Search results for: functional gait assessment

Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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Authors: Okanlawon Simon Ayorinde, Odunjo Oluronke Omolola, Fadamiro Joseph Akinlabi, Adedibu Afolabi Adebgite

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A road is a path established over land, especially prepared way between places for the use of pedestrian, riders, and vehicles: a hard surface built for vehicles to travel on. The social, economic and health importance of roads in any community and nation cannot be underestimated. Roads provide access to properties and they also provide mobility which is ability to transport goods and services from one place to another. In the residential zones of many indigenous cities in Nigeria, roads are usually blocked for social ceremonies. Road blocked for ceremonies as used in this study are a temporary barrier across a road, used to stop or hinder traffic from passing through to the other side. Social ceremonies that could warrant road blockage include marriage, child naming, funeral, celebration of life’s achievement, birthday anniversary etc. These activities are likely to generate environmental hazards and their attendant risks. The assessment of these hazards and risks in residential zones of indigenous cities in Nigeria becomes imperative. The study is focused on Ogbomoso, Oyo State, Nigeria. The town has two local government councils namely Ogbomoso North and Ogbomoso South. Urban tracts that are easy to identify are political wards in the absence of land use segregation, houses numbering and street naming. The wards that had residential having a minimum of 60% of their land use components were surveyed and fifteen out of twenty wards identified in the town were surveyed. The study utilized primary data collected through questionnaire administration The three major road categories (Trunk A-Federal; Trunk B- State; Trunk C-Local) were identified and trunk C-Local roads were purposively selected being the concern of this study because they are the ones often blocked for social activities. The major stakeholders interviewed and the respective sampling methods are residents (random and systematic), social ceremony organizers (purposive), government officials (purposive) and road users namely commercial motorists and commercial motor cyclists (random and incidental). Data analysis was mainly descriptive. Two indices to measure respondents’ perception were developed. These are ‘Hazard Severity Index’ (HSI) and ‘Relative Awareness Index’ (RAI).Thereafter, policy implications and recommendations were provided.

Keywords: road, residential zones, indigenous cities, blocked, social ceremonies

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Authors: Hatice Akbıyık, Hülya Gökmen Özel, Nagehan Emiralioğlu, Elmas Ebru Güneş Yalçın, Deniz Doğru Ersöz, Hayriye Uğur Özçelik, Nural Kiper

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Background: Dietary recommendations in cystic fibrosis (CF) are based on the need to compensate for the increased energy needs of infection, the increased energy cost of breathing and the losses, incurred from malabsorption. Studies in CF indicate that dietary recommendations for CF patients can be difficult to achieve Aim: The aim of this study was to evaluate the energy and nutrient intakes and to compare in accordance with CF dietary guidelines in CF. Methods: One-hundred sixty patients with CF, aged between 2 to 20 years (mean±SD= 7.4±4.8 years) attending Hacettepe University, Faculty of Medicine, Department of Pediatric Pulmonary Diseases were included. Energy and nutrient intakes from foods and enteral products were calculated using a-24-hour dietary recall method with BEBIS 7.2 programme. Percentages of energy and nutrient intakes were compared in accordance with CF dietary guidelines. Patients or/and parents completed a questionnaire showing mealtime problems, usage of alternative therapies and type of nutrition. Statistical analyses were done using SPSS 16.0 programme. Results: It was obtained that 14.5% and 46.9% of the total energy intake were from proteins and carbohydrates, respectively. The actual contribution of total, saturated, monounsaturated and polyunsaturated fats to the total caloric intake was 37.5%, 14.3%, 14.9%, 9.9%, respectively. It was found that 87.7% of energy, 85% of protein 91.7% of carbohydrate, 81.1% of fat intakes were met, when compared CF recommended intakes of 120% RDA. Additionally 67%, 69.5%, 68.2% and 68.9% of the subjects did not achieve CF recommended intakes of 120% RDA for energy, protein, carbohydrate and fat, respectively. Patients with CF had low intakes for age for almost all vitamins and minerals, although supplementation was given. Especially most patients did not achieve the minimum recommended vitamin K intake of 120% RDA. The percentage meeting 120% RDA was 75.9% for vitamin K. It was shown that 41% of the patients had mealtime problems and they skipped the breakfast. Moreover 25.4% of the patients used alternative products outside the standard treatment (such as omega-3, ginger, turmeric, local honey). It was also showed that 60.8% of patients were using enteral products in addition to normal foods, the remaining patients were on only normal foods. Conclusion: The aims of improving nutritional status in children are to achieve normal weight gain and growth; optimize vitamin and mineral status; and slow the rate of clinical decline. In this study although enteral products were used in patients with CF, it was found that energy and nutrient requirements were unable to meet. Because dietary assessment is essential to identify the need for earlier nutritional intervention, in each visit patients need to be referred to CF specialist dietitian.

Keywords: cystic fibrosis, energy and nutrient intakes, mealtime problems, malabsorbtion

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Authors: Jayshree P. Zend, Ashatai B. Pawar

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The study was carried out in Parbhani district of Maharashtra state, India with the objectives to study environmental problems faced by flour mill workers, prevalence of work-related health hazards and the physiological cost of workers while performing work in flour mill in traditional method as well as improved method. The use of flour presser, dust controlling bag and noise and dust controlling mask developed by AICRP College of Home Science, VNMKV, Parbhani was considered as an improved method. This investigation consisted survey and experiment which was conducted in the respective locations of flour mills. Healthy, non-smoking 30 flour mill workers ranged between the age group of 20-50 yrs comprising 16 female and 14 male working at flour mill for 4-8 hrs/ day and 6 days/ week and had minimum five years experience of work in flour mill were selected for the study. Pulmonary function test of flour mill workers was carried out by trained technician at Dr. ShankarraoChavan Government Medical College, Nanded by using Electronic Spirometer. The data regarding heart rate (resting, working and recovery), energy expenditure, musculoskeletal problems and occupational health hazards and accidents were recorded by using pretested questionnaire. Scientific equipment used in the experiment were polar sport test heart rate monitor, Hygrometer, Goniometer, Dialed Thermometer, Sound Level Meter, Lux Meter, Ambient Air Sampler and Air Quality Monitor. The collected data were subjected to appropriate statistical analysis such as 't' test and correlation coefficient test. Results indicated that improved method i.e. use of noise and dust controlling mask, flour presser and dust controlling bag were effective in reducing physiological cost of work of flour mill workers. Lung function test of flour mill workers showed decreased values of all parameters, hence the results of present study support paying attention to use of personal protective noise and dust controlling mask by flour mill workers and also to the working conditions in flour mill especially ventilation and illumination level needs to be enhanced in flour mill. The study also emphasizes the need to develop some mechanism for lifting load of grains and unloading in the hopper. It is also suggested that the flour mill workers should use flour presser suitable to their height to avoid frequent bending and should use dust controlling bag to flour outlet of machine to reduce inhalable flour dust level in the flour mill.

Keywords: physiological cost, energy expenditure, musculoskeletal problems

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Authors: Laura Micheli, Majd Hijazi, Mahmoud Faytarouni

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The damage reported by oil and gas industrial facilities revealed the utmost vulnerability of steel liquid storage tanks to seismic events. The failure of steel storage tanks may yield devastating and long-lasting consequences on built and natural environments, including the release of hazardous substances, uncontrolled fires, and soil contamination with hazardous materials. It is, therefore, fundamental to reliably predict the damage that steel liquid storage tanks will likely experience under future seismic hazard events. The seismic performance of steel liquid storage tanks is usually assessed using vulnerability curves obtained from the numerical simulation of a tank under different hazard scenarios. However, the computational demand of high-fidelity numerical simulation models, such as finite element models, makes the vulnerability assessment of liquid storage tanks time-consuming and often impractical. As a solution, this paper presents a surrogate model-based strategy for predicting seismic-induced damage in steel liquid storage tanks. In the proposed strategy, the surrogate model is leveraged to reduce the computational demand of time-consuming numerical simulations. To create the data set for training the surrogate model, field damage data from past earthquakes reconnaissance surveys and reports are collected. Features representative of steel liquid storage tank characteristics (e.g., diameter, height, liquid level, yielding stress) and seismic excitation parameters (e.g., peak ground acceleration, magnitude) are extracted from the field damage data. The collected data are then utilized to train a surrogate model that maps the relationship between tank characteristics, seismic hazard parameters, and seismic-induced damage via a data-driven surrogate model. Different types of surrogate algorithms, including naïve Bayes, k-nearest neighbors, decision tree, and random forest, are investigated, and results in terms of accuracy are reported. The model that yields the most accurate predictions is employed to predict future damage as a function of tank characteristics and seismic hazard intensity level. Results show that the proposed approach can be used to estimate the extent of damage in steel liquid storage tanks, where the use of data-driven surrogates represents a viable alternative to computationally expensive numerical simulation models.

Keywords: damage prediction , data-driven model, seismic performance, steel liquid storage tanks, surrogate model

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Authors: Peng Guo

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Objective: This study investigates the clinical characteristics of sleep disorders (SD) in patients with Alzheimer's disease (AD) and their relationship with cognitive impairment. Methods: According to the inclusion and exclusion criteria of AD, 460 AD patients were consecutively included in Beijing Tiantan Hospital from January 2016 to April 2022. Demographic data, including gender, age, age of onset, course of disease, years of education and body mass index, were collected. The Pittsburgh sleep quality index (PSQI) scale was used to evaluate the overall sleep status. AD patients with PSQI ≥7 was divided into AD with SD (AD-SD) group, and those with PSQI < 7 were divided into AD with no SD (AD-nSD) group. The overall cognitive function of AD patients was evaluated by the scales of Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA), memory was evaluated by the AVLT-immediate recall, AVLT-delayed recall and CFT-delayed memory scales, the language was evaluated by BNT scale, visuospatial ability was evaluated by CFT-imitation, executive function was evaluated by Stroop-A, Stroop-B and Stroop-C scales, attention was evaluated by TMT-A, TMT-B, and SDMT scales. The correlation between cognitive function and PSQI score in AD-SD group was analyzed. Results: Among the 460 AD patients, 173 cases (37.61%) had SD. There was no significant difference in gender, age, age of onset, course of disease, years of education and body mass index between AD-SD and AD-nSD groups (P>0.05). The factors with significant difference in PSQI scale between AD-SD and AD-nSD groups include sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication and daytime dysfunction (P<0.05). Compared with AD-nSD group, the total scores of MMSE, MoCA, AVLT-immediate recall and CFT-imitation scales in AD-SD group were significantly lower（P＜0.01，P＜0.01，P＜0.01，P＜0.05）. In AD-SD group, subjective sleep quality was significantly and negatively correlated with the scores of MMSE, MoCA, AVLT-immediate recall and CFT-imitation scales (r=-0.277，P=0.000; r=-0.216，P=0.004; r=-0.253，P=0.001; r=-0.239, P=0.004), daytime dysfunction was significantly and negatively correlated with the score of AVLT-immediate recall scale (r=-0.160，P=0.043). Conclusion The incidence of AD-SD is 37.61%. AD-SD patients have worse subjective sleep quality, longer time to fall asleep, shorter sleep time, lower sleep efficiency, severer nighttime SD, more use of sleep medicine, and severer daytime dysfunction. The overall cognitive function, immediate recall and visuospatial ability of AD-SD patients are significantly impaired and are closely correlated with the decline of subjective sleep quality. The impairment of immediate recall is highly correlated with daytime dysfunction in AD-SD patients.

Keywords: Alzheimer's disease, sleep disorders, cognitive impairment, correlation

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Authors: Nisha Govender, Siju Senan, Zeti-Azura Hussein, Wickneswari Ratnam

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Jatropha curcas, a well-described bioenergy crop has been extensively accepted as future fuel need especially in tropical regions. Ideal planting material required for large-scale plantation is still lacking. Breeding programmes for improved J. curcas varieties are rendered difficult due to limitations in genetic diversity. Using a combined transcriptome and physiological data, we investigated the molecular and physiological differences in high and low yielding Jatropha curcas to address plausible heritable variations underpinning these differences, in regard to photosynthesis, a key metabolism affecting yield potentials. A total of 6 individual Jatropha plant from 4 accessions described as high and low yielding planting materials were selected from the Experimental Plot A, Universiti Kebangsaan Malaysia (UKM), Bangi. The inflorescence and shoots were collected for transcriptome study. For the physiological study, each individual plant (n=10) from the high and low yielding populations were screened for agronomic traits, chlorophyll content and stomatal patterning. The J. curcas transcriptomes are available under BioProject PRJNA338924 and BioSample SAMN05827448-65, respectively Each transcriptome was subjected to functional annotation analysis of sequence datasets using the BLAST2Go suite; BLASTing, mapping, annotation, statistical analysis and visualization Large-scale phenotyping of the number of fruits per plant (NFPP) and fruits per inflorescence (FPI) classified the high yielding Jatropha accessions with average NFPP =60 and FPI > 10, whereas the low yielding accessions yielded an average NFPP=10 and FPI < 5. Next generation sequencing revealed genes with differential expressions in the high yielding Jatropha relative to the low yielding plants. Distinct differences were observed in transcript level associated to photosynthesis metabolism. DEGs collection in the low yielding population showed comparable CAM photosynthetic metabolism and photorespiration, evident as followings: phosphoenolpyruvate phosphate translocator chloroplastic like isoform with 2.5 fold change (FC) and malate dehydrogenase (2.03 FC). Green leaves have the most pronounced photosynthetic activity in a plant body due to significant accumulation of chloroplast. In most plants, the leaf is always the dominant photosynthesizing heart of the plant body. Large number of the DEGS in the high-yielding population were found attributable to chloroplast and chloroplast associated events; STAY-GREEN chloroplastic, Chlorophyllase-1-like (5.08 FC), beta-amylase (3.66 FC), chlorophyllase-chloroplastic-like (3.1 FC), thiamine thiazole chloroplastic like (2.8 FC), 1-4, alpha glucan branching enzyme chloroplastic amyliplastic (2.6FC), photosynthetic NDH subunit (2.1 FC) and protochlorophyllide chloroplastic (2 FC). The results were parallel to a significant increase in chlorophyll a content in the high yielding population. In addition to the chloroplast associated transcript abundance, the TOO MANY MOUTHS (TMM) at 2.9 FC, which code for distant stomatal distribution and patterning in the high-yielding population may explain high concentration of CO2. The results were in agreement with the role of TMM. Clustered stomata causes back diffusion in the presence of gaps localized closely to one another. We conclude that high yielding Jatropha population corresponds to a collective function of C3 metabolism with a low degree of CAM photosynthetic fixation. From the physiological descriptions, high chlorophyll a content and even distribution of stomata in the leaf contribute to better photosynthetic efficiency in the high yielding Jatropha compared to the low yielding population.

Keywords: chlorophyll, gene expression, genetic variation, stomata

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Authors: Dorit Alt, Nirit Raichel

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Although university teaching is claimed to have a special task to support students in adopting ways of thinking and producing new knowledge anchored in scientific inquiry practices, it is argued that students' habits of learning are still overwhelmingly skewed toward passive acquisition of knowledge from authority sources rather than from collaborative inquiry activities.This form of instruction is criticized for encouraging students to acquire inert knowledge that can be used in instructional settings at best, however cannot be transferred into real-life complex problem settings. In order to overcome this critical inadequacy between current educational goals and instructional methods, the LLAF consortium (including 16 members from 8 countries) is aimed at developing updated instructional practices that put a premium on adaptability to the emerging requirements of present society. LLAF has created a practical guide for teachers containing updated pedagogical strategies and assessment tools, based on the constructivist approach for learning that put a premium on adaptability to the emerging requirements of present society. This presentation will be limited to teachers' education only and to the contribution of the project in providing a scale designed to measure the extent to which the constructivist activities are efficiently applied in the learning environment. A mix-method approach was implemented in two phases to construct the scale: The first phase included a qualitative content analysis involving both deductive and inductive category applications of students' observations. The results foregrounded eight categories: knowledge construction, authenticity, multiple perspectives, prior knowledge, in-depth learning, teacher- student interaction, social interaction and cooperative dialogue. The students' descriptions of their classes were formulated as 36 items. The second phase employed structural equation modeling (SEM). The scale was submitted to 597 undergraduate students. The goodness of fit of the data to the structural model yielded sufficient fit results. This research elaborates the body of literature by adding a category of in-depth learning which emerged from the content analysis. Moreover, the theoretical category of social activity has been extended to include two distinctive factors: cooperative dialogue and social interaction. Implications of these findings for the LLAF project are discussed.

Keywords: constructivist learning, higher education, mix-methodology, structural equation modeling

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Authors: Ramoshweu Melvin Sethobya, Emmanuel Chirenje, Mihlali Hobo, Simon Sebothoma

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The recent surge in residential infrastructure development around the metropolitan areas of South Africa has necessitated conditions for thorough geotechnical assessments to be conducted prior to site developments to ensure human and infrastructure safety. This paper appraises the success in the application of multi-method geophysical techniques for the delineation of sinkhole vulnerability in a residential landscape. Geophysical techniques ERT, MASW, VES, Magnetics and gravity surveys were conducted to assist in mapping sinkhole vulnerability, using an existing sinkhole as a constraint at Venterspost town, West of Johannesburg city. A combination of different geophysical techniques and results integration from those proved to be useful in the delineation of the lithologic succession around sinkhole locality, and determining the geotechnical characteristics of each layer for its contribution to the development of sinkholes, subsidence and cavities at the vicinity of the site. Study results have also assisted in the determination of the possible depth extension of the currently existing sinkhole and the location of sites where other similar karstic features and sinkholes could form. Results of the ERT, VES and MASW surveys have uncovered dolomitic bedrock at varying depths around the sites, which exhibits high resistivity values in the range 2500-8000ohm.m and corresponding high velocities in the range 1000-2400 m/s. The dolomite layer was found to be overlain by a weathered chert-poor dolomite layer, which has resistivities between the range 250-2400ohm.m, and velocities ranging from 500-600m/s, from which the large sinkhole has been found to collapse/ cave in. A compiled 2.5D high resolution Shear Wave Velocity (Vs) map of the study area was created using 2D profiles of MASW data, offering insights into the prevailing lithological setup conducive for formation various types of karstic features around the site. 3D magnetic models of the site highlighted the regions of possible subsurface interconnections between the currently existing large sinkhole and the other subsidence feature at the site. A number of depth slices were used to detail the conditions near the sinkhole as depth increases. Gravity surveys results mapped the possible formational pathways for development of new karstic features around the site. Combination and correlation of different geophysical techniques proved useful in delineation of the site geotechnical characteristics and mapping the possible depth extend of the currently existing sinkhole.

Keywords: resistivity, magnetics, sinkhole, gravity, karst, delineation, VES

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Authors: Eyob Seife, Molla Alemayaehu, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew

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Globally, immunization averts between 2 and 3 million deaths yearly, but Vaccine-Preventable Diseases still account for more in Sub-Saharan African countries and takes the majority of under-five deaths yearly, which indicates the need for consistent and on-time information to have evidence-based decision so as to save lives of these vulnerable groups. However, ensuring data of sufficient quality and promoting an information-use culture at the point of collection remains critical and challenging, especially in remote areas where the Ararso district is selected based on a hypothesis of there is a difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Ararso district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers and reporting documents were reviewed at 4 health facilities (1 health center and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio, availability and timeliness of reports. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and at the district health office. A quality index (QI), availability and timeliness of reports were assessed. Accuracy ratios formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), TT2+ and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed poor timeliness at all levels and both over-reporting and under-reporting were observed at all levels when computing the accuracy ratio of registration to health post reports found at health centers for almost all antigens verified. A quality index (QI) of all facilities also showed poor results. Most of the verified immunization data accuracy ratios were found to be relatively better than that of quality index and timeliness of reports. So attention should be given to improving the capacity of staff, timeliness of reports and quality of monitoring system components, namely recording, reporting, archiving, data analysis and using information for decisions at all levels, especially in remote and areas.

Keywords: accuracy ratio, ararso district, quality of monitoring system, regular immunization program, timeliness of reports, Somali region-Ethiopia

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Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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Authors: P. L. Madhushi Kavindya

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Sri Lanka is a developing country where hydrology plays an important role in its economic and social growth, followed by irrigation and power generation. Therefore, reservoirs are a principal element of the culture and social status of Sri Lankans. The emergence of a newly built reservoir goes along with a community relocation process which eventually causes alterations in the cultural landscape around it. From the 18th century, the emergence of reservoirs has caused major impacts on the landscape of Sri Lanka. Foremost aspects can be identified as the increased and decreased value of the cultural landscape around a reservoir. Community relocation in regard to reservoir projects is discussed as a key factor in the research. The study further carries out observations and findings of the relocation process of reservoirs in global and local contexts. Consequently, the study discusses the vast study area of ‘cultural landscape’ in brief and its behavior overall. Besides, specific data about reservoir-related cultural landscapes in a worldwide context, along with facts about the evolution, has been discussed. The significance and diversity of the Sri Lankan reservoir-related cultural landscape are explored in the succeeding study. This study will mainly identify the existing constraints and tendencies regarding the relocation process in an overall status. The base for the research has been laid thereafter by broadening the study on alterations which occur in the cultural landscape in relevance to reservoir-related relocation. Uma Oya multipurpose development project is selected as the exemplary study area considering its visible impacts. This analysis will indicate strategies, theories, and methods that can be applied to apprehend the impact of the relocation process on the cultural landscape of reservoirs. The research was carried out by conducting the Uma Oya multipurpose development project case study and by defining its cultural landscape and process of relocation. A suitable theoretical framework is developed in order to assess the set of vulnerable areas of a cultural landscape which are likely to change due to relocation. A questionnaire survey is done in order to assess socio-economic aspects, and a GIS data analysis is conducted to analyze the impact on physical aspects. Findings show that the impacts of the cultural landscape fall under both positive and negative categories. It also shows that the previous condition before resettlement and post stages have significant changes, where the previous condition had more socio-economic benefits for the community. And it also shows a clear alteration pattern of physical environment changes. These specifically developed theories, areas of assessment, and strategies, along with the outcomes, can be used for any location with geographical similarities worldwide.

Keywords: cultural diffusion theory, cultural landscape, physical aspects, relocation, reservoirs, socio-economic aspects

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Authors: Scarlet Tabot Enanga Longsti

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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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Authors: Rajeswari Raguraman, Sowmya Parameswaran, Krishnakumar Subramanian, Jagat Kanwar, Rupinder Kanwar

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Background: Tumor microenvironment has been implicated in several cancers to regulate cell growth, invasion and metastasis culminating in outcome of therapy. Tumor stroma consists of multiple cell types that are in constant cross-talk with the tumor cells to favour a pro-tumorigenic environment. Not much is known about the existence of tumor microenvironment in the pediatric intraocular malignancy, Retinoblastoma (RB). In the present study, we aim to understand the multiple stromal cellular subtypes and tumor stromal interactions expressed in RB tumors. Materials and Methods: Immunohistochemistry for stromal cell markers CD31, CD68, alpha-smooth muscle (α-SMA), vimentin and glial fibrillary acidic protein (GFAP) was performed on formalin fixed paraffin embedded tissues sections of RB (n=12). The differential expression of stromal target molecules; fibroblast activation protein (FAP), tenascin-C (TNC), osteopontin (SPP1), bone marrow stromal antigen 2 (BST2), stromal derived factor 2 and 4 (SDF2 and SDF4) in primary RB tumors (n=20) and normal retina (n=5) was studied by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blotting. The differential expression was correlated with the histopathological features of RB. The interaction between RB cell lines (Weri-Rb-1, NCC-RbC-51) and Bone marrow stromal cells (BMSC) was also studied using direct co-culture and indirect co-culture methods. The functional effect of the co-culture methods on the RB cells was evaluated by invasion and proliferation assays. Global gene expression was studied by using Affymetrix 3’ IVT microarray. Pathway prediction was performed using KEGG and the key molecules were validated using qRT-PCR. Results: The immunohistochemistry revealed the presence of several stromal cell types such as endothelial cells (CD31+;Vim+/-); macrophages (CD68+;Vim+/-); Fibroblasts (Vim+; CD31-;CD68- );myofibroblasts (α-SMA+/ Vim+) and invading retinal astrocytes/ differentiated retinal glia (GFAP+; Vim+). A characteristic distribution of these stromal cell types was observed in the tumor microenvironment, with endothelial cells predominantly seen in blood vessels and macrophages near actively proliferating tumor or necrotic areas. Retinal astrocytes and glia were predominant near the optic nerve regions in invasive tumors with sparse distribution in tumor foci. Fibroblasts were widely distributed with rare evidence of myofibroblasts in the tumor. Both gene and protein expression revealed statistically significant (P<0.05) up-regulation of FAP, TNC and BST2 in primary RB tumors compared to the normal retina. Co-culture of BMSC with RB cells promoted invasion and proliferation of RB cells in direct and indirect contact methods respectively. Direct co-culture of RB cell lines with BMSC resulted in gene expression changes in ECM-receptor interaction, focal adhesion, IL-8 and TGF-β signaling pathways associated with cancer. In contrast, various metabolic pathways such a glucose, fructose and amino acid metabolism were significantly altered under the indirect co-culture condition. Conclusion: The study suggests that the close interaction between RB cells and the stroma might be involved in RB tumor invasion and progression which is likely to be mediated by ECM-receptor interactions and secretory factors. Targeting the tumor stroma would be an attractive option for redesigning treatment strategies for RB.

Keywords: gene expression profiles, retinoblastoma, stromal cells, tumor microenvironment

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Authors: Silvia Baralla, Raffaella Zucaro, Romina Lorenzetti

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Water management needs to cope with economic, societal, and environmental changes. This could be guaranteed through 'shifting from government to governance'. In the last decades, it was applied in Europe through and within important legislative pillars (Water Framework Directive and Common Agricultural Policy) and their measures focused on resilience and adaptation to climate change, with particular attention to the creation of synergies among policies and all the actors involved at different levels. Within the climate change context, the agricultural sector can play, through sustainable water management, a leading role for climate-resilient growth and environmental integrity. A recent analysis on the water management governance of different countries identified some common gaps dealing with administrative, policy, information, capacity building, funding, objective, and accountability. The ability of a country to fill these gaps is an essential requirement to make some of the changes requested by Europe, in particular the improvement of the agro-ecosystem resilience to the effect of climatic change, supporting green and digital transitions, and sustainable water use. This research aims to contribute in sharing examples of water governances and related advantages useful to fill the highlighted gaps. Italy has developed a strong and exhaustive model of water governance in order to react with strategic and synergic actions since it is one of the European countries most threatened by climate change and its extreme events (drought, floods). In particular, the Italian water governance model was able to overcome several gaps, specifically as concerns the water use in agriculture, adopting strategies as a systemic/integrated approach, the stakeholder engagement, capacity building, the improvement of planning and monitoring ability, and an adaptive/resilient strategy for funding activities. They were carried out, putting in place regulatory, structural, and management actions. Regulatory actions include both the institution of technical committees grouping together water decision-makers and the elaboration of operative manuals and guidelines by means of a participative and cross-cutting approach. Structural actions deal with the funding of interventions within European and national funds according to the principles of coherence and complementarity. Finally, management actions regard the introduction of operational tools to support decision-makers in order to improve planning and monitoring ability. In particular, two cross-functional and interoperable web databases were introduced: SIGRIAN (National Information System for Water Resources Management in Agriculture) and DANIA (National Database of Investments for Irrigation and the Environment). Their interconnection allows to support sustainable investments, taking into account the compliance about irrigation volumes quantified in SIGRIAN, ensuring a high level of attention on water saving, and monitoring the efficiency of funding. Main positive results from the Italian water governance model deal with a synergic and coordinated work at the national, regional, and local level among institutions, the transparency on water use in agriculture, a deeper understanding from the stakeholder side of the importance of their roles and of their own potential benefits and the capacity to guarantee continuity to this model, through a sensitization process and the combined use of management operational tools.

Keywords: agricultural sustainability, governance model, water management, water policies

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Authors: Aneta Binkowska, Artur Kamecki

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The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.

Keywords: BLS, first aid, medical rescue, resuscitation

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Authors: Ellen Patricia, Marilou Hyson

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Coaching has been showing great potential to strengthen the impact of brief group trainings and help early childhood teachers solve specific problems at work with the goal of raising the quality of early childhood services. However, there have been some doubts about the benefits that village teachers can receive from coaching. It is perceived that village teachers may struggle with the thinking skills needed to make coaching beneficial. Furthermore, there are reservations about whether principals and supervisors in villages are open to coaching’s facilitative approach, as opposed to the directive approach they have been using. As such, the use of coaching to develop the professionalism of early childhood teachers in the villages needs to be examined. The Coaching Pilot for early childhood teachers in Indonesia villages provides insights for the above issues. The Coaching Pilot is part of the ECED Frontline Pilot, which is a collaboration project between the Government of Indonesia and the World Bank with the support from the Australian Government (DFAT). The Pilot started with coordinated efforts with the local government in two districts to select principals and supervisors who have been equipped with basic knowledge about early childhood education to take part in 2-days coaching training. Afterwards, the participants were asked to collect 25 hours of coaching early childhood teachers who have participated in the Enhanced Basic Training for village teachers. The participants who completed this requirement were then invited to come for an assessment of their coaching skills. Following that, a qualitative evaluation was conducted using in-depth interviews and Focus Group Discussion techniques. The evaluation focuses on the impact of the coaching pilot in helping the village teachers to develop in their professionalism, as well as on the sustainability of the intervention. Results from the evaluation indicated that although their low education may limit their thinking skills, village teachers benefited from the coaching that they received. Moreover, the evaluation results also suggested that with enough training and support, principals and supervisors in the villages were able to provide an adequate coaching service for the teachers. On top of that, beyond this small start, interest is growing, both within the pilot districts and even beyond, due to word of mouth of the benefits that the Coaching Pilot has created. The districts where coaching was piloted have planned to continue the coaching program, since a number of early childhood teachers have requested to be coached, and a number of principals and supervisors have also requested to be trained as a coach. Furthermore, the Association for Early Childhood Educators in Indonesia has started to adopt coaching into their program. Although further research is needed, the Coaching Pilot suggests that coaching can positively impact early childhood teachers in villages, and village principals and supervisors can become a promising source of future coaches. As such, coaching has a significant potential to become a sustainable model for a continuous professional development program for early childhood teachers in villages.

Keywords: coaching, coaching pilot, early childhood teachers, principals and supervisors, village teachers

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Authors: Antonis Skouloudis, Konstantinos Evangelinos, Walter Leal-Filho, Panagiotis Vouros, Ioannis Nikolaou

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Organizational resilience capacity to extreme weather events (EWEs) has sparked a growth in scholarly attention over the past decade as an essential aspect in business continuity management, with supporting evidence for this claim to suggest that it retains a key role in successful responses to adverse situations, crises and shocks. Small and medium-sized enterprises (SMEs) are more vulnerable to face floods compared to their larger counterparts, so they are disproportionately affected by such extreme weather events. The limited resources at their disposal, the lack of time and skills all conduce to inadequate preparedness to challenges posed by floods. SMEs tend to plan in the short-term, reacting to circumstances as they arise and focussing on their very survival. Likewise, they share less formalised structures and codified policies while they are most usually owner-managed, resulting in a command-and-control management culture. Such characteristics result in them having limited opportunities to recover from flooding and quickly turnaround their operation from a loss making to a profit making one. Scholars frame the capacity of business entities to be resilient upon an EWE disturbance (such as flash floods) as the rate of recovery and restoration of organizational performance to pre-disturbance conditions, the amount of disturbance (i.e. threshold level) a business can absorb before losing structural and/or functional components that will alter or cease operation, as well as the extent to which the organization maintains its function (i.e. impact resistance) before performance levels are driven to zero. Nevertheless, while it seems to be accepted as an essential trait of firms effectively transcending uncertain conditions, research deconstructing the enabling conditions and/or inhibitory factors of SMEs resilience capacity to natural hazards is still sparse, fragmentary and mostly fuelled by anecdotal evidence or normative assumptions. Focusing on the individual level of analysis, i.e. the individual enterprise and its endeavours to succeed, the emergent picture from this relatively new research strand delineates the specification of variables, conceptual relationships or dynamic boundaries of resilience capacity components in an attempt to provide prescriptions for policy-making as well as business management. This study will present the development of a flood resilience capacity index (FRCI) and its application to Greek SMEs. The proposed composite indicator pertains to cognitive, behavioral/managerial and contextual factors that influence an enterprise’s ability to shape effective responses to meet flood challenges. Through the proposed indicator-based approach, an analytical framework is set forth that will help standardize such assessments with the overarching aim of reducing the vulnerability of SMEs to flooding. This will be achieved by identifying major internal and external attributes explaining resilience capacity which is particularly important given the limited resources these enterprises have and that they tend to be primary sources of vulnerabilities in supply chain networks, generating Single Points of Failure (SPOF).

Keywords: Floods, Small & Medium-Sized enterprises, organizational resilience capacity, index development

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Authors: B. Bricklin Zeff

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This research explores the development and application of a specialized chatbot tailored for a nursing English course, with a primary objective of augmenting student engagement through situational content and responsiveness to key expressions and vocabulary. Introducing the chatbot, elucidating its purpose, and outlining its functionality are crucial initial steps in the research study, as they provide a comprehensive foundation for understanding the design and objectives of the specialized chatbot developed for the nursing English course. These elements establish the context for subsequent evaluations and analyses, enabling a nuanced exploration of the chatbot's impact on student engagement and language learning within the nursing education domain. The subsequent exploration of the intricate language model development process underscores the fusion of scientific methodologies and artistic considerations in this application of artificial intelligence (AI). Tailored for educators and curriculum developers in nursing, practical principles extending beyond AI and education are considered. Some insights into leveraging technology for enhanced language learning in specialized fields are addressed, with potential applications of similar chatbots in other professional English courses. The overarching vision is to illuminate how AI can transform language learning, rendering it more interactive and contextually relevant. The presented chatbot is a tangible example, equipping educators with a practical tool to enhance their teaching practices. Methodologies employed in this research encompass surveys and discussions to gather feedback on the chatbot's usability, effectiveness, and potential improvements. The chatbot system was integrated into a nursing English course, facilitating the collection of valuable feedback from participants. Significant findings from the study underscore the chatbot's effectiveness in encouraging more verbal practice of target expressions and vocabulary necessary for performance in role-play assessment strategies. This outcome emphasizes the practical implications of integrating AI into language education in specialized fields. This research holds significance for educators and curriculum developers in the nursing field, offering insights into integrating technology for enhanced English language learning. The study's major findings contribute valuable perspectives on the practical impact of the chatbot on student interaction and verbal practice. Ultimately, the research sheds light on the transformative potential of AI in making language learning more interactive and contextually relevant, particularly within specialized domains like nursing.

Keywords: chatbot, nursing, pragmatics, role-play, AI

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Authors: Anusha Vaddiraj Pallapu

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Across the globe, there is a steady increase in people residing in urban areas. Due to this increase in urban population, urban health is affecting. The major issues identified like overcrowding, air pollution, unhealthy diet, inadequate infrastructure, poor solid waste management systems and insufficient access to health facilities, these issues are gradually clearly observed in health statistics of diseases and deaths rapidly increase in urban areas. Therefore, the present study aims to assess the health statistics and infrastructure services at urban areas to know the cause and effect between Infrastructure, its management and diseases (water borne). Most of the Indian cities have the municipal boundaries, which authorized by their respective municipal corporations and development authorities. Generally, cities have various zones under which municipal wards exist. The paper focuses on the city Ahmedabad, at Gujarat state. Ahmedabad Municipal Corporation (AMC) is divided into six zones namely Central zone, West zone, New-West zone, East zone, North zone, and South zone. Each zone includes various wards within it. Incidence of diseases in Ahmadabad which are linked to infrastructure was identified such as water-borne diseases. Later on, the occurrence of water-borne diseases at urban area was examined at each zone level. The study methodology follows four steps i.e. 1) Pre-Field literature study: Study on Sewerage system in urban areas and its best practices and public health status globally and Indian scenario; 2) Field study: Data collection and interviews of stakeholders regarding heal status and issues at each zone and ward level; 3) Post field: Data analysis with qualitative description of each ward of zones, followed by correlation coefficient analysis between sewerage coverage, diseases and density of each ward using geographic information system mapping (GIS); 4) Identification of reasons: Affected health on each of zone and wards followed by correlation analysis on each reason. The results reveal that the health conditions in Ahmedabad municipal zones or boundaries are effected due to the slums created by the migrated people from various rural and urban areas. It is also observed that due to increase in population water supply and sewerage management is affecting. The overall effect on infrastructure is creating the health diseases which detailed in the paper using geographical information system in Indian city.

Keywords: infrastructure, municipal wards, GIS, water supply, sewerage, medical facilities, water borne diseases

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Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

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Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

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Authors: Elham Soltani Dehnavi

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In today’s compact cities, bringing daylighting and fresh air to buildings is a significant challenge, but it also presents opportunities to reduce energy consumption in buildings by reducing the need for artificial lighting and mechanical systems. Simple adjustments to building form can contribute to their efficiency. This paper examines how the relationship between the width and depth of the rooms in office buildings affects visual and thermal comfort, and consequently energy savings. Based on these evaluations, we can determine the best location for sedentary areas in a room. We can also propose improvements to occupant experience and minimize the difference between the predicted and measured performance in buildings by changing other design parameters, such as natural ventilation strategies, glazing properties, and shading. This study investigates the condition of spatial daylighting and thermal comfort for a range of room configurations using computer simulations, then it suggests the best depth for optimizing both daylighting and thermal comfort, and consequently energy performance in each room type. The Window-to-Wall Ratio (WWR) is 40% with 0.8m window sill and 0.4m window head. Also, there are some fixed parameters chosen according to building codes and standards, and the simulations are done in Seattle, USA. The simulation results are presented as evaluation grids using the thresholds for different metrics such as Daylight Autonomy (DA), spatial Daylight Autonomy (sDA), Annual Sunlight Exposure (ASE), and Daylight Glare Probability (DGP) for visual comfort, and Predicted Mean Vote (PMV), Predicted Percentage of Dissatisfied (PPD), occupied Thermal Comfort Percentage (occTCP), over-heated percent, under-heated percent, and Standard Effective Temperature (SET) for thermal comfort that are extracted from Grasshopper scripts. The simulation tools are Grasshopper plugins such as Ladybug, Honeybee, and EnergyPlus. According to the results, some metrics do not change much along the room depth and some of them change significantly. So, we can overlap these grids in order to determine the comfort zone. The overlapped grids contain 8 metrics, and the pixels that meet all 8 mentioned metrics’ thresholds define the comfort zone. With these overlapped maps, we can determine the comfort zones inside rooms and locate sedentary areas there. Other parts can be used for other tasks that are not used permanently or need lower or higher amounts of daylight and thermal comfort is less critical to user experience. The results can be reflected in a table to be used as a guideline by designers in the early stages of the design process.

Keywords: occupant experience, office buildings, space depth, thermal comfort, visual comfort

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Authors: M. Martín-Morales, D. Eliche-Quesada, L. Pérez-Villarejo, M. Zamorano

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Olive oil is a product of particular importance within the Mediterranean and Spanish agricultural food system, and more specifically in Andalusia, owing to be the world's main production area. Olive oil processing generates olive stones which are dried and cleaned to remove pulp and olive stones fines to produce biofuel characterized to have high energy efficiency in combustion processes. Olive stones fine fraction is not too much appreciated as biofuel, so it is important the study of alternative solutions to be valorized. Some researchers have studied recycling different waste to produce ceramic bricks. The main objective of this study is to investigate the effects of olive stones addition on the properties of fired clay bricks for building construction. Olive stones were substituted by volume (7.5%, 15%, and 25%) to brick raw material in three different sizes (lower than 1 mm, lower than 2 mm and between 1 and 2 mm). In order to obtain comparable results, a series without olive stones was also prepared. The prepared mixtures were compacted in laboratory type extrusion under a pressure of 2.5MPa for rectangular shaped (30 mm x 60 mm x 10 mm). Dried and fired industrial conditions were applied to obtain laboratory brick samples. Mass loss after sintering, bulk density, porosity, water absorption and compressive strength of fired samples were investigated and compared with a sample manufactured without biomass. Results obtained have shown that olive stone addition decreased mechanical properties due to the increase in water absorption, although values tested satisfied the requirements in EN 772-1 about methods of test for masonry units (Part 1: Determination of compressive strength). Finally, important advantages related to the properties of bricks as well as their environmental effects could be obtained with the use of biomass studied to produce ceramic bricks. The increasing of the percentage of olive stones incorporated decreased bulk density and then increased the porosity of bricks. On the one hand, this lower density supposes a weight reduction of bricks to be transported, handled as well as the lightening of building; on the other hand, biomass in clay contributes to auto thermal combustion which involves lower fuel consumption during firing step. Consequently, the production of porous clay bricks using olive stones could reduce atmospheric emissions and improve their life cycle assessment, producing eco-friendly clay bricks.

Keywords: clay bricks, olive stones, sustainability, valorization

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Authors: Isabel Brás, Artur Figueirinha, Bruno Esteves, Luísa P. Cruz-Lopes

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The agriculture lignocellulosic by-products are receiving increased attention, namely in the search for filter materials that retain contaminants from water. These by-products, specifically almond and hazelnut shells are abundant in Portugal once almond and hazelnuts production is a local important activity. Hazelnut and almond shells have as main constituents lignin, cellulose and hemicelluloses, water soluble extractives and tannins. Along the adsorption of heavy metals from contaminated waters, water soluble compounds can leach from shells and have a negative impact in the environment. Usually, the chemical characterization of treated water by itself may not show environmental impact caused by the discharges when parameters obey to legal quality standards for water. Only biological systems can detect the toxic effects of the water constituents. Therefore, the evaluation of toxicity by biological tests is very important when deciding the suitability for safe water discharge or for irrigation applications. The main purpose of the present work was to assess the potential impacts of waters after been treated for heavy metal removal by hazelnut and almond shells adsorption systems, with short term acute toxicity tests. To conduct the study, water at pH 6 with 25 mg.L-1 of lead, was treated with 10 g of shell per litre of wastewater, for 24 hours. This procedure was followed for each bark. Afterwards the water was collected for toxicological assays; namely bacterial resistance, seed germination, Lemna minor L. test and plant grow. The effect in isolated bacteria strains was determined by disc diffusion method and the germination index of seed was evaluated using lettuce, with temperature and humidity germination control for 7 days. For aquatic higher organism, Lemnas were used with 4 days contact time with shell solutions, in controlled light and temperature. For terrestrial higher plants, biomass production was evaluated after 14 days of tomato germination had occurred in soil, with controlled humidity, light and temperature. Toxicity tests of water treated with shells revealed in some extent effects in the tested organisms, with the test assays showing a close behaviour as the control, leading to the conclusion that its further utilization may not be considered to create a serious risk to the environment.

Keywords: lignocellulosic wastes, adsorption, acute toxicity tests, risk assessment

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Authors: Manon Ghislain, Timothée Bonnet, Olivier Gimenez, Olivier Dehorter, Pierre-Yves Henry

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Climatic fluctuations affect the demography of animal populations, generating changes in population size, phenology, distribution and community assemblages. However, very few studies have identified the underlying demographic processes. For short-lived species, like common passerine birds, are these changes generated by changes in adult survival or in fecundity and recruitment? This study tests for an effect of annual climatic conditions (spring and winter) on annual, local adult survival at very large spatial (a country, 252 sites), temporal (25 years) and biological (25 species) scales. The Constant Effort Site ringing has allowed the collection of capture - mark - recapture data for 100 000 adult individuals since 1989, over metropolitan France, thus documenting annual, local survival rates of the most common passerine birds. We specifically developed a set of multi-year, multi-species, multi-site Bayesian models describing variations in local survival and recapture probabilities. This method allows for a statistically powerful hierarchical assessment (global versus species-specific) of the effects of climate variables on survival. A major part of between-year variations in survival rate was common to all species (74% of between-year variance), whereas only 26% of temporal variation was species-specific. Although changing spring climate is commonly invoked as a cause of population size fluctuations, spring climatic anomalies (mean precipitation or temperature for March-August) do not impact adult survival: only 1% of between-year variation of species survival is explained by spring climatic anomalies. However, for sedentary birds, winter climatic anomalies (North Atlantic Oscillation) had a significant, quadratic effect on adult survival, birds surviving less during intermediate years than during more extreme years. For migratory birds, we do not detect an effect of winter climatic anomalies (Sahel Rainfall). We will analyze the life history traits (migration, habitat, thermal range) that could explain a different sensitivity of species to winter climate anomalies. Overall, we conclude that changes in population sizes for passerine birds are unlikely to be the consequences of climate-driven mortality (or emigration) in spring but could be induced by other demographic parameters, like fecundity.

Keywords: Bayesian approach, capture-recapture, climate anomaly, constant effort sites scheme, passerine, seasons, survival

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Authors: Hortènsia Curell, Ana Fernández-Montraveta

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This paper presents the creation, development, and analysis of a corpus designed to study the presence of attitude markers and author’s stance in research articles in two different areas of linguistics (theoretical linguistics and sociolinguistics). These two disciplines are expected to behave differently in this respect, given the disparity in their discursive conventions. Attitude markers in this work are understood as the linguistic elements (adjectives, nouns and verbs) used to convey the writer's stance towards the content presented in the article, and are crucial in understanding writer-reader interaction and the writer's position. These attitude markers are divided into three broad classes: assessment, significance, and emotion. In addition to them, we also consider first-person singular and plural pronouns and possessives, modal verbs, and passive constructions, which are other linguistic elements expressing the author’s stance. The corpus, Corpus of Attitude in Academic Writing (CAAW), comprises a collection of 21 articles, collected from six journals indexed in JCR. These articles were originally written in English by a single native-speaker author from the UK or USA and were published between 2022 and 2023. The total number of words in the corpus is approximately 222,400, with 106,422 from theoretical linguistics (Lingua, Linguistic Inquiry and Journal of Linguistics) and 116,022 from sociolinguistics journals (International Journal of the Sociology of Language, Language in Society and Journal of Sociolinguistics). Together with the corpus, we present the tool created for the creation and storage of the corpus, along with a tool for automatic annotation. The steps followed in the compilation of the corpus are as follows. First, the articles were selected according to the parameters explained above. Second, they were downloaded and converted to txt format. Finally, examples, direct quotes, section titles and references were eliminated, since they do not involve the author’s stance. The resulting texts were the input for the annotation of the linguistic features related to stance. As for the annotation, two articles (one from each subdiscipline) were annotated manually by the two researchers. An existing list was used as a baseline, and other attitude markers were identified, together with the other elements mentioned above. Once a consensus was reached, the rest of articles were annotated automatically using the tool created for this purpose. The annotated corpus will serve as a resource for scholars working in discourse analysis (both in linguistics and communication) and related fields, since it offers new insights into the expression of attitude. The tools created for the compilation and annotation of the corpus will be useful to study author’s attitude and stance in articles from any academic discipline: new data can be uploaded and the list of markers can be enlarged. Finally, the tool can be expanded to other languages, which will allow cross-linguistic studies of author’s stance.

Keywords: academic writing, attitude, corpus, english

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Authors: Eva Laryea, Clement Yeboah Authors

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A pretest-posttest within subjects, experimental design was employed to examine the effects of a computerized basic statistics learning game on achievement and statistics-related anxiety of students enrolled in introductory graduate statistics course. Participants (N = 34) were graduate students in a variety of programs at state-funded research university in the Southeast United States. We analyzed pre-test posttest differences using paired samples t-tests for achievement and for statistics anxiety. The results of the t-test for knowledge in statistics were found to be statistically significant indicating significant mean gains for statistical knowledge as a function of the game-based intervention. Likewise, the results of the t-test for statistics-related anxiety were also statistically significant indicating a decrease in anxiety from pretest to posttest. The implications of the present study are significant for both teachers and students. For teachers, using computer games developed by the researchers can help to create a more dynamic and engaging classroom environment, as well as improve student learning outcomes. For students, playing these educational games can help to develop important skills such as problem solving, critical thinking, and collaboration. Students can develop interest in the subject matter and spend quality time to learn the course as they play the game without knowing that they are even learning the presupposed hard course. The future directions of the present study are promising, as technology continues to advance and become more widely available. Some potential future developments include the integration of virtual and augmented reality into educational games, the use of machine learning and artificial intelligence to create personalized learning experiences, and the development of new and innovative game-based assessment tools. It is also important to consider the ethical implications of computer game-based pedagogy, such as the potential for games to perpetuate harmful stereotypes and biases. As the field continues to evolve, it will be crucial to address these issues and work towards creating inclusive and equitable learning experiences for all students. This study has the potential to revolutionize the way basic statistics graduate students learn and offers exciting opportunities for future development and research. It is an important area of inquiry for educators, researchers, and policymakers, and will continue to be a dynamic and rapidly evolving field for years to come.

Keywords: pretest-posttest within subjects, experimental design, achievement, statistics-related anxiety

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Authors: Muhammad Yasir Tarar

Abstract:

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

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Sarah M. Schoellhammer, Stephen Gibb

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Bureaucracy, in particular, its core element, a formal and stable hierarchy of authority, is proving less and less appropriate under the conditions of today’s knowledge economy. Centralization and formalization were consistently found to hinder innovation, undermining cross-functional collaboration, personal responsibility, and flexibility. With its focus on systematical planning, controlling and monitoring the development of new or improved solutions for customers, even innovation management as a discipline is to a significant extent based on a mechanistic understanding of organizations. The most important drivers of innovation, human creativity, and initiative, however, can be more hindered than supported by central elements of classic innovation management, such as predefined innovation strategies, rigid stage gate processes, and decisions made in management gate meetings. Heterarchy, as an alternative network form of organization, is essentially characterized by its dynamic influence structures, whereby the biggest influence is allocated by the collective to the persons perceived the most competent in a certain issue. Theoretical arguments that the non-hierarchical concept better supports innovation than bureaucracy have been supported by empirical research. These prior studies either focus on the structure and general functioning of non-hierarchical organizations or on their innovativeness, that means innovation as an outcome. Complementing classic innovation management approaches, this work aims to shed light on how innovations are initiated and realized in heterarchies in order to identify alternative solutions practiced under conditions of the post-bureaucratic organization. Through an initial individual case study, which is part of a multiple-case project, the innovation practices of an innovative and highly heterarchical medium-sized company in the German fire engineering industry are investigated. In a pragmatic mixed methods approach media resonance, company documents, and workspace architecture are analyzed, in addition to qualitative interviews with the CEO and employees of the case company, as well as a quantitative survey aiming to characterize the company along five scaled dimensions of a heterarchy spectrum. The analysis reveals some similarities and striking differences to approaches suggested by classic innovation management. The studied heterarchy has no predefined innovation strategy guiding new product and service development. Instead, strategic direction is provided by the CEO, described as visionary and creative. Procedures for innovation are hardly formalized, with new product ideas being evaluated on the basis of gut feeling and flexible, rather general criteria. Employees still being hesitant to take responsibility and make decisions, hierarchical influence is still prominent. Described as open-minded and collaborative, culture and leadership were found largely congruent with definitions of innovation culture. Overall, innovation efforts at the case company tend to be coordinated more through cultural than through formal organizational mechanisms. To better enable innovation in mainstream organizations, responsible practitioners are recommended not to limit changes to reducing the central elements of the bureaucratic organization, formalization, and centralization. The freedoms this entails need to be sustained through cultural coordination mechanisms, with personal initiative and responsibility by employees as well as common innovation-supportive norms and values. These allow to integrate diverse competencies, opinions, and activities and, thus, to guide innovation efforts.

Keywords: bureaucracy, heterarchy, innovation management, values

Procedia PDF Downloads 184

Authors: Jonalee Das Bajpai, Sandeep Shastri

Abstract:

The Indian Textile and Garment Industry is one of the major contributors to the country’s economy. This industry is also one of the largest labour intensive industries after agriculture and livestock. This Indian garment industry caters to both the domestic and international market. Although this industry comes under the purview of Indian Labour Laws and other voluntary work place standards yet, this industry is often criticized for the undue exploitation of the workers. This paper explored the status of forced labour and discrimination at work place in the garment manufacturing units in Bengaluru. This study is conducted from the perspective of women sewing operators as majority of operators in Bengaluru are women. The research also explored to study the impact of social compliance certification in abolishing forced labour and discrimination at work place. Objectives of the Research: 1. To study the impact of 'Social Compliance Certification' on abolition of forced labour among the women workforce. 2. To study the impact of 'Social Compliance Certification' on abolition of discrimination at workplace among the women workforce. Sample Size and Data Collection Techniques: The main backbone of the data which is the primary data was collected through a structured questionnaire. The questionnaire attempted to explore the extent of prevalence of forced labour and discrimination against women workers from the perspective of women workers themselves. The sample size for the same was 600 (n) women sewing operators from the garment industry with minimum one year of work experience. Three hundred samples were selected from units with Social Compliance Certification like SA8000, WRAP, BSCI, ETI and so on. Other three hundred samples were selected from units without Social Compliance Certification. Out of these three hundred samples, one hundred and fifty samples were selected from units with Buyer’s Code of Conduct and another one hundred and fifty were from domestic units that do not come under the purview of any such certification. The responses of the survey were further authenticated through on sight visit and personal interactions. Comparative analysis of the workplace environment between units with Social Compliance certification, units with Buyer’s Code of Conduct and domestic units that do not come under the purview of any such voluntary workplace environment enabled to analyze the impact of Social Compliance certification on abolition of workplace environment and discrimination at workplace. Correlation analysis has been conducted to measure the relationship between impact of forced labour and discrimination at workplace on the level of job satisfaction. The result displayed that abolition of forced labour and abolition of discrimination at workplace have a higher level of job satisfaction among the women workers.

Keywords: discrimination, garment industry, forced labour, social compliance certification

Procedia PDF Downloads 191