCN), this paper introduces the "collective action" theory to deeply analyze changes in the urban renewal governance model in OCN and tries to summarize the governance strategies that promote the formation of collective action within recent practices from a micro-scale. The study found that the practice in OCN experienced three different stages "government-led", "growth coalition" and "asymmetric game". With the transformation of government governance concepts, the rise of residents' consciousness of rights, and the wider participation of social organizations in recent years, the urban renewal in OCN is entering a new stage of "collective renewal action". Through the establishment of the renewal organization model, incentive policies, and dynamic negotiation mechanism, urban renewal in OCN not only achieves a relative balance between individual interests and collective interests but also makes the willingness of residents the dominant factor in formulating urban renewal policies. However, the presentation of "collective renewal action" in OCN is still mainly based on typical cases. Although the government is no longer the dominant role, a large number of resident-led collective actions have not yet emerged, which puts forward new research needs for a sustainable governance policy innovation in this action.

Keywords: urban renewal, collective action theory, governance, cooperation mechanism, China

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815 The Relationship between Vitamin D and Vitamin B12 Concentrations in Cataract Patients (Senile vs Diabetic)

Authors: Ali Showail Ali Alasmari

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Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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814 Modelling Distress Sale in Agriculture: Evidence from Maharashtra, India

Authors: Disha Bhanot, Vinish Kathuria

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This study focusses on the issue of distress sale in horticulture sector in India, which faces unique challenges, given the perishable nature of horticulture crops, seasonal production and paucity of post-harvest produce management links. Distress sale, from a farmer’s perspective may be defined as urgent sale of normal or distressed goods, at deeply discounted prices (way below the cost of production) and it is usually characterized by unfavorable conditions for the seller (farmer). The small and marginal farmers, often involved in subsistence farming, stand to lose substantially if they receive lower prices than expected prices (typically framed in relation to cost of production). Distress sale maximizes price uncertainty of produce leading to substantial income loss; and with increase in input costs of farming, the high variability in harvest price severely affects profit margin of farmers, thereby affecting their survival. The objective of this study is to model the occurrence of distress sale by tomato cultivators in the Indian state of Maharashtra, against the background of differential access to set of factors such as - capital, irrigation facilities, warehousing, storage and processing facilities, and institutional arrangements for procurement etc. Data is being collected using primary survey of over 200 farmers in key tomato growing areas of Maharashtra, asking information on the above factors in addition to seeking information on cost of cultivation, selling price, time gap between harvesting and selling, role of middleman in selling, besides other socio-economic variables. Farmers selling their produce far below the cost of production would indicate an occurrence of distress sale. Occurrence of distress sale would then be modelled as a function of farm, household and institutional characteristics. Heckman-two-stage model would be applied to find the probability/likelihood of a famer falling into distress sale as well as to ascertain how the extent of distress sale varies in presence/absence of various factors. Findings of the study would recommend suitable interventions and promotion of strategies that would help farmers better manage price uncertainties, avoid distress sale and increase profit margins, having direct implications on poverty.

Keywords: distress sale, horticulture, income loss, India, price uncertainity

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813 Use of Pig as an Animal Model for Assessing the Differential MicroRNA Profiling in Kidney after Aristolochic Acid Intoxication

Authors: Daniela E. Marin, Cornelia Braicu, Gina C. Pistol, Roxana Cojocneanu-Petric, Ioana Berindan Neagoe, Mihail A. Gras, Ionelia Taranu

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Aristolochic acid (AA) is a carcinogenic, mutagenic, and nephrotoxic compound commonly found in the Aristolochiaceae family of plants. AA is frequently associated with urothelial carcinoma of the upper urinary tract in human and animals and is considered as being responsible for Balkan Endemic Nephropathy. The pig provides a good animal model because the porcine urological system is very similar to that of humans, both in aspects of physiology and anatomy. MicroRNA (miRNA) are small non-coding RNAs that have an impact on a wide range of biological processes by regulating gene expression at post-transcriptional level. The objective of this study was to analyze the miRNA profiling in the kidneys of AA intoxicated swine. For this purpose, ten TOPIGS-40 crossbred weaned piglets, 4-week-old, male and females with an initial average body weight of 9.83 ± 0.5 kg were studied for 28 days. They were given ad libitum access to water and feed and randomly allotted to one of the following groups: control group (C) or aristolochic acid group (AA). They were fed a maize-soybean-meal-based diet contaminated or not with 0.25mgAA/kg. To profile miRNA in the kidneys of pigs, microarrays and bioinformatics approaches were applied to analyze the miRNA in the kidney of control and AA intoxicated pigs. After normalization, our results have shown that a total of 5 known miRNAs and 4 novel miRNAs had different profiling in the kidney of intoxicated animals versus control ones. Expression of miR-32-5p, miR-497-5p, miR-423-3p, miR-218-5p, miR-128-3p were up-regulated by 0.25mgAA/kg feed, while the expression of miR-9793-5p, miR-9835-3p, miR-9840-3p, miR-4334-5p was down-regulated. The microRNA profiling in kidney of intoxicated animals was associated with modified expression of target genes as: RICTOR, LASP1, SFRP2, DKK2, BMI1, RAF1, IGF1R, MAP2K1, WEE1, HDGF, BCL2, EIF4E etc, involved in cell division cycle, apoptosis, cell differentiation and cell migration, cell signaling, cancer etc. In conclusion, this study provides new data concerning the microRNA profiling in kidney after aristolochic acid intoxications with important implications for human and animal health.

Keywords: aristolochic acid, kidney, microRNA, swine

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812 Casusation and Criminal Responsibility

Authors: László Schmidt

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“Post hoc ergo propter hoc” means after it, therefore because of it. In other words: If event Y followed event X, then event Y must have been caused by event X. The question of causation has long been a central theme in philosophical thought, and many different theories have been put forward. However, causality is an essentially contested concept (ECC), as it has no universally accepted definition and is used differently in everyday, scientific, and legal thinking. In the field of law, the question of causality arises mainly in the context of establishing legal liability: in criminal law and in the rules of civil law on liability for damages arising either from breach of contract or from tort. In the study some philosophical theories of causality will be presented and how these theories correlate with legal causality. It’s quite interesting when philosophical abstractions meet the pragmatic demands of jurisprudence. In Hungarian criminal judicial practice the principle of equivalence of conditions is the generally accepted and applicable standard of causation, where all necessary conditions are considered equivalent and thus a cause. The idea is that without the trigger, the subsequent outcome would not have occurred; all the conditions that led to the subsequent outcome are equivalent. In the case where the trigger that led to the result is accompanied by an additional intervening cause, including an accidental one, independent of the perpetrator, the causal link is not broken, but at most the causal link becomes looser. The importance of the intervening causes in the outcome should be given due weight in the imposition of the sentence. According to court practice if the conduct of the offender sets in motion the causal process which led to the result, it does not exclude his criminal liability and does not interrupt the causal process if other factors, such as the victim's illness, may have contributed to it. The concausa does not break the chain of causation, i.e. the existence of a causal link establish the criminal liability of the offender. Courts also adjudicates that if an act is a cause of the result if the act cannot be omitted without the result being omitted. This essentially assumes a hypothetical elimination procedure, i.e. the act must be omitted in thought and then examined to see whether the result would still occur or whether it would be omitted. On the substantive side, the essential condition for establishing the offence is that the result must be demonstrably connected with the activity committed. The provision on the assessment of the facts beyond reasonable doubt must also apply to the causal link: that is to say, the uncertainty of the causal link between the conduct and the result of the offence precludes the perpetrator from being held liable for the result. Sometimes, however, the courts do not specify in the reasons for their judgments what standard of causation they apply, i.e. on what basis they establish the existence of (legal) causation.

Keywords: causation, Hungarian criminal law, responsibility, philosophy of law

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811 Determining Factors of Suspended Glass Systems with Pre-Stress Cable Truss

Authors: Cemil Atakara, Hüseyin Eryaman

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The use of glass as an envelope of a building has been increasing in the twentieth century. For more transparency and dematerialization new glass facade types have emerged in the past two decades which depends on point fixed glazing system (PFGS). The aim of this study is to analyze of the PFGS systems which are used on the glass curtain wall according to their types, degree, architectural and structural effects. This new system is desired because it enhances the transparency of the façade and it minimizes the component of the frames or of the profiles. This PFGS led to new structural elements which use cables, rods, trusses when designing a glass building facades, this structural element called the suspended glass system with pre-stressed cable truss (SGSPCT) which has been used for the first time in 1980 in Serres building. The twenty glass buildings which are designed in different systems have been analyzed during this study. After these analyses five selected SGSPCT building analyzed deeply and one skeletal frame building selected from Lefkosa redesigned according to the analysis results. These selected buildings have been included of various cable-truss system typologies and degree. The methodology of this study is building analysis method and literature survey with the help of books, articles, magazines, drawings, internet sources and applied connection details of the glass buildings. The selected five glass buildings and case building have been detailed analyzed with their architectural drawings, photographs and details. A gridshell structure can be compared with a shell structure; it consists of discrete members connecting nodal points. As these nodal points lie on the surface of an imaginary shell, their shapes function almost identically. Difference between shell and gridshell structures can be found in the fact that, due to their free-form and thus, due to the presence of bending forces, gridshells are required to resist loading through their cross-section. This research is divided into parts. A general study about the glass building and cable-glass and grid shell system will be done in the first chapters. Structural analyses and detailed analyses with schematic drawings with the plans, sections of the selected buildings will be explained in the second part. The third part it consists of the advantages and disadvantages of the use of the SGSPCT and Grid Shell in architecture. The study consists of four chapters including the introduction chapter. The general information of the SGSPCT and glazing system has been mentioned in the first chapter. Structural features, typologies, transparency principle and analytical information on systems have been explained of the selected buildings in the second chapter. The detailed analyses of case building have been done according to their schematic drawings with the plans, sections in the third chapter. After third chapter SGSPCT discussed on to the case building and selected buildings. SGSPCT systems have been compared with their advantages and disadvantages to the other systems. Advantages of cable-truss systems and SGSPCT have been concluded that the use of glass substrates in the last chapter.

Keywords: cable truss, glass, grid shell, transparency

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810 Identifying Effective Strategies to Promote Vietnamese Fashion Brands in an Internationally Dominated Market

Authors: Lam Hong Lan, Gabor Sarlos

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It is hard to search for best practices in promotion for local fashion brands in Vietnam as the industry is still very young. Local fashion start-ups have grown quickly in the last five years, thanks in part to the internet and social media. However, local designer/owners can face a huge challenge when competing with international brands in the Vietnamese market – and few local case studies are available for guidance. In response, this paper studied how local small- to medium-sized enterprises (SMEs) promote to their target customers in order to compete with international brands. Knowledge of both successful and unsuccessful approaches generated by this study is intended to both contribute to the academic literature on local fashion in Vietnam as well as to help local designers to learn from and improve their brand-building strategy. The primary study featured qualitative data collection via semi-structured depth interviews. Transcription and data analysis were conducted manually in order to identify success factors that local brands should consider as part of their promotion strategy. Purposive sampling of SMEs identified five designers in Ho Chi Minh City (the biggest city in Vietnam) and three designers in Hanoi (the second biggest) as interviewees. Participant attributes included: born in the 1980s or 1990s; familiar with internet and social media; designer/owner of a successful local fashion brand in the key middle market and/or mass market segments (which are crucial to the growth of local brands). A secondary study was conducted using social listening software to gather further qualitative data on what were considered to be successful or unsuccessful approaches to local fashion brand promotion on social media. Both the primary and secondary studies indicated that local designers had maximized their promotion budget by using owned media and earned media instead of paid media. Findings from the qualitative interviews indicate that internet and social media have been used as effective promotion platforms by local fashion start-ups. Facebook and Instagram were the most popular social networks used by the SMEs interviewed, and these social platforms were believed to offer a more affordable promotional strategy than traditional media such as TV and/or print advertising. Online stores were considered an important factor in helping the SMEs to reach customers beyond the physical store. Furthermore, a successful online store allowed some SMEs to reduce their business rental costs by maintaining their physical store in a cheaper, less central city area as opposed to a more traditional city center store location. In addition, the small comparative size of the SMEs allowed them to be more attentive to their customers, leading to higher customer satisfaction and rate of return. In conclusion, this study found that these kinds of cost savings helped the SMEs interviewed to focus their scarce resources on producing unique, high-quality collections in order to differentiate themselves from international brands. Facebook and Instagram were the main platforms used for promotion and brand-building. The main challenge to this promotion strategy identified by the SMEs interviewed was to continue to find innovative ways to maximize the impact of a limited marketing budget.

Keywords: Vietnam, SMEs, fashion brands, promotion, marketing, social listening

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809 Pandemic-Related Disruption to the Home Environment and Early Vocabulary Acquisition

Authors: Matthew McArthur, Margaret Friend

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The COVID-19 pandemic disrupted the stability of the home environment for families across the world. Potential disruptions include parent work modality (in-person vs. remote), levels of health anxiety, family routines, and caregiving. These disruptions may have interfered with the processes of early vocabulary acquisition, carrying lasting effects over the life course. Our justification for this research is as follows: First, early, stable, caregiver-child reciprocal interactions, which may have been disrupted during the pandemic, contribute to the development of the brain architecture that supports language, cognitive, and social-emotional development. Second, early vocabulary predicts several cognitive outcomes, such as numeracy, literacy, and executive function. Further, disruption in the home is associated with adverse cognitive, academic, socio-emotional, behavioral, and communication outcomes in young children. We are interested in how disruptions related to the COVID-19 pandemic are associated with vocabulary acquisition in children born during the first two waves of the pandemic. We are conducting a moderated online experiment to assess this question. Participants are 16 children (10F) ranging in age from 19 to 39 months (M=25.27) and their caregivers. All child participants were screened for language background, health history, and history of language disorders, and were typically developing. Parents completed a modified version of the COVID-19 Family Stressor Scale (CoFaSS), a published measure of COVID-19-related family stressors. Thirteen items from the original scale were replaced to better capture change in family organization and stability specifically related to disruptions in income, anxiety, family relations, and childcare. Following completion of the modified CoFaSS, children completed a Web-Based version of the Computerized Comprehension Task and the Receptive One Word Picture Vocabulary if 24 months or older or the MacArthur-Bates Communicative Development Inventory if younger than 24 months. We report our preliminary data as a partial correlation analysis controlling for age. Raw vocabulary scores on the CCT, ROWPVT-4, and MCDI were all negatively associated with pandemic-related disruptions related to anxiety (r12=-.321; r1=-.332; r9=-.509), family relations (r12=-.590*; r1=-.155; r9=-.468), and childcare (r12=-.294; r1=-.468; r9=-.177). Although the small sample size for these preliminary data limits our power to detect significance, this trend is in the predicted direction, suggesting that increased pandemic-related disruption across multiple domains is associated with lower vocabulary scores. We anticipate presenting data on a full sample of 50 monolingual English participants. A sample of 50 participants would provide sufficient statistical power to detect a moderate effect size, adhering to a nominal alpha of 0.05 and ensuring a power level of 0.80.

Keywords: COVID-19, early vocabulary, home environment, language acquisition, multiple measures

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808 Perspectives and Challenges a Functional Bread With Yeast Extract to Improve Human Diet

Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires

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Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.

Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia

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807 Weight Loss and Symptom Improvement in Women with Secondary Lymphedema Using Semaglutide

Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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The prevalence of lymphedema in women in rural communities highlights the importance of developing effective treatment and prevention methods. Subjects with secondary lymphedema in California’s Central Valley were surveyed at 6 surgical clinics to assess demographics and symptoms of lymphedema. Additionally, subjects on semaglutide treatment for obesity and/or T2DM were monitored for their diabetes management, weight loss progress, and lymphedema symptoms compared to subjects who were not treated with semaglutide. The subjects were followed for 12 months. Subjects who were treated with semaglutide completed pre-treatment questionnaires and follow-up post-treatment questionnaires at 3, 6, 9, 12 months, along with medical assessment. The untreated subjects completed similar questionnaires. The questionnaires investigated subjective feelings regarding lymphedema symptoms and management using a Likert-scale; quantitative leg measurements were collected, and blood work reviewed at these appointments. Paired difference t-tests, chi-squared tests, and independent sample t-tests were performed. 50 subjects, aged 18-75 years, completed the surveys evaluating secondary lymphedema: 90% female, 69% Hispanic, 45% Spanish speaking, 42% disabled, 57 % employed, 54% income range below 30 thousand dollars, and average BMI of 40. Both treatment and non-treatment groups noted the most common symptoms were leg swelling (x̄=3.2, ▁d= 1.3), leg pain (x̄=3.2, ▁d=1.6 ), loss of daily function (x̄=3, ▁d=1.4 ), and negative body image (x̄=4.4, ▁d=0.54). Subjects in the semaglutide treatment group >3 months of treatment compared to the untreated group demonstrated: 55% subject in the treated group had a 10% weight loss vs 3% in the untreated group (average BMI reduction by 11% vs untreated by 2.5%, p<0.05) and improved subjective feelings about their lymphedema symptoms: leg swelling (x̄=2.4, ▁d=0.45 vs x̄=3.2, ▁d=1.3, p<0.05), leg pain (x̄=2.2, ▁d=0.45 vs x̄= 3.2, ▁d= 1.6, p<0.05), and heaviness (x̄=2.2, ▁d=0.45 vs x̄=3, ▁d=1.56, p<0.05). Improvement in diabetes management was demonstrated by an average of 0.9 % decrease in A1C values compared to untreated 0.1 %, p<0.05. In comparison to untreated subjects, treatment subjects on semaglutide noted 6 cm decrease in the circumference of the leg, knee, calf, and ankle compared to 2 cm in untreated subjects, p<0.05. Semaglutide was shown to significantly improve weight loss, T2DM management, leg circumference, and secondary lymphedema functional, physical and psychosocial symptoms.

Keywords: diabetes, secondary lymphedema, semaglutide, obesity

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806 Anti-Graft Instruments and Their Role in Curbing Corruption: Integrity Pact and Its Impact on Indian Procurement

Authors: Jot Prakash Kaur

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The paper aims to showcase that with the introduction of anti-graft instruments and willingness of the governments towards their implementation, a significant change can be witnessed in the anti-corruption landscape of any country. Since the past decade anti-graft instruments have been introduced by several international non-governmental organizations with the vision of curbing corruption. Transparency International’s ‘Integrity Pact’ has been one such initiative. Integrity Pact has been described as a tool for preventing corruption in public contracting. Integrity Pact has found its relevance in a developing country like India where public procurement constitutes 25-30 percent of Gross Domestic Product. Corruption in public procurement has been a cause of concern even though India has in place a whole architecture of rules and regulations governing public procurement. Integrity Pact was first adopted by a leading Oil and Gas government company in 2006. Till May 2015, over ninety organizations had adopted Integrity Pact, of which majority of them are central government units. The methodology undertaken to understand impact of Integrity Pact on Public procurement is through analyzing information received from important stakeholders of the instrument. Government, information was sought through Right to Information Act 2005 about the details of adoption of this instrument by various government organizations and departments. Contractor, Company websites and annual reports were used to find out the steps taken towards implementation of Integrity Pact. Civil Society, Transparency International India’s resource materials which include publications and reports on Integrity Pact were also used to understand the impact of Integrity Pact. Some of the findings of the study include organizations adopting Integrity pacts in all kinds of contracts such that 90% of their procurements fall under Integrity Pact. Indian State governments have found merit in Integrity Pact and have adopted it in their procurement contracts. Integrity Pact has been instrumental in creating a brand image of companies. External Monitors, an essential feature of Integrity Pact have emerged as arbitrators for the bidders and are the first line of procurement auditors for the organizations. India has cancelled two defense contracts finding it conflicting with the provisions of Integrity Pact. Some of the clauses of Integrity Pact have been included in the proposed Public Procurement legislation. Integrity Pact has slowly but steadily grown to become an integral part of big ticket procurement in India. Government’s commitment to implement Integrity Pact has changed the way in which public procurement is conducted in India. Public Procurement was a segment infested with corruption but with the adoption of Integrity Pact a number of clean up acts have been performed to make procurement transparent. The paper is divided in five sections. First section elaborates on Integrity Pact. Second section talks about stakeholders of the instrument and the role it plays in its implementation. Third section talks about the efforts taken by the government to implement Integrity Pact in India. Fourth section talks about the role of External Monitor as Arbitrator. The final section puts forth suggestions to strengthen the existing form of Integrity Pact and increase its reach.

Keywords: corruption, integrity pact, procurement, vigilance

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805 Conceptualizing Personalized Learning: Review of Literature 2007-2017

Authors: Ruthanne Tobin

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As our data-driven, cloud-based, knowledge-centric lives become ever more global, mobile, and digital, educational systems everywhere are struggling to keep pace. Schools need to prepare students to become critical-thinking, tech-savvy, life-long learners who are engaged and adaptable enough to find their unique calling in a post-industrial world of work. Recognizing that no nation can afford poor achievement or high dropout rates without jeopardizing its social and economic future, the thirty-two nations of the OECD are launching initiatives to redesign schools, generally under the banner of Personalized Learning or 21st Century Learning. Their intention is to transform education by situating students as co-enquirers and co-contributors with their teachers of what, when, and how learning happens for each individual. In this focused review of the 2007-2017 literature on personalized learning, the author sought answers to two main questions: “What are the theoretical frameworks that guide personalized learning?” and “What is the conceptual understanding of the model?” Ultimately, the review reveals that, although the research area is overly theorized and under-substantiated, it does provide a significant body of knowledge about this potentially transformative educational restructuring. For example, it addresses the following questions: a) What components comprise a PL model? b) How are teachers facilitating agency (voice & choice) in their students? c) What kinds of systems, processes and procedures are being used to guide the innovation? d) How is learning organized, monitored and assessed? e) What role do inquiry based models play? f) How do teachers integrate the three types of knowledge: Content, pedagogical and technological? g) Which kinds of forces enable, and which impede, personalizing learning? h) What is the nature of the collaboration among teachers? i) How do teachers co-regulate differentiated tasks? One finding of the review shows that while technology can dramatically expand access to information, expectations of its impact on teaching and learning are often disappointing unless the technologies are paired with excellent pedagogies in order to address students’ needs, interests and aspirations. This literature review fills a significant gap in this emerging field of research, as it serves to increase conceptual clarity that has hampered both the theorizing and the classroom implementation of a personalized learning model.

Keywords: curriculum change, educational innovation, personalized learning, school reform

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804 Promoting Self-Esteem and Social Integration in Secondary German Schools: An Evaluation Study

Authors: Susanne Manes, Anni Glaeser, Katharina Wick, Bernhard Strauss, Uwe Berger

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Introduction: Over the last decades growing rates of mental health concerns among children and adolescents have been observed. At the same time, physical well-being of children and adolescents becomes increasingly impaired as well. Schools play an important role in preventing mental and physical disorders and in promoting well-being. Self-esteem, as well as social integration, are vital influence factors for mental and physical well-being. The purpose of this study was to develop and evaluate the program 'VorteilJena' for secondary schools in Germany focusing on self-esteem and social integration to improve mental and physical well-being. Method: The school-based health promotion program was designed for students in 5th grade and higher. It consists of several short pedagogical exercises instructed by a teacher and were integrated into the regular class over the course of ten weeks. The exercises focused on fostering social integration using either tasks improving team spirit or exercises that increase tolerance and sense of belonging. Other exercises focused on strengthening the self-esteem of the students. Additionally, the program included a poster exhibition titled 'Belonging' which was put up in the school buildings. The exhibition comprised ten posters which addressed relevant risk factors and resources related to social integration and self-esteem. The study was a randomized controlled sequential study with a pre and post measurement conducted in ten German schools. A total of 1642 students (44% male) were recruited. Their age ranged from 9 to 21 years (M=12.93 years; SD= 2.11). The program was conducted in classes ranging from 5th to 12th grade. Results: The program improved wellbeing, self-esteem and social integration of the involved students compared to the control group. Differential effects depending on implementation rates or age of the students will be analyzed. Moreover, implications for future school-based health promotion programs targeting self-esteem and social integration will be discussed. Conclusion: Social integration considerably influences self-esteem and well-being of students and can be targeted by school-based programs including short and modest exercises. Since a sufficient implementation of health promotion programs is essential, the present program due to its practicability represents a good opportunity to install health promotion focusing on social integration in schools.

Keywords: social integration, well-being, health promotion in schools, self-esteem

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803 A Qualitative Study on Overcoming Problems and Limitations of Telepsychological Support (Online Counseling): Through Interviews with Practitioners

Authors: Toshiki Ito, Takahiro Yamane, Yuki Adachi, Yoshiko Kato, Eiji Tsuda, Kousaku Nagasaka, Keigo Yoshida, Yoshiko Kawasaki, Naoki Aizawa, Kyouhei Nishi, Tetsuko Kato

Abstract:

The epidemic of the coronavirus (COVID-19), first reported in Wuhan at the end of 2019, has drastically changed our daily lives. Under these circumstances, counseling, which provides psychological support to people, was also greatly affected. The structure of counseling, which had generally been implicitly common practice to be conducted in person, was greatly shaken. The author wondered how counseling can be conducted in situations where it is impossible to meet face-to-face. This is where telepsychological support (online counseling) came into use. The authors found that there were the following problems in telepsychological support: (1) anxiety about whether the communication is appropriate, (2) difficulty in understanding the client's situation and condition, (3) inability to perceive what was normally perceived in person, (4) difficulty in adjusting to severely ill clients, (5) difficulty in dealing with emergency situations, etc. In this study, we interviewed psychologists who had been accustomed to telepsychological support for more than two years after the Corona disaster began to clarify how they had or had not overcome the problems of telepsychological support identified in the above studies. We also aim to consider the unique possibilities of how telepsychological support, a new technique of psychological support, can be implemented to provide more effective and meaningful support in society after the end of the Corona disaster (post-Corona society). Thirteen psychologists who are currently providing telepsychological support in the Corona Disaster will be interviewed, and semi-structured interviews will be conducted for one hour per person. In order to empirically examine how the problems in telepsychological support had been overcome or not through the interview survey, the authors asked (1) how they overcame their anxiety about whether they were able to communicate appropriately, (2) how they devised ways to overcome it, (3) how they overcame the difficulty in adapting to heavy clients in terms of the level of the disease, (4) how they overcame the difficulty in dealing with emergency situations. The interviews were analyzed using Thematic Analysis, a qualitative analysis method commonly used in qualitative research overseas. The authors found that some devices and perspectives were newly discovered as a result of two years of practice of telepsychological support and that psychologists in this study considered face-to-face interviews and telepsychological support to be separate and were flexible enough to use them when available and to move to face-to-face interviews when not appropriate.

Keywords: telepsychology, COVID-19, Corona, psychologist

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802 Optical and Surface Characteristics of Direct Composite, Polished and Glazed Ceramic Materials After Exposure to Tooth Brush Abrasion and Staining Solution

Authors: Maryam Firouzmandi, Moosa Miri

Abstract:

Aim and background: esthetic and structural reconstruction of anterior teeth may require the application of different restoration material. In this regard combination of direct composite veneer and ceramic crown is a common treatment option. Despite the initial matching, their long term harmony in term of optical and surface characteristics is a matter of concern. The purpose of this study is to evaluate and compare optical and surface characteristic of direct composite polished and glazed ceramic materials after exposure to tooth brush abrasion and staining solution. Materials and Methods: ten 2 mm thick disk shape specimens were prepared from IPS empress direct composite and twenty specimens from IPS e.max CAD blocks. Composite specimens and ten ceramic specimens were polished by using D&Z composite and ceramic polishing kit. The other ten specimens of ceramic were glazed with glazing liquid. Baseline measurement of roughness, CIElab coordinate, and luminance were recorded. Then the specimens underwent thermocycling, tooth brushing, and coffee staining. Afterword, the final measurements were recorded. Color coordinate were used to calculate ΔE76, ΔE00, translucency parameter, and contrast ratio. Data were analyzed by One-way ANOVA and post hoc LSD test. Results: baseline and final roughness of the study group were not different. At baseline, the order of roughness for the study group were as follows: composite < glazed ceramic < polished ceramic, but after aging, no difference. Between ceramic groups was not detected. The comparison of baseline and final luminance was similar to roughness but in reverse order. Unlike differential roughness which was comparable between the groups, changes in luminance of the glazed ceramic group was higher than other groups. ΔE76 and ΔE00 in the composite group were 18.35 and 12.84, in the glazed ceramic group were 1.3 and 0.79, and in polished ceramic were 1.26 and 0.85. These values for the composite group were significantly different from ceramic groups. Translucency of composite at baseline was significantly higher than final, but there was no significant difference between these values in ceramic groups. Composite was more translucency than ceramic at baseline and final measurement. Conclusion: Glazed ceramic surface was smoother than polished ceramic. Aging did not change the roughness. Optical properties (color and translucency) of the composite were influenced by aging. Luminance of composite, glazed ceramic, and polished ceramic decreased after aging, but the reduction in glazed ceramic was more pronounced.

Keywords: ceramic, tooth-brush abrasion, staining solution, composite resin

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801 Barriers and Facilitators of Community Based Mental Health Intervention (CMHI) in Rural Bangladesh: Findings from a Descriptive Study

Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

Abstract:

Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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