Search results for: improvement factor

Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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Authors: Iva Buchberger, Vesna Kovač

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Global education policy trends and recommendations underline the importance of (distributive) school leadership as a school effectiveness key factor. In this context, the broader aim of this research (supported by the Croatian Science Foundation) is to identify school leadership characteristics in Croatian schools and to examine the correlation between school leadership and school effectiveness. The aim of the proposed conference paper is to focus on the school leadership characteristics which are additionally explained with school leadership facilitators that contribute to (distributive) school leadership development. The aforementioned school leadership characteristics include the following dimensions: (a) participation in the process of making different types of decisions, (b) influence in the decision making process, (c) social interactions between different stakeholders in the decision making process in schools. Further, the school leadership facilitators are categorized as follows: (a) principal’s activities (such as providing support to different stakeholders and developing mutual trust among them), (b) stakeholders’ characteristics (such as developed stakeholders’ interest and competence to participate in decision-making process), (c) organizational and material resources (such as school material conditions, the necessary information and time as resources for making decisions). The data were collected by a constructed and validated questionnaire for examining the school leadership characteristics and facilitators from teachers’ perspective. The main population in this study consists of all primary schools in Croatia while the sample is comprised of 100 primary schools, selected by random sampling. Furthermore, the sample of teachers was selected by an additional procedure taking into consideration the independent variables of sex, work experience, etc. Data processing was performed by standard statistical methods of descriptive and inferential statistics. Statistical program IBM SPSS 20.0 was used for data processing. The results of this study show that there is a (positive) correlation between school leadership characteristics and school leadership facilitators. Specifically, it is noteworthy to mention that all the dimensions of school leadership characteristics are in positive correlation with the categories of school leadership facilitators. These results are indicative for the education policy creators who should ensure positive and supportive environment for the school leadership development including the development of school leadership characteristics and school leadership facilitators.

Keywords: distributive school leadership, school effectiveness , school leadership characteristics, school leadership facilitators

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Authors: F. Z. Aliyat, M. El Guilli, L. Nassiri, J. Ibijbijen

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Climate change is becoming a crucial factor that can significantly impact all ecosystems. It has a negative impact on the environment in many parts of the planet. Agriculture is the main sector affected by climate change. Particularly, the salinity of agricultural soils is among the problems caused by climate change. The use of phosphate solubilizing bacteria (PSB) as a biofertilizer requires previous research on their tolerance to abiotic stress, specifically saline stress tolerance, before the formation of biofertilizers. In this context, the main goal of this research was to assess the salinity tolerance of four strains: Serratia rubidaea strain JCM1240, Enterobacter bugandensis strain 247BMC, Pantoea agglomerans strain ATCC 27155, Pseudomonas brassicacearum subsp. Neoaurantiaca strain CIP109457, which was isolated from solid phosphate sludge. Additionally, their capacity to solubilize potassium and zinc, as well as their effect on Wheat (Triticum Durum 'Karim') germination. The four PSB strains were tested for their ability to solubilize phosphate in NBRIP medium with tricalcium phosphate (TCP) as the sole source of phosphorus under salt stress. Five concentrations of NaCl were used (0%, 0.5%, 1%, 2.5%, 5%). Their phosphate solubilizing activity was estimated by the vanadate-molybdate method. The potassium and zinc solubilization has been tested qualitatively and separately on solid media with mica and zinc oxide as the only sources of potassium and zinc, respectively. The result showed that the solubilization decreases with the increase in the concentration of NaCl; all the strains solubilize the TCP even with 5% NaCl, with a significant difference among the four strains. The Serratia rubidaea strain was the most tolerant strain. In addition, the four strains solubilize the potassium and the zinc. The Serratia rubidaea strain was the most efficient. Therefore, biofertilization with PSB salt-tolerant strains could be a climate-change-preparedness strategy for agriculture in salt soil.

Keywords: bioavailability of mineral nutrients, phosphate solid sludge; phosphate solubilization, potassium solubilization, salt stress, zinc solubilization.

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Authors: Danilo A. F. Fontes, Magaly A. M.Lyra, Maria L. C. Moura, Leslie R. M. Ferraz, Salvana P. M. Costa, Amanda C. Q. M. Vieira, Larissa A. Rolim, Giovanna C. R. M. Schver, Ping I. Lee, Severino Alves-Júnior, José L. Soares-Sobrinho, Pedro J. Rolim-Neto

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Efavirenz (EFV) is a first-choice drug in antiretroviral therapy with high efficacy in the treatment of infection by Human Immunodeficiency Virus, which causes Acquired Immune Deficiency Syndrome (AIDS). EFV has low solubility in water resulting in a decrease in the dissolution rate and, consequently, in its bioavailability. Among the technological alternatives to increase solubility, the Lamellar Double Hydroxides (LDH) have been applied in the development of systems with poorly water-soluble drugs. The use of analytical techniques such as X-Ray Diffraction (XRD), Infrared Spectroscopy (IR) and Differential Scanning Calorimetry (DSC) allowed the elucidation of drug interaction with the lamellar compounds. The objective of this work was to characterize and develop the binary systems with EFV and LDH in order to increase the solubility of the drug. The LDH-CaAl was synthesized by the method of co-precipitation from salt solutions of calcium nitrate and aluminum nitrate in basic medium. The systems EFV-LDH and their physical mixtures (PM) were obtained at different concentrations (5-60% of EFV) using the solvent technique described by Takahashi & Yamaguchi (1991). The characterization of the systems and the PM’s was performed by XRD techniques, IR, DSC and dissolution test under non-sink conditions. The results showed improvements in the solubility of EFV when associated with LDH, due to a possible change in its crystal structure and formation of an amorphous material. From the DSC results, one could see that the endothermic peak at 173°C, temperature that correspond to the melting process of EFZ in the crystal form, was present in the PM results. For the EFZ-LDH systems (with 5, 10 and 30% of drug loading), this peak was not observed. XRD profiles of the PM showed well-defined peaks for EFV. Analyzing the XRD patterns of the systems, it was found that the XRD profiles of all the systems showed complete attenuation of the characteristic peaks of the crystalline form of EFZ. The IR technique showed that, in the results of the PM, there was the appearance of one band and overlap of other bands, while the IR results of the systems with 5, 10 and 30% drug loading showed the disappearance of bands and a few others with reduced intensity. The dissolution test under non-sink conditions showed that systems with 5, 10 and 30% drug loading promoted a great increase in the solubility of EFV, but the system with 10% of drug loading was the only one that could keep substantial amount of drug in solution at different pHs.

Keywords: Efavirenz, Lamellar Double Hydroxides, Pharmaceutical Techonology, Solubility

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Authors: Muhammad Farooq

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The present article explores the woman's consent as a paramount element in contracting a Muslim marriage. Also, whether permission of the wali (guardian) is a condition per se for a valid nikah (marriage deed) in the eye of law and Sharia. The researcher attempts to treat it through the related issues, inter alia; the marriage guardian, the women's legal capacity to give consent whether she is a virgin or nonvirgin and how that consent is to be given or may be understood. Does her laugh, tears or salience needs a legal interpretation as well as other female manifestations of emotion explained by the Muslim jurists? The silence of Muslim Family Law Ordinance 1961 (hereafter; MFLO 1961) in this regard and the likely reasons behind such silence is also inquired in brief. Germane to the theme, the various cases in which the true notion of woman's consent is interpreted by courts in Pakistan are also examined. In order to address the issue in hand, it is proposed to provide a brief overview of a few contemporary writers' opinions in which the real place of woman's consent in Muslim marriage is highlighted. Key to the idea of young Muslim woman's marriage, the doctrine of kafa'a (equality or suitability) between the man and woman is argued here to be grounded in the patriarchal and social norms. It is, therefore, concluded that such concept was the result of analogical reasoning and has less importance in the present time. As such it is not a valid factor in current scenarios to validate or invalidate marital bonds. A standard qualitative convention is used for this research. Among primary and secondary sources; for examples, Qur'an, Sunnah, Books, Scholarly articles, texts of law and case law is used to point out the researcher's view. In summation, the article is concluded with a bold statement that a young woman being a party to the contract, is absolutely entitled to 'full and free' consent for the Muslim marriage contract. It is the woman, an indispensable partaker and her consent (not the guardian' permission) that does validate or invalidate the said agreement in the eye of contemporary personal law and in Sharia.

Keywords: consent of woman, ejab (declaration), Nikah (marriage agreement), qabol (acceptance), sui juris (of age; independent), wali (guardian), wilayah (guardianship)

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Authors: Khashayar Nasrifar

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Ionic liquids (ILs) exhibit particular properties exemplified by extremely low vapor pressure and high thermal stability. The properties of ILs can be tailored by proper selection of cations and anions. As such, ILs are appealing as potential solvents to substitute traditional solvents with high vapor pressure. One of the IL properties required in chemical and process design is density. In developing corresponding state liquid density correlations, scaling hypothesis is often used. The hypothesis expresses the temperature dependence of saturated liquid densities near the vapor-liquid critical point as a function of reduced temperature. Extending the temperature dependence, several successful correlations were developed to accurately correlate the densities of normal liquids from the triple point to a critical point. Applying mixing rules, the liquid density correlations are extended to liquid mixtures as well. ILs are not molecular liquids, and they are not classified among normal liquids either. Also, ILs are often used where the condition is far from equilibrium. Nevertheless, in calculating the properties of ILs, the use of corresponding state correlations would be useful if no experimental data were available. With well-known generalized saturated liquid density correlations, the accuracy in predicting the density of ILs is not that good. An average error of 4-5% should be expected. In this work, a data bank was compiled. A simplified and concise corresponding state saturated liquid density correlation is proposed by phenomena-logically modifying reduced temperature using the temperature-dependence for an interacting parameter of the Soave-Redlich-Kwong equation of state. This modification improves the temperature dependence of the developed correlation. Parametrization was next performed to optimize the three global parameters of the correlation. The correlation was then applied to the ILs in our data bank with satisfactory predictions. The correlation of IL density applied at 0.1 MPa and was tested with an average uncertainty of around 2%. No adjustable parameter was used. The critical temperature, critical volume, and acentric factor were all required. Methods to extend the predictions to higher pressures (200 MPa) were also devised. Compared to other methods, this correlation was found more accurate. This work also presents the chronological order of developing such correlations dealing with ILs. The pros and cons are also expressed.

Keywords: correlation, corresponding state principle, ionic liquid, density

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Authors: Ayman El Sabagh, SobhySorour, AbdElhamid Omar, Adel Ragab, Mohammad Sohidul Islam, Celaleddin Barutçular, Akihiro Ueda, Hirofumi Saneoka

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Salinity is one of the major factors limiting crop production in an arid environment. What adds to the concern is that all the legume crops are sensitive to increasing soil salinity. So it is implacable to either search for salinity enhancement of legume plants. The exogenous of osmoprotectants has been found effective in reducing the adverse effects of salinity stress on plant growth. Despite its global importance soybean production suffer the problems of salinity stress causing damages at plant development. Therefore, in the current study we try to clarify the mechanism that might be involved in the ameliorating effects of osmo-protectants such as proline and glycine betaine and compost application on soybean plants grown under salinity stress. Experiments were carried out in the greenhouse of the experimental station, plant nutritional physiology, Hiroshima University, Japan in 2011- 2012. The experiment was arranged in a factorial design with 4 replications at NaCl concentrations (0 and 15 mM). The exogenous, proline and glycine betaine concentrations (0 mM and 25 mM) for each. Compost treatments (0 and 24 t ha-1). Results indicated that salinity stress induced reduction in all growth and physiological parameters (dry weights plant-1, chlorophyll content, N and K+ content) likewise, seed and quality traits of soybean plant compared with those of the unstressed plants. In contrast, salinity stress led to increases in the electrolyte leakage ratio, Na and proline contents. Thus tolerance against salt stress was observed, the improvement of salt tolerance resulted from proline, glycine betaine and compost were accompanied with improved membrane stability, K+, and proline accumulation on contrary, decreased Na+ content. These results clearly demonstrate that could be used to reduce the harmful effect of salinity on both physiological aspects and growth parameters of soybean. They are capable of restoring yield potential and quality of seed and may be useful in agronomic situations where saline conditions are diagnosed as a problem. Consequently, exogenous osmo-protectants combine with compost will effectively solve seasonal salinity stress problem and are a good strategy to increase salinity resistance in the drylands.

Keywords: compost, glycine betaine, proline, salinity tolerance, soybean

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Authors: V. Reyes, P. Ferreira

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In response to high levels of competitiveness, industrial systems have evolved to improve productivity. As a consequence, a rapid increase in volume production and simultaneously, a customization process require lower costs, more variety, and accurate quality of products. Reducing time-cycle production, enabling customizability, and ensure continuous quality improvement are key features in advance intelligent industry. In this scenario, customers and producers will be able to participate in the ongoing production life cycle through real-time interaction. To achieve this vision, transparency, predictability, and adaptability are key features that provide the industrial systems the capability to adapt to customer demands modifying the manufacturing process through an autonomous response and acting preventively to avoid errors. The industrial system incorporates a diversified number of components that in advanced industry are expected to be decentralized, end to end communicating, and with the capability to make own decisions through feedback. The evolving process towards advanced intelligent industry defines a set of stages to empower components of intelligence and enhancing efficiency to achieve the decision-making stage. The integrated system follows an industrial cyber-physical system (CPS) architecture whose real-time integration, based on a set of enabler technologies, links the physical and virtual world generating the digital twin (DT). This instance allows incorporating sensor data from real to virtual world and the required transparency for real-time monitoring and control, contributing to address important features of the advanced intelligent industry and simultaneously improve sustainability. Assuming the industrial CPS as the core technology toward the latest advanced intelligent industry stage, this paper reviews and highlights the correlation and contributions of the enabler technologies for the operationalization of each stage in the path toward advanced intelligent industry. From this research, a real-time integration architecture for a cyber-physical system with applications to collaborative robotics is proposed. The required functionalities and issues to endow the industrial system of adaptability are identified.

Keywords: cyber-physical systems, digital twin, sensor data, system integration, virtual model

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Authors: Saeidreza Radpour, Md. Alam Mondal, Amit Kumar

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Market penetration of high energy efficiency technologies has key impacts on energy consumption and GHG mitigation. Also, it will be useful to manage the policies formulated by public or private organizations to achieve energy or environmental targets. Energy intensity in residential sector of Alberta was 148.8 GJ per household in 2012 which is 39% more than the average of Canada 106.6 GJ, it was the highest amount among the provinces on per household energy consumption. Energy intensity by appliances of Alberta was 15.3 GJ per household in 2012 which is 14% higher than average value of other provinces and territories in energy demand intensity by appliances in Canada. In this research, a framework has been developed to analyze the market penetration and market share of high energy efficiency technologies in residential sector. The overall methodology was based on development of data-intensive models’ estimation of the market penetration of the appliances in the residential sector over a time period. The developed models were a function of a number of macroeconomic and technical parameters. Developed mathematical equations were developed based on twenty-two years of historical data (1990-2011). The models were analyzed through a series of statistical tests. The market shares of high efficiency appliances were estimated based on the related variables such as capital and operating costs, discount rate, appliance’s life time, annual interest rate, incentives and maximum achievable efficiency in the period of 2015 to 2050. Results show that the market penetration of refrigerators is higher than that of other appliances. The stocks of refrigerators per household are anticipated to increase from 1.28 in 2012 to 1.314 and 1.328 in 2030 and 2050, respectively. Modelling results show that the market penetration rate of stand-alone freezers will decrease between 2012 and 2050. Freezer stock per household will decline from 0.634 in 2012 to 0.556 and 0.515 in 2030 and 2050, respectively. The stock of dishwashers per household is expected to increase from 0.761 in 2012 to 0.865 and 0.960 in 2030 and 2050, respectively. The increase in the market penetration rate of clothes washers and clothes dryers is nearly parallel. The stock of clothes washers and clothes dryers per household is expected to rise from 0.893 and 0.979 in 2012 to 0.960 and 1.0 in 2050, respectively. This proposed presentation will include detailed discussion on the modelling methodology and results.

Keywords: appliances efficiency improvement, energy star, market penetration, residential sector

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Authors: Hanan Mohamed Abd Elmoneim, Rawan Saleh AlJawi, Razan Saleh AlJawi, Aseel Abdullah AlMasoudi , Zyad Adnan Turkistani, Anas Abdulkarim Alkhoutani , Ohood Musaed AlJuhani , Hanan Attiyah AlZahrani

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Background Esophageal cancer is the eighth most common cancer worldwide. More than 90% of esophageal cancers are either squamous cell carcinoma or adenocarcinoma. Squamous dysplasia is a precancerous lesion for squamous cell carcinoma and Barrett's esophagus is the precancerous lesion for adenocarcinoma. Gastro-esophageal reflux disease (GERD) is the initiation factor for Barrett's esophagus. Cyclooxygenase-2 (COX-2) is a key enzyme in arachidonic metabolism. It appears to play an important role in gastrointestinal carcinogenesis. COX-2 activity may be a potential target for the prevention of cancer progression by selective COX-2 inhibitors, which decrease proliferation and increase apoptosis. Objectives To assess COX-2 expression in premalignant and malignant esophageal epitheliums changes and detect its roles in progression of these lesions. Materials and Methods We analyzed the expression of COX-2 immunohistochemically in 40 esophageal biopsies utilizing the streptavidin-biotin-peroxidase complex method on archival formalin fixed-paraffin embedded blocks. Histopathologically, 17 (42.5%) of cases were non-malignant cases which included GERD, Barrett's esophagus and squamous dysplasia. The malignant cases were 23 (57.5%) squamous cell carcinoma, adenocarcinoma and undifferentiated carcinoma. Results In non-malignant cases 7 (41.2%) out of 17 cases had high COX-2 expression. In squamous cell carcinoma 10 (83.3%) out of 12 cases had high COX-2 expression. The expression of COX-2 was high in all 9 (100%) cases of adenocarcinoma. COX-2 expression is significantly increased (P=0.005 and P=0.0001) in squamous cell carcinoma and adenocarcinoma respectively. There was a significant difference in COX-2 immunoreactivity between malignant and non-malignant lesions (P=0.0003). Conclusion COX-2 is responsible for the progression of esophageal diseases from benign to malignant. We recommend that COX-2 immunohistochemistry should be done routinely for premalignant and malignant esophageal lesions as selective COX-2 inhibitors will be helpful in the treatment. Further studies on molecular and genetic basis of COX-2 expression are needed to unmask its role and relation to progression of esophageal lesions.

Keywords: Cox-2, Esophageal adinocarcinoma, Esophageal squamous cell carcinoma, Immunohistochemistry.

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Sanjay Rathee, Arti Kashyap

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Extraction of useful information from large datasets is one of the most important research problems. Association rule mining is one of the best methods for this purpose. Finding possible associations between items in large transaction based datasets (finding frequent patterns) is most important part of the association rule mining. There exist many algorithms to find frequent patterns but Apriori algorithm always remains a preferred choice due to its ease of implementation and natural tendency to be parallelized. Many single-machine based Apriori variants exist but massive amount of data available these days is above capacity of a single machine. Therefore, to meet the demands of this ever-growing huge data, there is a need of multiple machines based Apriori algorithm. For these types of distributed applications, MapReduce is a popular fault-tolerant framework. Hadoop is one of the best open-source software frameworks with MapReduce approach for distributed storage and distributed processing of huge datasets using clusters built from commodity hardware. However, heavy disk I/O operation at each iteration of a highly iterative algorithm like Apriori makes Hadoop inefficient. A number of MapReduce-based platforms are being developed for parallel computing in recent years. Among them, two platforms, namely, Spark and Flink have attracted a lot of attention because of their inbuilt support to distributed computations. Earlier we proposed a reduced- Apriori algorithm on Spark platform which outperforms parallel Apriori, one because of use of Spark and secondly because of the improvement we proposed in standard Apriori. Therefore, this work is a natural sequel of our work and targets on implementing, testing and benchmarking Apriori and Reduced-Apriori and our new algorithm ReducedAll-Apriori on Apache Flink and compares it with Spark implementation. Flink, a streaming dataflow engine, overcomes disk I/O bottlenecks in MapReduce, providing an ideal platform for distributed Apriori. Flink's pipelining based structure allows starting a next iteration as soon as partial results of earlier iteration are available. Therefore, there is no need to wait for all reducers result to start a next iteration. We conduct in-depth experiments to gain insight into the effectiveness, efficiency and scalability of the Apriori and RA-Apriori algorithm on Flink.

Keywords: apriori, apache flink, Mapreduce, spark, Hadoop, R-Apriori, frequent itemset mining

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Authors: Gurfateh Singh, Mu Khan, Razia Khanam, Govind Mohan

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Objective: The present study has been designed to investigate the beneficial role of Fenofibrate & Clofibrate in attenuated the cardioprotective effect of ischemic preconditioning (IPC) in hyperlipidemic rat hearts. Materials & Methods: Experimental hyperlipidemia was produced by feeding high fat diet to rats for a period of 28 days. Isolated langendorff’s perfused normal and hyperlipidemic rat hearts were subjected to global ischemia for 30 min followed by reperfusion for 120 min. The myocardial infarct size was assessed macroscopically using triphenyltetrazolium chloride staining. Coronary effluent was analyzed for lactate dehydrogenase (LDH) and creatine kinase-MB release to assess the extent of cardiac injury. Moreover, the oxidative stress in heart was assessed by measuring thiobarbituric acid reactive substance, superoxide anion generation and reduced form of glutathione. Results: The ischemia-reperfusion (I/R) has been noted to induce oxidative stress by increasing TBARS, superoxide anion generation and decreasing reduced form of glutathione in normal and hyperlipidemic rat hearts. Moreover, I/R produced myocardial injury, which was assessed in terms of increase in myocardial infarct size, LDH and CK-MB release in coronary effluent and decrease in coronary flow rate in normal and hyperlipidemic rat hearts. In addition, the hyperlipidemic rat hearts showed enhanced I/R-induced myocardial injury with high degree of oxidative stress as compared with normal rat hearts subjected to I/R. Four episodes of IPC (5 min each) afforded cardioprotection against I/R-induced myocardial injury in normal rat hearts as assessed in terms of improvement in coronary flow rate and reduction in myocardial infarct size, LDH, CK-MB and oxidative stress. On the other hand, IPC mediated myocardial protection against I/R-injury was abolished in hyperlipidemic rat hearts. However, Treatment with Fenofibrate (100 mg/kg/day, i.p.), Clofibrate (300mg/kg/day, i.p.) as a agonists of PPAR-α have not affected the cardioprotective effect of IPC in normal rat hearts, but its treatment markedly restored the cardioprotective potentials of IPC in hyperlipidemic rat hearts. Conclusion: It is noted that the high degree of oxidative stress produced in hyperlipidemic rat heart during reperfusion and consequent down regulation of PPAR-α may be responsible to abolish the cardioprotective potentials of IPC.

Keywords: Hyperlipidemia, ischemia-reperfusion injury, ischemic preconditioning, PPAR-α

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

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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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Authors: Julius Oluwayomi Oluwadamilare, Michael Olutayo Olatunji

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In the African traditional societies, women have always played the role of a teacher, albeit informally. This is evident in the upbringing of their babies. As mothers, they also serve as the first teachers to teach their wards lessons through day-to-day activities. Furthermore, women always play the role of a musician during naming ceremonies, in the singing of lullabies, during initiation rites of adolescent boys and girls into adulthood, and in preparing their children especially daughters (and sons) for marriage. They also perform this role during religious and cultural activities, chieftaincy title/coronation ceremonies, singing of dirges during funeral ceremonies, and so forth. This traditional role of the African/Nigerian women puts them at a vantage point to contribute maximally to the teaching and learning of music at every level of education. The need for more women in the field of music education in Nigeria cannot be overemphasized. Today, gender equality is a major discourse in most countries of the world, Nigeria inclusive. Statistical data in the field of education and music education reveal the high ratio of male teachers/lecturers over their female counterparts in Nigerian tertiary institutions. The percentage is put at 80% Male and a distant 20% Female! This paper, therefore, examines feminine gender in Nigerian music education by tracing the involvement of women in musical practice from the pre-colonial to the post-colonial periods. The study employed both primary and secondary sources of data collection. The primary source included interviews conducted with 19 music lecturers from 8 purposively selected tertiary institutions from 4 geo-political zones of Nigeria. In addition, observation method was employed in the selected institutions. The results show, inter alia, that though there is a remarkable improvement in the rate of admission of female students into the music programme of Nigerian tertiary institutions, there is still an imbalance in the job placement in these institutions especially in the Colleges of Education which is the main focus of this research. Religious and socio-cultural factors are highly traceable to this development. This paper recommends the need for more female music teachers to be employed in the Nigerian tertiary institutions in line with the provisions stated in the Millennium Development Goals (MDGs) of the Federal Republic of Nigeria.

Keywords: gender, education, music, women

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Authors: Michelle Ablian Mejica

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Female drop-outs due to teenage pregnancy and gender-based violence in schools are two of the most contentious and current gender-related issues faced by the Department of Education (DepEd) in the Philippines. The country adopted gender mainstreaming as the main strategy to eliminate gender inequalities in all aspects of the society including education since 1990. This research examines the extent and magnitude by which gender mainstreaming is implemented in the basic education from the national to the school level. It seeks to discover the challenges faced by the central and field offices, particularly by the principals who served as decision-makers in the schools where teaching and learning take place and where opportunities that may aggravate, conform and transform gender inequalities and hierarchies exist. The author conducted surveys and interviews among 120 elementary and secondary principals in the Division of Zambales as well as selected gender division and regional focal persons within Region III- Central Luzon. The study argues that DepEd needs to review, strengthen and revitalize its gender mainstreaming because the efforts do not penetrate the schools and are not enough to lessen or eliminate gender inequalities within the schools. The study found out some of the major challenges in the implementation of gender mainstreaming as follows: absence of a national gender-responsive education policy framework, lack of gender responsive assessment and monitoring tools, poor quality of gender and development related training programs and poor data collection and analysis mechanism. Furthermore, other constraints include poor coordination mechanism among implementing agencies, lack of clear implementation strategy, ineffective or poor utilization of GAD budget and lack of teacher and learner centered GAD activities. The paper recommends the review of the department’s gender mainstreaming efforts to align with the mandate of the agency and provide gender responsive teaching and learning environment. It suggests that the focus must be on formulation of gender responsive policies and programs, improvement of the existing mechanism and conduct of trainings focused on gender analysis, budgeting and impact assessment not only for principals and GAD focal point system but also to parents and other school stakeholders.

Keywords: curriculum and instruction, gender analysis, gender budgeting, gender impact assessment

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Authors: Michal Bialy, Marcin Szlachetka, Mateusz Paszko

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This paper discusses the CFD results of heat transfer in water channels in the engine body. The research engine was a newly designed Diesel combustion engine. The engine has three cylinders with three pairs of opposed pistons inside. The engine will be able to generate 100 kW mechanical power at a crankshaft speed of 3,800-4,000 rpm. The water channels are in the engine body along the axis of the three cylinders. These channels are around the three combustion chambers. The water channels transfer combustion heat that occurs the cylinders to the external radiator. This CFD research was based on the ANSYS Fluent software and aimed to optimize the geometry of the water channels. These channels should have a maximum flow of heat from the combustion chamber or the external radiator. Based on the parallel simulation research, the boundary and initial conditions enabled us to specify average values of key parameters for our numerical analysis. Our simulation used the average momentum equations and turbulence model k-epsilon double equation. There was also used a real k-epsilon model with a function of a standard wall. The turbulence intensity factor was 10%. The working fluid mass flow rate was calculated for a single typical value, specified in line with the research into the flow rate of automotive engine cooling pumps used in engines of similar power. The research uses a series of geometric models which differ, for instance, in the shape of the cross-section of the channel along the axis of the cylinder. The results are presented as colourful distribution maps of temperature, speed fields and heat flow through the cylinder walls. Due to limitations of space, our paper presents the results on the most representative geometric model only. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A. and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: Ansys fluent, combustion engine, computational fluid dynamics CFD, cooling system

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Authors: Sungmin Park, Gyungmok Nam, Seungpyo Woo, Young Choi, Sangheon Park, Sang-Hee Yoon

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Puncturing human skin with microneedles is critically important for microneedle-mediate drug delivery. Despite of extensive efforts in the past decades, the scale-up fabrication of sharp-tipped and high-aspect-ratio microneedles, especially made of biodegradable polymers, is still a long way off. Here, we present a UV dose insensitive and cost-effective microfabrication method for the biodegradable polymer microneedles with sharp tips and long lengths which can pierce human skin with low insertion force. The biodegradable polymer microneedles are fabricated with the polymer solution casting where a poly(lactic-co-glycolic acid) (PLGA, 50:50) solution is coated onto a SU-8 mold prepared with a reverse, ramped, and rotational (R3) UV exposure. The R3 UV exposure is modified from the multidirectional UV exposure both to suppress UV reflection from the bottom surface without anti-reflection layers and to optimize solvent concentration in the SU-8 photoresist, therefore achieving robust (i.e., highly insensitive to UV dose) and cost-effective fabrication of biodegradable polymer microneedles. An optical model for describing the spatial distribution of UV irradiation dose of the R3 UV exposure is also developed to theoretically predict the microneedle geometry fabricated with the R3 UV exposure and also to demonstrate the insensitiveness of microneedle geometry to UV dose. In the experimental characterization, the microneedles fabricated with the R3 UV exposure are compared with those fabricated with a conventional method (i.e., multidirectional UV exposure). The R3 UV exposure-based microfabrication reduces the end-tip radius by a factor of 5.8 and the deviation from ideal aspect ratio by 74.8%, compared with conventional method-based microfabrication. The PLGA microneedles fabricated with the R3 UV exposure pierce full-thickness porcine skins successfully and are demonstrated to completely dissolve in PBS (phosphate-buffered saline). The findings of this study will lead to an explosive growth of the microneedle-mediated drug delivery market.

Keywords: R³ UV exposure, optical model, UV dose, reflection, solvent concentration, biodegradable polymer microneedle

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Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

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Authors: Shadia Al-Bahlani, Ruqaya Al-Rashdi, Shadia Al-Sinawi, Maya Al-Bahri

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Background: Breast cancer is the most common cancer in women worldwide. Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer, which is defined by the absence of Estrogen (ER), Progesterone (PR) and Human epidermal growth factor (Her-2) receptors. The calpain system plays an important role in many cellular processes including apoptosis, necrosis, cell signaling and proliferation. The role of clapins in pathogenesis and tumor progression has been studied in certain cancer types; however, its definite role is not yet established in breast cancer especially in the TNBC subtype. Objectives: This study aims to measure calpain-1 expression and correlate this measurement with the proliferating/apoptotic index as well with the prognostic factors in TNBC patients’ tissue. Materials and Methods: Thirty nine paraffin blocks from patients diagnosed with TNBC were used to measure the expression of calpain-1 and Ki-67 (proliferating marker) proteins using immunohistochemistry. Apoptosis was assessed morphological and biochemically using conventional Haematoxylin and Eosin (H&E) staining method and terminal deoxynucleotidyl transferase-mediate dUTP nick and labeling (TUNEL) assay respectively. Data was statistically analyzed using Pearson X2 test of association. Results: Calpain-1 content was visualized in the nucleus of the TNBC cells and its expression varied from low to high among the patients tissue. Calpain expression showed no significant correlation with the proliferating/apoptotic index as well with the clinicopathological variables. Apoptotic counts quantified by H&E staining showed significant association with the apoptotic TUNEL assay, validating both approaches. Conclusion: Although calpain-1 expression showed no significant association with the clinical outcome, its variable level of expression might indicate a hidden role in breast cancer tissue. Larger number of samples and different mode of assessments are needed to fully investigate such role. Exploring the involvement of calpain-1 in cancer progression might help in considering it as a biomarker of breast cancer.

Keywords: breast cancer, calpain, apoptosis, prognosis

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Authors: Isalira Peroba Ramos, Cherley Borba Vieira de Andrade, Grazielle Suhett, Camila Salata, Paulo Cesar Canary, Guilherme Visconde Brasil, Antonio Carlos Campos de Carvalho, Regina Coeli dos Santos Goldenberg

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Background: The therapeutic options for patients with cancer now include increasingly complex combinations of medications, radiation therapy (RT), and surgical intervention. Many of these treatments have important potential adverse cardiac effects and are likely to have significant effects on patient outcomes. Cell therapy appears to be promising for the treatment of chronic and degenerative diseases, including cardiomyopathy induced by RT, as the current therapeutic options are insufficient. Aims: To evaluate the potential of bone marrow mesenchymal cells (BMMCs) in radioinduced cardiac damage Methods: Female Wistar rats, 3 months old (Ethics Committee 054/14), were divided into 2 groups, non-treated irradiated group (IR n=15) and irradiated and BMMC treated (IRT n=10). Echocardiography was performed to evaluate heart function. After euthanasia, 3 months post treatment; the left ventricle was removed and prepared for RT-qPCR (VEGF and Pro Collagen I) and histological (picrosirius) analysis. Results: In both groups, 45 days after irradiation, ejection fraction (EF) was in the normal range for these animals (> 70%). However, the BMMC treated group had EF (83.1%±2.6) while the non-treated IR group showed a significant reduction (76.1%±2.6) in relation to the treated group. In addition, we observed an increase in VEGF gene expression and a decrease in Pro Collagen I in IRT when compared to IR group. We also observed by histology that the collagen deposition was reduced in IRT (10.26%±0.83) when compared to IR group (25.29%±0.96). Conclusions: Treatment with BMMCs was able to prevent ejection fraction reduction and collagen deposition in irradiated animals. The increase of VEGF and the decrease of pro collagen I gene expression might explain, at least in part, the cell therapy benefits. All authors disclose no financial or personal relationships with individuals or organizations that could be perceived to bias their work. Sources of funding: FAPERJ, CAPES, CNPq, MCT.

Keywords: mesenchymal cells, radioation, cardiotoxicity, bone marrow

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Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

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Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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Authors: Buruk Kitachew Wossenyeleh

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Groundwater is the largest freshwater reservoir in the world. Like the other reservoirs of the hydrologic cycle, it is a finite resource. This study focused on the groundwater modeling of the Ter Kamerenbos well field to understand the groundwater flow system and the impact of different scenarios. The study area covers 68.9Km2 in the Brussels Capital Region and is situated in two river catchments, i.e., Zenne River and Woluwe Stream. The aquifer system has three layers, but in the modeling, they are considered as one layer due to their hydrogeological properties. The catchment aquifer system is replenished by direct recharge from rainfall. The groundwater recharge of the catchment is determined using the spatially distributed water balance model called WetSpass, and it varies annually from zero to 340mm. This groundwater recharge is used as the top boundary condition for the groundwater modeling of the study area. During the groundwater modeling using Processing MODFLOW, constant head boundary conditions are used in the north and south boundaries of the study area. For the east and west boundaries of the study area, head-dependent flow boundary conditions are used. The groundwater model is calibrated manually and automatically using observed hydraulic heads in 12 observation wells. The model performance evaluation showed that the root means the square error is 1.89m and that the NSE is 0.98. The head contour map of the simulated hydraulic heads indicates the flow direction in the catchment, mainly from the Woluwe to Zenne catchment. The simulated head in the study area varies from 13m to 78m. The higher hydraulic heads are found in the southwest of the study area, which has the forest as a land-use type. This calibrated model was run for the climate change scenario and well operation scenario. Climate change may cause the groundwater recharge to increase by 43% and decrease by 30% in 2100 from current conditions for the high and low climate change scenario, respectively. The groundwater head varies for a high climate change scenario from 13m to 82m, whereas for a low climate change scenario, it varies from 13m to 76m. If doubling of the pumping discharge assumed, the groundwater head varies from 13m to 76.5m. However, if the shutdown of the pumps is assumed, the head varies in the range of 13m to 79m. It is concluded that the groundwater model is done in a satisfactory way with some limitations, and the model output can be used to understand the aquifer system under steady-state conditions. Finally, some recommendations are made for the future use and improvement of the model.

Keywords: Ter Kamerenbos, groundwater modelling, WetSpass, climate change, well operation

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Authors: Kenichi Yamahara, Makiko Ohshima, Shunsuke Ohnishi, Hidetoshi Tsuda, Akihiko Taguchi, Toshihiro Soma, Hiroyasu Ogawa, Jun Yoshimatsu, Tomoaki Ikeda

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We have previously reported the therapeutic potential of rat fetal membrane(FM)-derived mesenchymal stem cells (MSCs) using various rat models including hindlimb ischemia, autoimmune myocarditis, glomerulonephritis, renal ischemia-reperfusion injury, and myocardial infarction. In this study, 1) we isolated and characterized MSCs from human amnion and chorion; 2) we examined their differences in the expression profile of growth factors and cytokines; and 3) we investigated the therapeutic potential and difference of these MSCs using murine hindlimb ischemia and acute graft-versus-host disease (GVHD) models. Isolated MSCs from both amnion and chorion layers of FM showed similar morphological appearance, multipotency, and cell-surface antigen expression. Conditioned media obtained from amnion- and chorion-derived MSCs inhibited cell death caused by serum starvation or hypoxia in endothelial cells and cardiomyocytes. Amnion and chorion MSCs secreted significant amounts of angiogenic factors including HGF, IGF-1, VEGF, and bFGF, although differences in the cellular expression profile of these soluble factors were observed. Transplantation of human amnion or chorion MSCs significantly increased blood flow and capillary density in a murine hindlimb ischemia model. In addition, compared to human chorion MSCs, human amnion MSCs markedly reduced T-lymphocyte proliferation with the enhanced secretion of PGE2, and improved the pathological situation of a mouse model of GVHD disease. Our results highlight that human amnionand chorion-derived MSCs, which showed differences in their soluble factor secretion and angiogenic/immuno-suppressive function, could be ideal cell sources for regenerative medicine.

Keywords: amnion, chorion, fetal membrane, mesenchymal stem cells

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Authors: Nazish Badar

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Background: To investigate the epidemic resurgent wave of influenza A (H1N1) pdm09 infections during 2015-16 Influenza season(Nov,15 –Feb,16) we compared epidemiological features of influenza A (H1N1) pdm09 associated hospitalizations and deaths during this period in Pakistan. Methods: Respiratory samples were tested using CDC Real-Time RT-PCR protocols. Demographic and epidemiological data was analyzed using SPSS. Risk ratio was calculated between age groups to compare patients that were hospitalized and died due to influenza A (H1N1) pdm09 during this period. Results: A total of 1970 specimens were analyzed; influenza virus was detected in 494(25%) samples, including 458(93%) Influenza type A and 36(7%) influenza type B viruses. Amongst influenza A viruses, 351(77%) A(H1N1) pdm09 and 107(23%) were A/H3N2. Influenza A(H1N1)pdm09 peaked in January 2016 when 250(54%) of tested patients were positive. The resurgent waves increased hospitalizations due to pdmH1N1 as compared to the rest part of the year. Overall 267(76%) A(H1N1) pdm09 cases were hospitalized. Adults ≥18 years showed the highest relative risk of hospitalization (1.2). Median interval of hospitalization and symptom onset was five days for all age groups. During this period, a total of 34 laboratory-confirmed deaths associated with pandemic influenza A (H1N1) were reported out of 1970 cases, the case fatality rate was 1.72%. the male to female ratio was 2:1in reported deaths. The majority of the deaths during that period occurred in adults ≥18 years of age. Overall median age of the death cases was 42.8 years with underlying medical conditions. The median number of days between symptom onset was two days. The diagnosis upon admission in influenza-associated fatal cases was pneumonia (53%). Acute Respiratory Distress Syndrome 9 (26%), eight out of which (88%) required mechanical ventilation. Conclusions: The present resurgence of pandemic virus cannot be attributed to a single factor. The prolong cold and dry weather, possibility of drift in virus and absence of annual flu vaccination may have played an integrated role in resurfacing of pandemic virus.

Keywords: influenza A (H1N1)pdm 09, resurgence, epidemiology, Pakistan

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Authors: Yulin Zhang, Kaixi Dong, Guozhen Zhao

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Background: Different levels of life satisfaction are associated with some individual differences. Understanding the mechanism between them will help to enhance an individual’s well-being. On the one hand, traditional personality such as extraversion has been considered as the most stable and effective factor in predicting life satisfaction to the author’s best knowledge. On the other, individual emotional difference, such as alexithymia (difficulties identifying and describing one’s own feelings), is also closely related to life satisfaction. With the development of positive psychology, positive personalities such as virtues attract wide attention. And according to the broaden-and-build theory, social connectivity may mediate between emotion and life satisfaction. Therefore, the current study aims to explore the mediating role of social connectivity in the effect of positive personality and alexithymia on life satisfaction. Method: This study was conducted with 318 healthy Chinese college students whose age range from 18 to 30. Positive personality (including interpersonal, vitality, and cautiousness) was measured by the Chinese version of Values in Action Inventory of Strengths (VIA-IS). Alexithymia was measured by the Toronto Alexithymia Scale (TAS), and life satisfaction was measured by Satisfaction With Life Scale (SWLS). And social connectivity was measured by six items which have been used in previous studies. Each scale showed high reliability and validity. The mediating model was examined in Mplus 7.2 within a structural equation modeling (SEM) framework. Findings: The model fitted well and results revealed that both positive personality (95% confidence interval of indirect effect was [0.023, 0.097]) and alexithymia (95% confidence interval of indirect effect was [-0.270, -0.089]) predicted life satisfaction level significantly through social connectivity. Also, only positive personality significantly and directly predicted life satisfaction compared to alexithymia (95% confidence interval of direct effect was [0.109, 0.260]). Conclusion: Alexithymia predicts life satisfaction only through social connectivity, which emphasizes the importance of social bonding in enhancing the well-being of Chinese college students with alexithymia. And the positive personality can predict life satisfaction directly or through social connectivity, which provides implications for enhancing the well-being of Chinese college students by cultivating their virtue and positive psychological quality.

Keywords: alexithymia, life satisfaction, positive personality, social connectivity

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Authors: Maria Antonieta Erna Castillo Holly

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During the last decade, data analysis, strategic decision making, and the use of artificial intelligence (AI) tools in Latin American agriculture have been a challenge. In some countries, the availability, quality, and reliability of historical data, in addition to the current data recording methodology in the field, makes it difficult to use information systems, complete data analysis, and their support for making the right strategic decisions. This is something essential in Agriculture 4.0. where the increase in the global demand for fresh agricultural products of tropical origin, during all the seasons of the year requires a change in the production model and greater agility in the responses to the consumer market demands of quality, quantity, traceability, and sustainability –that means extensive data-. Having quality information available and updated in real-time on what, how much, how, when, where, at what cost, and the compliance with production quality standards represents the greatest challenge for sustainable and profitable agriculture in the region. The objective of this work is to present a methodological proposal for the collection of georeferenced data from the protected agriculture sector, specifically in production units (UP) with tall structures (Greenhouses), initially for Venezuela, taking the state of Mérida as the geographical framework, and horticultural products as target crops. The document presents some background information and explains the methodology and tools used in the 3 phases of the work: diagnosis, data collection, and analysis. As a result, an evaluation of the process is carried out, relevant data and dashboards are displayed, and the first satellite maps integrated with layers of information in a geographic information system are presented. Finally, some improvement proposals and tentatively recommended applications are added to the process, understanding that their objective is to provide better qualified and traceable georeferenced data for subsequent analysis of the information and more agile and accurate strategic decision making. One of the main points of this study is the lack of quality data treatment in the Latin America area and especially in the Caribbean basin, being one of the most important points how to manage the lack of complete official data. The methodology has been tested with horticultural products, but it can be extended to other tropical crops.

Keywords: greenhouses, protected agriculture, data analysis, geographic information systems, Venezuela

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Authors: Ahmeda Ali, Mary Codd, Susan Brundage

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Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

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Authors: Jordan Chamarande, Lisiane Cunat, Corentine Alauzet, Catherine Cailliez-Grimal

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Gut microbiota (GM) is now considered a new organ mainly due to the microorganism’s specific biochemical interaction with its host. Although mechanisms underlying host-microbiota interactions are not fully described, it is now well-defined that cell surface molecules and structures of the GM play a key role in such relation. The study of surface structures of GM members is also fundamental for their role in the establishment of species in the versatile and competitive environment of the digestive tract and as a potential virulence factor. Among these structures are capsular polysaccharides (CPS), fimbriae, pili and lipopolysaccharides (LPS), all well-described for their central role in microorganism colonization and communication with host epithelium. The health-promoting Parabacteroides distasonis, which is part of the core microbiome, has recently received a lot of attention, showing beneficial properties for its host and as a new potential biotherapeutic product. However, to the best of the authors’ knowledge, the cell surface molecules and structures of P. distasonis that allow its maintain within the GM are not identified. Moreover, although P. distasonis is strongly recognized as intestinal commensal species with benefits for its host, it has also been recognized as an opportunistic pathogen. In this study, we reported gene clusters potentially involved in the synthesis of the capsule, fimbriae-like and pili-like cell surface structures in 26 P. distasonis genomes and applied the new RfbA-Typing classification in order to better understand and characterize the beneficial/pathogenic behaviour related to P. distasonis strains. In context, 2 different types of fimbriae, 3 of pilus and up to 14 capsular polysaccharide loci, have been identified over the 26 genomes studied. Moreover, the addition of data to the rfbA-Type classification modified the outcome by rearranging rfbA genes and adding a fifth group to the classification. In conclusion, the strain variability in terms of external proteinaceous structure could explain the inter-strain differences previously observed in P. distasonis adhesion capacities and its potential pathogenicity.

Keywords: gut microbiota, Parabacteroides distasonis, capsular polysaccharide, fimbriae, pilus, O-antigen, pathogenicity, probiotic, comparative genomics

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