Search results for: functions of random variables

Authors: Özge Çeliker Tosun, Melda Başer Secer, İsmail Düşmez, Sedat Çapar, İlkay Kozak, Melahat Aktaş, Furkan Can Şimşek, Gökhan Tosun

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Purpose: Portable innovative balance room system with digital game program; It was created to be able to be divided into small areas, such as inside the house, garden, balcony, to enable the person to enter and perform both evaluation and exercise safely, and to ensure that these results can be stored and sent to the therapist live or later when desired. The aim is to compare the effectiveness of the exercise program applied by the elderly within this system and the exercise program implemented under the supervision of a physiotherapist on balance and urinary incontinence symptoms. Materials and Methods: The study was conducted in a randomized controlled manner on 63 people with urinary incontinence (mean age: 75.5 years) at Narlıdere Nursing Home Elderly Care and Rehabilitation Center. Elderly people participating in the study were divided into 3 groups: 1. Group, an exercise program consisting of pelvic floor muscle training and OTOGA exercises, 2. Group, only pelvic floor muscle training, and 3. Group, pelvic floor muscle training and Otoga exercises in the form of a digital game program in a portable balance room system. (self-administered) for 12 weeks. Pelvic floor distress inventory (PTDE-20) and bladder diary were used to evaluate the incontinance symptoms of the cases. Pelvic floor muscle function was evaluated with superficial EMG. Berg, Fall Effectiveness Scale (FES) and Functional Status Evaluations (Chair Stand Test, Eight (8) Food Up and Go Test, Chair Sit and Reach Test, Two Minutes Step Test) were used to evaluate balance. The existence of differences between groups was analyzed using Krusskal Wallis analysis of variance, and the difference between before and after exercise was analyzed with Wilcoxon tests. Results: After treatment, PTDE-20, daily urinary incontinence and toilet visits values decreased significantly in all three groups (p < 0.001). While there was a statistically significant increase in pelvic floor muscle EMG values in the 2nd and third groups after treatment, there was no change in the other group (2nd Group PFM average EMG before-after: 5.5 (4.15-10.95) - 10.95 (8.68-13.68), P=0.05, 3 Group PFM average EMG before-after: 6.5 (4.28-11.55) - 11.75 (8.67-14.26), p=0.04). While BERG score, Chair Stand Test, Eight (8) Food Up and Go Test, and Two Minutes Step Test values increased in all groups (p<0.05), Fall Effectiveness Scale (FES) values did not change after treatment. Conclusion: Although pelvic floor muscle training combined with balance exercises reduces symptoms, it may not lead to a positive improvement in the functions of the pelvic floor muscles. For this reason, recovery lasts for a short time, and then symptoms may reoccur in the future. However, thanks to the new system, when balance exercises are combined with a game program for the pelvic floor muscles, a double effect can be achieved with a single application and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on this subject. However, thanks to the new system, a double effect can be achieved with a single application, and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on new system

Keywords: fall, urinary incontinance, balance, elderly

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Authors: Kenneth Okelo, Esther Waithaka, Maureen Mweru

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Development of oral language skills is a precursor to writing and reading acquisition. Oral skill is a means of communication through which people express their desires, ideas, excitements, amusements, disappointments and exchange information. In addition, oral skills have been found to be an important tool for thinking and concept development in children. Research carried out in industrialised countries have identified some appropriate teaching strategies used to enhance acquisition of oral language skills such as repetition, substitution, explanation, contrast, exemplification and code-switching. However, these studies’ geographical locations do not reflect the diversity of the Kenyan society. In addition, studies conducted in Kenya in the past have not established why pre-primary school teachers are not using appropriate teaching strategies. The purpose of this study was to find out whether teachers’ experience, academic qualification and type of training influences their choice of teaching strategies in the development of oral language skills inside and out of the classroom in selected preschools in Kibra Sub-County, Nairobi County. In addition, this study aimed at finding out the strategies used by teachers in Kibra Sub-County to promote oral skills development among pre-primary school children. The study was guided by Holdaway’s theory of language acquisition. Descriptive survey design was employed during this study. Questionnaires and observation schedules were used to collect data. Eighty-three (83) preschool teachers were sampled using multistage sampling methods for observation. Data was analysed using SPSS version 20. The researcher carried out content analysis on the qualitative data. The main descriptive methods used were tabulation of frequencies and percentages. Chi squire test was the inferential statistic used to test the relationship between variables. The main findings of the study indicate that teaching strategies that were mostly used by pre-primary school teachers were code-switching, examples, repetition, substitution and explanation. While questions, direction, expansion of children words and contrast were the least used teaching strategies when teaching oral language skills. The study revealed that the there is a slight correlation between the type of training of teachers and the teaching strategies as most of DICECE trained teachers used more teaching strategies when teaching oral skills compared to other teachers. The findings also revealed that there was a partial significant correlation between teacher’s academic qualifications and a few teaching strategies. A similar correlation was also observed between teaching experience and a few teaching strategies. Since the strategies used by pre-primary school teachers under the study were less than half of the recommended teaching strategies to promote oral skills, the study recommends that teachers should be encouraged to use more in structural strategies to improve children’s oral language skills.

Keywords: Kenya early childhood education, Kenya education, oral language skills acquisition, teaching methods

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Authors: Su Hui Tsai, Weir Sen Lin, Rhay Hung Weng

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There are numerous outpatient departments at hospitals with enormous amounts of outpatients. Although the work of outpatient nursing staff does not include the ward, emergency and critical care units that involve patient life-threatening conditions, the work is cumbersome and requires facing and dealing with a large number of outpatients in a short period of time. Therefore, nursing staff often do not feel satisfied with their work and cannot identify with their professional role, leading to intentions to leave their job. Thus, the main purpose of this study is to explore the correlation between the job satisfaction and role identity of nursing staff with turnover intention. This research was conducted using a questionnaire, and the subjects were outpatient nursing staff in three regional hospitals in Southern Taiwan. A total of 175 questionnaires were distributed, and 166 valid questionnaires were returned. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The influence of role identity and job satisfaction on nursing staff’s turnover intention was analyzed by descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. Results showed that 'role identity' had significant differences in different types of marriages. Job satisfaction of 'grasp of environment' had significant differences in different levels of education. Job satisfaction of 'professional growth' and 'shifts and days off' showed significant differences in different types of marriages. 'Role identity' and 'job satisfaction' were negatively correlated with turnover intention respectively. Job satisfaction of 'salary and benefits' and 'grasp of environment' were significant predictors of role identity. The higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. Job satisfaction of 'patient and family interaction' were significant predictors of turnover intention. The lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. This study found that outpatient nursing staff had the lowest satisfaction towards salary structure. It is recommended that bonuses, promotion opportunities and other incentives be established to increase the role identity of outpatient nursing staff. The results showed that the higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. It is recommended that regular evaluations be conducted to reward nursing staff with excellent service and invite nursing staff to share their work experiences and thoughts, to enhance nursing staff’s expectation and identification of their occupational role, as well as instilling the concept of organizational service and organizational expectations of emotional display. The results showed that the lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. It is recommended that interpersonal communication and workplace violence prevention educational training courses be organized to enhance the communication and interaction of nursing staff with patients and their families.

Keywords: outpatient, job satisfaction, turnover, intention

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Authors: Ngoc Nguyen

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There is large plantation of Eucalyptus globulus established which has been grown to produce pulpwood. This resource is not suitable for the production of decorative products, principally due to low grades of wood and “dull” appearance but many trials have been already undertaken for the production of veneer and veneer-based engineered wood products, such as plywood and laminated veneer lumber (LVL). The manufacture of veneer-based products has been recently identified as an unprecedented opportunity to promote higher value utilisation of plantation resources. However, many uncertainties remain regarding the impacts of inferior wood quality of young plantation trees on product recovery and value, and with respect to optimal processing techniques. Moreover, the quality of veneer and veneer-based products is far from optimal as trees are young and have small diameters; and the veneers have the significant colour variation which affects to the added value of final products. Developing production methods which would enhance appearance of low-quality veneer would provide a great potential for the production of high-value wood products such as furniture, joinery, flooring and other appearance products. One of the methods of enhancing appearance of low quality veneer, developed in Italy, involves the production of multilaminar veneer, also named “reconstructed veneer”. An important stage of the multilaminar production is colouring the veneer which can be achieved by dyeing veneer with dyes of different colours depending on the type of appearance products, their design and market demand. Although veneer dyeing technology has been well advanced in Italy, it has been focused on poplar veneer from plantation which wood is characterized by low density, even colour, small amount of defects and high permeability. Conversely, the majority of plantation eucalypts have medium to high density, have a lot of defects, uneven colour and low permeability. Therefore, detailed study is required to develop dyeing methods suitable for colouring eucalypt veneers. Brown reactive dye is used for veneer colouring process. Veneers from sapwood and heartwood of two moisture content levels are used to conduct colouring experiments: green veneer and veneer dried to 12% MC. Prior to dyeing, all samples are treated. Both soaking (dipping) and vacuum pressure methods are used in the study to compare the results and select most efficient method for veneer dyeing. To date, the results of colour measurements by CIELAB colour system showed significant differences in the colour of the undyed veneers produced from heartwood part. The colour became moderately darker with increasing of Sodium chloride, compared to control samples according to the colour measurements. It is difficult to conclude a suitable dye solution used in the experiments at this stage as the variables such as dye concentration, dyeing temperature or dyeing time have not been done. The dye will be used with and without UV absorbent after all trials are completed using optimal parameters in colouring veneers.

Keywords: Eucalyptus globulus, veneer colouring/dyeing, multilaminar veneer, reactive dye

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Authors: Jyh-Ping Chen, Yu-Tin Lai

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Wound healing is a complicated process involving overlapping hemostasis, inflammation, proliferation, and maturation phases. Ideal wound dressings can replace native skin functions in full thickness skin wounds through faster healing rate and also by reducing scar formation. Poly(lactic-co-glycolic acid) (PLGA) is an U.S. FDA approved biodegradable polymer to be used as ideal wound dressing material. Several in vitro and in vivo studies have demonstrated the effectiveness of curcumin in decreasing the release of inflammatory cytokines, inhibiting enzymes associated with inflammations, and scavenging free radicals that are the major cause of inflammation during wound healing. Heparin has binding affinities to various growth factors. With the unique and beneficial features offered by those molecules toward the complex process of wound healing, we postulate a composite wound dressing constructed from PLGA, curcumin and heparin would be a good candidate to accelerate scarless wound healing. In this work, we use electrospinning to prepare curcumin-loaded aligned PLGA nanofibrous membranes (PC NFMs). PC NFMs were further subject to oxygen plasma modification and surfaced-grafted with heparin through carbodiimide-mediated covalent bond formation to prepare curcumin-loaded PLGA-g-heparin (PCH) NFMs. The nanofibrous membranes could act as three-dimensional scaffolds to attract fibroblast migration, reduce inflammation, and increase wound-healing related growth factors concentrations at wound sites. From scanning electron microscopy analysis, the nanofibers in each NFM are with diameters ranging from 456 to 479 nm and with alignment angles within  0.5°. The NFMs show high tensile strength and good water absorptivity and provide suitable pore size for nutrients/wastes transport. Exposure of human dermal fibroblasts to the extraction medium of PC or PCH NFM showed significant protective effects against hydrogen peroxide than PLGA NFM. In vitro wound healing assays also showed that the extraction medium of PCH NFM showed significantly better migration ability toward fibroblasts than PC NFM, which is further better than PLGA NFM. The in vivo healing efficiency of the NFMs was further evaluated by a full thickness excisional wound healing diabetic rat model. After 14 days, PCH NFMs exhibits 86% wound closure rate, which is significantly different from other groups (79% for PC and 73% for PLGA NFM). Real-time PCR analysis indicated PC and PCH NFMs down regulated anti-oxidative enzymes like glutathione peroxidase (GPx) and superoxide dismutase (SOD), which are well-known transcription factors involved in cellular inflammatory responses to stimuli. From histology, the wound area treated with PCH NFMs showed more vascular lumen formation from immunohistochemistry of α-smooth muscle actin. The wound site also had more collagen type III (65.8%) expression and less collagen type I (3.5%) expression, indicating scar-less wound healing. From Western blot analysis, the PCH NFM showed good affinity toward growth factors from increased concentration of transforming growth factor-β (TGF-β) and fibroblast growth factor-2 (FGF-2) at the wound site to accelerate wound healing. From the results, we suggest PCH NFM as a promising candidate for wound dressing applications.

Keywords: Curcumin, heparin, nanofibrous membrane, poly(lactic-co-glycolic acid) (PLGA), wound dressing

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Authors: Mohammad Idrees Yusofzai, Hirobata Yasuhiro, Matsuo Kojiro

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Kabul is the capital of Afghanistan. It is the focal point of educational, industrial, etc. of Afghanistan. Additionally, the population of Kabul has grown recently and will increase because of return of refugees and shifting of people from other province to Kabul city. However, this increase in population, the issues of urban congestion and other related problems of urban transportation in Kabul city arises. One of the problems is public transport (large buses) service and needs to be modified and enhanced especially large bus routes that are operating in each zone of the 22 zone of Kabul City. To achieve the above mentioned goal of improving public transport, Spatial Accessibility Analysis is one of the important attributes to assess the effectiveness of transportation system and urban transport policy of a city, because accessibility indicator as an alternative tool to support public policy that aims the reinforcement of sustainable urban space. The case study of this research compares the present model (present bus route) and the modified model of public transport. Furthermore, present model, the bus routes in most of the zones are active, however, with having low frequency and unpublished schedule, and accessibility result is analyzed in four cases, based on the variables of accessibility. Whereas in modified model all zones in Kabul is taken into consideration with having specified origin and high frequency. Indeed the number of frequencies is kept high; however, this number is based on the number of buses Millie Bus Enterprise Authority (MBEA) owns. The same approach of cases is applied in modified model to figure out the best accessibility for the modified model. Indeed, the modified model is having a positive impact in congestion level in Kabul city. Besides, analyses of person trip and trip distribution have been also analyzed because how people move in the study area by each mode of transportation. So, the general aims of this research are to assess the present movement of people, identify zones in need of public transport and assess equity level of accessibility in Kabul city. The framework of methodology used in this research is based on gravity analysis model of accessibility; besides, generalized cost (time) of travel and travel mode is calculated. The main data come from person trip survey, socio-economic characteristics, demographic data by Japan International Cooperation Agency, 2008, study of Kabul city and also from the previous researches on travel pattern and the remaining data regarding present bus line and routes have been from MBEA. In conclusion, this research explores zones where public transport accessibility level is high and where it is low. It was found that both models the downtown area or central zones of Kabul city is having high level accessibility. Besides, the present model is the most unfavorable compared with the modified model based on the accessibility analysis.

Keywords: accessibility, bus generalized cost, gravity model, public transportation network

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Authors: Alison L. Miles

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Almost all major financial institutions in the world suffered losses due to the financial crisis of 2007, but the extent varied widely. The causes of the crash of 2007 are well documented and predominately focus on the role and complexity of the financial markets. The dominant theme of the literature suggests the causes of the crash were a combination of globalization, financial sector innovation, moribund regulation and short termism. While these arguments are undoubtedly true, they do not tell the whole story. A key weakness in the current analysis is the lack of consideration of those leading the banks pre and during times of crisis. This purpose of this study is to examine the possible link between the leadership styles and characteristics of the CEO, CFO and chairman and the financial institutions that failed or needed recapitalization. As such, it contributes to the literature and debate on international financial crises and systemic risk and also to the debate on risk management and regulatory reform in the banking sector. In order to first test the proposition (p1) that there are prevalent leadership characteristics or traits in financial institutions, an initial study was conducted using a sample of the top 65 largest global banks and financial institutions according to the Banker Top 1000 banks 2014. Secondary data from publically available and official documents, annual reports, treasury and parliamentary reports together with a selection of press articles and analyst meeting transcripts was collected longitudinally from the period 1998 to 2013. A computer aided key word search was used in order to identify the leadership styles and characteristics of the chairman, CEO and CFO. The results were then compared with the leadership models to form a picture of leadership in the sector during the research period. As this resulted in separate results that needed combining, SPSS data editor was used to aggregate the results across the studies using the variables ‘leadership style’ and ‘company financial performance’ together with the size of the company. In order to test the proposition (p2) that there was a prevalent leadership style in the banks that failed and the proposition (P3) that this was different to those that did not, further quantitative analysis was carried out on the leadership styles of the chair, CEO and CFO of banks that needed recapitalization, were taken over, or required government bail-out assistance during 2007-8. These included: Lehman Bros, Merrill Lynch, Royal Bank of Scotland, HBOS, Barclays, Northern Rock, Fortis and Allied Irish. The findings show that although regulatory reform has been a key mechanism of control of behavior in the banking sector, consideration of the leadership characteristics of those running the board are a key factor. They add weight to the argument that if each crisis is met with the same pattern of popular fury with the financier, increased regulation, followed by back to business as usual, the cycle of failure will always be repeated and show that through a different lens, new paradigms can be formed and future clashes avoided.

Keywords: banking, financial crisis, leadership, risk

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Authors: Sam Derakhshan Deilami, Iain N. Kings, Lynne E. Macaskie, Brajendra K. Sharma, Anthony V. Bridgwater, Joseph Wood

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This paper reports the application of a bacteria-supported palladium catalyst to the hydrodeoxygenation (HDO) of pyrolysis bio-oil, towards producing an upgraded transport fuel. Biofuels are key to the timely replacement of fossil fuels in order to mitigate the emissions of greenhouse gases and depletion of non-renewable resources. The process is an essential step in the upgrading of bio-oils derived from industrial by-products such as agricultural and forestry wastes, the crude oil from pyrolysis containing a large amount of oxygen that requires to be removed in order to create a fuel resembling fossil-derived hydrocarbons. The bacteria supported catalyst manufacture is a means of utilizing recycled metals and second life bacteria, and the metal can also be easily recovered from the spent catalysts after use. Comparisons are made between bio-Pd, and a conventional activated carbon supported Pd/C catalyst. Bio-oil was produced by fast pyrolysis of beechwood at 500 C at a residence time below 2 seconds, provided by Aston University. 5 wt % BioPd/C was prepared under reducing conditions, exposing cells of E. coli MC4100 to a solution of sodium tetrachloropalladate (Na2PdCl4), followed by rinsing, drying and grinding to form a powder. Pd/C was procured from Sigma-Aldrich. The HDO experiments were carried out in a 100 mL Parr batch autoclave using ~20g bio-crude oil and 0.6 g bio-Pd/C catalyst. Experimental variables investigated for optimization included temperature (160-350C) and reaction times (up to 5 h) at a hydrogen pressure of 100 bar. Most of the experiments resulted in an aqueous phase (~40%) and an organic phase (~50-60%) as well as gas phase (<5%) and coke (<2%). Study of the temperature and time upon the process showed that the degree of deoxygenation increased (from ~20 % up to 60 %) at higher temperatures in the region of 350 C and longer residence times up to 5 h. However minimum viscosity (~0.035 Pa.s) occurred at 250 C and 3 h residence time, indicating that some polymerization of the oil product occurs at the higher temperatures. Bio-Pd showed a similar degree of deoxygenation (~20 %) to Pd/C at lower temperatures of 160 C, but did not rise as steeply with temperature. More coke was formed over bio-Pd/C than Pd/C at temperatures above 250 C, suggesting that bio-Pd/C may be more susceptible to coke formation than Pd/C. Reactions occurring during bio-oil upgrading include catalytic cracking, decarbonylation, decarboxylation, hydrocracking, hydrodeoxygenation and hydrogenation. In conclusion, it was shown that bio-Pd/C displays an acceptable rate of HDO, which increases with residence time and temperature. However some undesirable reactions also occur, leading to a deleterious increase in viscosity at higher temperatures. Comparisons are also drawn with earlier work on the HDO of Chlorella derived bio-oil manufactured from micro-algae via hydrothermal liquefaction. Future work will analyze the kinetics of the reaction and investigate the effect of bi-metallic catalysts.

Keywords: bio-oil, catalyst, palladium, upgrading

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Authors: Ritika Chaturvedi

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Introduction: Sexual objectification, characterized by the reduction of an individual to a mere object of sexual desire, remains a pervasive societal issue with profound repercussions on individual well-being. Such experiences, often rooted in systemic and cultural norms, have long-lasting implications for mental and emotional health. This study aims to explore the intricate relationship between experiences of sexual objectification and insidious trauma, further investigating the potential moderating effects of overexcitabilities as proposed by Dabrowski's theory of positive disintegration. Methodology: The research involved a comprehensive cohort of 204 women, spanning ages from 18 to 65 years. Participants were tasked with completing self-administered questionnaires designed to capture their experiences with sexual objectification. Additionally, the questionnaire assessed symptoms indicative of insidious trauma and explored overexcitabilities across five distinct domains: emotional, intellectual, psychomotor, sensory, and imaginational. Employing advanced statistical techniques, including multiple regression and moderation analysis, the study sought to decipher the intricate interplay among these variables. Findings: The study's results revealed a compelling positive correlation between experiences of sexual objectification and the onset of symptoms indicative of insidious trauma. This correlation underscores the profound and detrimental effects of sexual objectification on an individual's psychological well-being. Interestingly, the moderation analyses introduced a nuanced understanding, highlighting the differential roles of various overexcitabilities. Specifically, emotional, intellectual, and sensual overexcitabilities were found to exacerbate trauma symptomatology. In contrast, psychomotor overexcitability emerged as a protective factor, demonstrating a mitigating influence on the relationship between sexual objectification and trauma. Implications: The study's findings hold significant implications for a diverse array of stakeholders, encompassing mental health practitioners, educators, policymakers, and advocacy groups. The identified moderating effects of overexcitabilities emphasize the need for tailored interventions that consider individual differences in coping and resilience mechanisms. By recognizing the pivotal role of overexcitabilities in modulating the traumatic consequences of sexual objectification, this research advocates for the development of more nuanced and targeted support frameworks. Moreover, the study underscores the importance of continued research endeavors to unravel the intricate mechanisms and dynamics underpinning these relationships. Such endeavors are crucial for fostering the evolution of informed, evidence-based interventions and strategies aimed at mitigating the adverse effects of sexual objectification and promoting holistic well-being.

Keywords: sexual objectification, insidious trauma, emotional overexcitability, intellectual overexcitability, sensual overexcitability, psychomotor overexcitability, imaginational overexcitability

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Authors: Matteo Gentilucci, Marco Materazzi, Gilberto Pambianchi

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Climate change is an increasingly central issue in the world, because it affects many of human activities. In this context regional studies are of great importance because they sometimes differ from the general trend. This research focuses on a small area of central Italy which overlooks the Adriatic Sea, the province of Macerata. The aim is to analyze space-based climate changes, for precipitation and temperatures, in the last 3 climatological standard normals (1961-1990; 1971-2000; 1981-2010) through GIS software. The data collected from 30 weather stations for temperature and 61 rain gauges for precipitation were subject to quality controls: validation and homogenization. These data were fundamental for the spatialization of the variables (temperature and precipitation) through geostatistical techniques. To assess the best geostatistical technique for interpolation, the results of cross correlation were used. The co-kriging method with altitude as independent variable produced the best cross validation results for all time periods, among the methods analysed, with 'root mean square error standardized' close to 1, 'mean standardized error' close to 0, 'average standard error' and 'root mean square error' with similar values. The maps resulting from the analysis were compared by subtraction between rasters, producing 3 maps of annual variation and three other maps for each month of the year (1961/1990-1971/2000; 1971/2000-1981/2010; 1961/1990-1981/2010). The results show an increase in average annual temperature of about 0.1°C between 1961-1990 and 1971-2000 and 0.6 °C between 1961-1990 and 1981-2010. Instead annual precipitation shows an opposite trend, with an average difference from 1961-1990 to 1971-2000 of about 35 mm and from 1961-1990 to 1981-2010 of about 60 mm. Furthermore, the differences in the areas have been highlighted with area graphs and summarized in several tables as descriptive analysis. In fact for temperature between 1961-1990 and 1971-2000 the most areally represented frequency is 0.08°C (77.04 Km² on a total of about 2800 km²) with a kurtosis of 3.95 and a skewness of 2.19. Instead, the differences for temperatures from 1961-1990 to 1981-2010 show a most areally represented frequency of 0.83 °C, with -0.45 as kurtosis and 0.92 as skewness (36.9 km²). Therefore it can be said that distribution is more pointed for 1961/1990-1971/2000 and smoother but more intense in the growth for 1961/1990-1981/2010. In contrast, precipitation shows a very similar shape of distribution, although with different intensities, for both variations periods (first period 1961/1990-1971/2000 and second one 1961/1990-1981/2010) with similar values of kurtosis (1st = 1.93; 2nd = 1.34), skewness (1st = 1.81; 2nd = 1.62 for the second) and area of the most represented frequency (1st = 60.72 km²; 2nd = 52.80 km²). In conclusion, this methodology of analysis allows the assessment of small scale climate change for each month of the year and could be further investigated in relation to regional atmospheric dynamics.

Keywords: climate change, GIS, interpolation, co-kriging

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Authors: Agâh Tuğrul Korucu, Ismail Fatih Yavuzaslan, Lale Toraman

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Nowadays, thanks to development of technology, integration of technology into teaching and learning activities is spreading. Increasing technological literacy which is one of the expected competencies for individuals of 21st century is associated with the effective use of technology in education. The most important factor in effective use of technology in education institutions is ICT teachers. The concept of computer assisted instruction (CAI) refers to the utilization of information and communication technology as a tool aided teachers in order to make education more efficient and improve its quality in the process of educational. Teachers can use computers in different places and times according to owned hardware and software facilities and characteristics of the subject and student in CAI. Analyzing teachers’ use of computers in education is significant because teachers are the ones who manage the course and they are the most important element in comprehending the topic by students. To accomplish computer-assisted instruction efficiently is possible through having positive attitude of teachers. Determination the level of knowledge, attitude and behavior of teachers who get the professional knowledge from educational faculties and elimination of deficiencies if any are crucial when teachers are at the faculty. Therefore, the aim of this paper is to identify ICT teachers' attitudes toward computer-assisted instruction in terms of different variables. Research group consists of 200 prospective ICT teachers studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education CEIT department. As data collection tool of the study; “personal information form” developed by the researchers and used to collect demographic data and "the attitude scale related to computer-assisted instruction" are used. The scale consists of 20 items. 10 of these items show positive feature, while 10 of them show negative feature. The Kaiser-Meyer-Olkin (KMO) coefficient of the scale is found 0.88 and Barlett test significance value is found 0.000. The Cronbach’s alpha reliability coefficient of the scale is found 0.93. In order to analyze the data collected by data collection tools computer-based statistical software package used; statistical techniques such as descriptive statistics, t-test, and analysis of variance are utilized. It is determined that the attitudes of prospective instructors towards computers do not differ according to their educational branches. On the other hand, the attitudes of prospective instructors who own computers towards computer-supported education are determined higher than those of the prospective instructors who do not own computers. It is established that the departments of students who previously received computer lessons do not affect this situation so much. The result is that; the computer experience affects the attitude point regarding the computer-supported education positively.

Keywords: computer based instruction, teacher candidate, attitude, technology based instruction, information and communication technologies

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Authors: Antonio Munar-Frau, Sascha Klismoch, Manfred Schmolz, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

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Introduction: Biocompatibility of biomaterials has been proposed as one of the main criteria for treatment success. For guided bone regeneration (GBR), barrier membranes present a conflict given the number of origins and modifications of these materials. The biologic response to biomaterials is orchestrated by a series of events leading to the integration or rejection of the biomaterial, posing questions such as if a longer occlusive property may trigger an inflammatory reaction. Whole blood cultures are a solution to study the immune response to drugs or biomaterials during the first 24-48 hours. The aim of this study is to determine the early immune response of different origins and chemical modifications of barrier membranes. Materials & Methods: 5 different widely used barrier membranes were included in this study: Acellular dermal matrix (AlloDerm, LifeCell®), Porcine Peritoneum (BioGide, Geistlich Pharma®), Porcine Pericardium (Jason, Botiss Biomaterials GmbH®), Porcine Cross-linked collagen (Ossix Plus, Datum Dental®) and d-PTFE (Cytoplast TXT, Osteogenics Biomedical®). Blood samples were extracted from 3 different healthy donors and incubated with the different samples of barrier membranes for 24 hours. After the incubation time, serum samples were obtained and analyzed by means of biocompatibility assays taking into account 42 markers. Results: In an early stage of the inflammatory response, the Acellular dermal matrix, porcine peritoneum and porcine cross-linked collagen expressed similar patterns of cytokine expression with a great manifestation of ENA 78. Porcine pericardium and d-PTFE presented similar cytokine activation, especially for MMP-3 and MMP-9, although other cytokines were highlighted with lower expression. For the later immune response, Porcine peritoneum and acellular dermal matrix MCP-1 and IL-15 were evident. Porcine pericardium, porcine cross-linked collagen and d-PTFE presented a high expression of IL-16 and lower manifestation of other cytokines. Different behaviors depending on an earlier or later stage of the inflammation process were observed. Barrier membrane inflammatory expression does not only differ depending on the origin, variables such as treatment of the collagen and polymers may also have a great impact on the cytokine expression of the studied barrier membranes during inflammation. Conclusions: Surface treatment and modifications might affect the biocompatibility of the membranes, as different cytokine expressions were evidently depending on the origin of the biomaterial. This study is only a brushstroke regarding the biocompatibility of materials, as it is one of the pioneer studies for ex vivo barrier membranes assays. Studies regarding surface modification are needed in order to clarify mystifications of barrier membrane science.

Keywords: biomaterials, bone regeneration, biocompatibility, inflammation

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Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

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Authors: Margareth Guimaraes Lima, Marilisa Berti A. Barros, Deborah Carvalho Malta

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The relationship between physical activity (PA) and depression has been investigated, in both, observational and clinical studies: PA can integrate the treatments for depression; the physical inactivity (PI) may contribute to increase depression symptoms; and on the other hand, emotional problems can decrease PA. The main of this study was analyze the association among leisure and transportation PI and time watching television (TV) according to depression (minor and major), evaluated with the Patient Health Questionnaire (PHQ-9). The association was also analyzed by gender. This is a cross-sectional study. Data were obtained from the National Health Survey 2013 (PNS), performed with representative sample of the Brazilian adult population, in 2013. The PNS collected information from 60,202 individuals, aged 18 years or more. The independent variable were: leisure time physical inactivity (LTPI), considering inactive or insufficiently actives (categories were linked for analyzes), those who do not performed a minimum of 150 or 74 minutes of moderate or vigorous LTPA, respectively, by week; transportation physical inactivity (TPI), individuals who did not reached 150 minutes, by week, travelling by bicycle or on foot to work or other activities; daily time watching TV > 5 hours. The principal independent variable was depression, identified by PHQ-9. Individuals were classified with major depression, with > 5 symptoms, more than seven days, but one of the symptoms was “depressive mood” or “lack of interest or pleasure”. The others had minor depression. The variables used to adjustment were gender, age, schooling and chronic disease. The prevalence of LTPI, TPI and TV time were estimated according to depression, and differences were tested with Chi-Square test. Adjusted prevalence ratios were estimated using multiple Poisson regression models. The analyzes also had stratification by gender. Mean age of the studied population was 42.9 years old (CI95%:42.6-43.2) and 52.9% were women. 77.5% and 68.1% were inactive or insufficiently active in leisure and transportation, respectively and 13.3% spent time watching TV 5 > hours. 6% and 4.1% of the Brazilian population were diagnosed with minor or major depression. LTPI prevalence was 5% and 9% higher among individuals with minor and major depression, respectively, comparing with no depression. The prevalence of TPI was 7% higher in those with major depression. Considering larger time watching TV, the prevalence was 45% and 74% higher among those with minor and major depression, respectively. Analyzing by gender, the associations were greater in men than women and TPI was note be associated, in women. The study detected the higher prevalence of leisure time physical inactivity and, especially, time spent watching TV, among individuals with major and minor depression, after to adjust for a number of potential confounding factors. TPI was only associated with major disorders and among men. Considering the cross-sectional design of the research, these associations can point out the importance of the mental problems control of the population to increase PA and decrease the sedentary lifestyle; on the other hand, the study highlight the need of interventions by encouraging people with depression, to practice PA, even to transportation.

Keywords: depression, physical activity, PHQ-9, sedentary lifestyle

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Authors: Alemayehu Hailemicael Mezgebe, A. J. Solomon Raju

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Context: Lake Chamo is a significant lake in the Ethiopian Rift Valley, known for its diversity of wildlife and vegetation. However, the lake is facing various threats due to human activities and global effects. The poor management of resources could lead to food insecurity, ecological degradation, and loss of biodiversity. Research Aim: The aim of this study is to analyze the environmental implications of lake level changes using GIS and remote sensing. The research also aims to examine the floristic composition of the lakeside vegetation and propose spatially oriented environmental planning for the sustainable utilization of the biodiversity resources. Methodology: The study utilizes multi-temporal satellite images and aerial photographs to analyze the changes in the lake area over the past 45 years. Geospatial analysis techniques are employed to assess land use and land cover changes and change detection matrix. The composition and role of the lakeside vegetation in the ecological and hydrological functions are also examined. Findings: The analysis reveals that the lake has shrunk by 14.42% over the years, with significant modifications to its upstream segment. The study identifies various threats to the lake-wetland ecosystem, including changes in water chemistry, overfishing, and poor waste management. The study also highlights the impact of human activities on the lake's limnology, with an increase in conductivity, salinity, and alkalinity. Floristic composition analysis of the lake-wetland ecosystem showed definite pattern of the vegetation distribution. The vegetation composition can be generally categorized into three belts namely, the herbaceous belt, the legume belt and the bush-shrub-small trees belt. The vegetation belts collectively act as different-sized sieve screen system and calm down the pace of incoming foreign matter. This stratified vegetation provides vital information to decide the management interventions for the sustainability of lake-wetland ecosystem.Theoretical Importance: The study contributes to the understanding of the environmental changes and threats faced by Lake Chamo. It provides insights into the impact of human activities on the lake-wetland ecosystem and emphasizes the need for sustainable resource management. Data Collection and Analysis Procedures: The study utilizes aerial photographs, satellite imagery, and field observations to collect data. Geospatial analysis techniques are employed to process and analyze the data, including land use/land cover changes and change detection matrices. Floristic composition analysis is conducted to assess the vegetation patterns Question Addressed: The study addresses the question of how lake level changes and human activities impact the environmental health and biodiversity of Lake Chamo. It also explores the potential opportunities and threats related to water utilization and waste management. Conclusion: The study recommends the implementation of spatially oriented environmental planning to ensure the sustainable utilization and maintenance of Lake Chamo's biodiversity resources. It emphasizes the need for proper waste management, improved irrigation facilities, and a buffer zone with specific vegetation patterns to restore and protect the lake outskirt.

Keywords: buffer zone, geo-spatial, lake chamo, lake level changes, sustainable utilization

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Authors: Buket Celik Ünal, Onur Ünal

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Communication is the most challenging part of maintenance operations. Communication between expert and fieldworker is crucial for effective maintenance and this also affects the safety of the fieldworkers. To support a machine user in a remote collaborative physical task, both, a mobile and a stationary device are needed. Such a system is called a shared vision system and the system supports two people to solve a problem from different places. This system reduces the errors and provides a reliable support for qualified and less qualified users. Through this research, it was aimed to validate the effectiveness of using a shared vision system to facilitate communication between on-site workers and those issuing instructions regarding maintenance or inspection works over long distances. The system is designed with head-worn display which is called a shared vision system. As a part of this study, a substitute system is used and implemented by using a shared vision system for maintenance operation. The benefits of the use of a shared vision system are analyzed and results are adapted to the wind turbines to improve the occupational safety and health for maintenance technicians. The motivation for the research effort in this study can be summarized in the following research questions: -How can expert support technician over long distances during maintenance operation? -What are the advantages of using a shared vision system? Experience from the experiment shows that using a shared vision system is an advantage for both electrical and mechanical system failures. Results support that the shared vision system can be used for wind turbine maintenance and repair tasks. Because wind turbine generator/gearbox and the substitute system have similar failures. Electrical failures, such as voltage irregularities, wiring failures and mechanical failures, such as alignment, vibration, over-speed conditions are the common and similar failures for both. Furthermore, it was analyzed the effectiveness of the shared vision system by using a smart glasses in connection with the maintenance task performed by a substitute system under four different circumstances, namely by using a shared vision system, an audio communication, a smartphone and by yourself condition. A suitable method for determining dependencies between factors measured in Chi Square Test, and Chi Square Test for Independence measured for determining a relationship between two qualitative variables and finally Mann Whitney U Test is used to compare any two data sets. While based on this experiment, no relation was found between the results and the gender. Participants` responses confirmed that the shared vision system is efficient and helpful for maintenance operations. From the results of the research, there was a statistically significant difference in the average time taken by subjects on works using a shared vision system under the other conditions. Additionally, this study confirmed that a shared vision system provides reduction in time to diagnose and resolve maintenance issues, reduction in diagnosis errors, reduced travel costs for experts, and increased reliability in service.

Keywords: communication support, maintenance and inspection tasks, occupational health and safety, shared vision system

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Authors: Dian Mayasari, Yosi Bayu Murti, Sylvia Utami Tunjung Pratiwi, Sudarsono

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Melastoma malabathricum L. is an Indo-Pacific herb that has been traditionally used to treat several ailments such as wounds, dysentery, diarrhea, toothache, and diabetes. This plant is common across tropical Indo-Pacific archipelagos and is tolerant of a range of soils, from low-lying areas subject to saltwater inundation to the salt-free conditions of mountain slopes. How the soil and environmental variation influences secondary metabolite production in the herb, and an understanding of the plant’s utility as traditional medicine, remain largely unknown and unexplored. The objective of this study is to evaluate the variability of the metabolic profiles of M. malabathricum L. across its geographic distribution. By employing high-performance liquid chromatography-diode array detector (HPLC-DAD), a highly established, simple, sensitive, and reliable method was employed for establishing the chemical fingerprints of 72 samples of M. malabathricum L. leaves from various geographical locations in Indonesia. Specimens collected from six terrestrial and archipelago regions of Indonesia were analyzed by HPLC to generate chromatogram peak profiles that could be compared across each region. Data corresponding to the common peak areas of HPLC chromatographic fingerprint were analyzed by hierarchical component analysis (HCA) and principal component analysis (PCA) to extract information on the most significant variables contributing to characterization and classification of analyzed samples data. Principal component values were identified as PC1 and PC2 with 41.14% and 19.32%, respectively. Based on variety and origin, the high-performance liquid chromatography method validated the chemical fingerprint results used to screen the in vitro antioxidant activity of M. malabathricum L. The result shows that the developed method has potential values for the quality of similar M. malabathrium L. samples. These findings provide a pathway for the development and utilization of references for the identification of M. malabathricum L. Our results indicate the importance of considering geographic distribution during field-collection efforts as they demonstrate regional metabolic variation in secondary metabolites of M. malabathricum L., as illustrated by HPLC chromatogram peaks and their antioxidant activities. The results also confirm the utility of this simple approach to a rapid evaluation of metabolic variation between plants and their potential ethnobotanical properties, potentially due to the environments from whence they were collected. This information will facilitate the optimization of growth conditions to suit particular medicinal qualities.

Keywords: fingerprint, high performance liquid chromatography, Melastoma malabathricum l., metabolic profiles, principal component analysis

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Authors: Martin Grootveld, Benita Percival, Sarah Moumtaz, Kerry L. Grootveld

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Objectives/Hypotheses: The adverse health effect potential of dietary lipid oxidation products (LOPs) has evoked much clinical interest. Therefore, we employed a ¹H NMR-linked Principal Component Regression (PCR) chemometrics modelling strategy to explore relationships between data matrices comprising (1) aldehydic LOP concentrations generated in culinary oils/fats when exposed to laboratory-simulated shallow frying practices, and (2) the prior saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acid (PUFA) contents of such frying media (FM), together with their heating time-points at a standard frying temperature (180 ^oC). Methods: Corn, sunflower, extra virgin olive, rapeseed, linseed, canola, coconut and MUFA-rich algae frying oils, together with butter and lard, were heated according to laboratory-simulated shallow-frying episodes at 180 ^oC, and FM samples were collected at time-points of 0, 5, 10, 20, 30, 60, and 90 min. (n = 6 replicates per sample). Aldehydes were determined by ¹H NMR analysis (Bruker AV 400 MHz spectrometer). The first (dependent output variable) PCR data matrix comprised aldehyde concentration scores vectors (PC1* and PC2*), whilst the second (predictor) one incorporated those from the fatty acid content/heating time variables (PC1-PC4) and their first-order interactions. Results: Structurally complex trans,trans- and cis,trans-alka-2,4-dienals, 4,5-epxy-trans-2-alkenals and 4-hydroxy-/4-hydroperoxy-trans-2-alkenals (group I aldehydes predominantly arising from PUFA peroxidation) strongly and positively loaded on PC1*, whereas n-alkanals and trans-2-alkenals (group II aldehydes derived from both MUFA and PUFA hydroperoxides) strongly and positively loaded on PC2*. PCR analysis of these scores vectors (SVs) demonstrated that PCs 1 (positively-loaded linoleoylglycerols and [linoleoylglycerol]:[SFA] content ratio), 2 (positively-loaded oleoylglycerols and negatively-loaded SFAs), 3 (positively-loaded linolenoylglycerols and [PUFA]:[SFA] content ratios), and 4 (exclusively orthogonal sampling time-points) all powerfully contributed to aldehydic PC1* SVs (p 10^-3 to < 10^-9), as did all PC1-3 x PC4 interaction ones (p 10^-5 to < 10^-9). PC2* was also markedly dependent on all the above PC SVs (PC2 > PC1 and PC3), and the interactions of PC1 and PC2 with PC4 (p < 10^-9 in each case), but not the PC3 x PC4 contribution. Conclusions: NMR-linked PCR analysis is a valuable strategy for (1) modelling the generation of aldehydic LOPs in heated cooking oils and other FM, and (2) tracking their unsaturated fatty acid (UFA) triacylglycerol sources therein.

Keywords: frying oils, lipid oxidation products, frying episodes, chemometrics, principal component regression, NMR Analysis, cytotoxic/genotoxic aldehydes

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Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

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The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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Authors: Saul Estrin, Ute Stephan, Suncica Vujic

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Background and research question: Gender differences in pay are present at all organisational levels, including at the very top. One possible way for women to circumvent organizational norms and discrimination is to engage in entrepreneurship because, as CEOs of their own organizations, entrepreneurs largely determine their own pay. While commercial entrepreneurship plays an important role in job creation and economic growth, social entrepreneurship has come to prominence because of its promise of addressing societal challenges such as poverty, social exclusion, or environmental degradation through market-based rather than state-sponsored activities. This opens the research question whether social entrepreneurship might be a form of entrepreneurship in which the pay of men and women is the same, or at least more similar; that is to say there is little or no gender pay gap. If the gender gap in pay persists also at the top of social enterprises, what are the factors, which might explain these differences? Methodology: The Oaxaca-Blinder Decomposition (OBD) is the standard approach of decomposing the gender pay gap based on the linear regression model. The OBD divides the gender pay gap into the ‘explained’ part due to differences in labour market characteristics (education, work experience, tenure, etc.), and the ‘unexplained’ part due to differences in the returns to those characteristics. The latter part is often interpreted as ‘discrimination’. There are two issues with this approach. (i) In many countries there is a notable convergence in labour market characteristics across genders; hence the OBD method is no longer revealing, since the largest portion of the gap remains ‘unexplained’. (ii) Adding covariates to a base model sequentially either to test a particular coefficient’s ‘robustness’ or to account for the ‘effects’ on this coefficient of adding covariates might be problematic, due to sequence-sensitivity when added covariates are correlated. Gelbach’s decomposition (GD) addresses latter by using the omitted variables bias formula, which constructs a conditional decomposition thus accounting for sequence-sensitivity when added covariates are correlated. We use GD to decompose the differences in gaps of pay (annual and hourly salary), size of the organisation (revenues), effort (weekly hours of work), and sources of finances (fees and sales, grants and donations, microfinance and loans, and investors’ capital) between men and women leading social enterprises. Database: Our empirical work is made possible by our collection of a unique dataset using respondent driven sampling (RDS) methods to address the problem that there is as yet no information on the underlying population of social entrepreneurs. The countries that we focus on are the United Kingdom, Spain, Romania and Hungary. Findings and recommendations: We confirm the existence of a gender pay gap between men and women leading social enterprises. This gap can be explained by differences in the accumulation of human capital, psychological and social factors, as well as cross-country differences. The results of this study contribute to a more rounded perspective, highlighting that although social entrepreneurship may be a highly satisfying occupation, it also perpetuates gender pay inequalities.

Keywords: Gelbach’s decomposition, gender gap, returns to social entrepreneurship, values and preferences

Procedia PDF Downloads 220

Authors: Joanne DiFrancisco-Donoghue, Seth E. Jenny, Peter C. Douris, Sophia Ahmad, Kyle Yuen, Hillary Gan, Kenney Abraham, Amber Sousa

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Background: Guidelines for the maintenance of health of esports players and the cognitive changes that accompany competitive gaming are understudied. Executive functioning is an important cognitive skill for an esports player. The relationship between executive functions and physical exercise has been well established. However, the effects of prolonged sitting regardless of physical activity level have not been established. Prolonged uninterrupted sitting reduces cerebral blood flow. Reduced cerebral blood flow is associated with lower cognitive function and fatigue. This decrease in cerebral blood flow has been shown to be offset by frequent and short walking breaks. These short breaks can be as little as 2 minutes at the 30-minute mark and 6 minutes following 60 minutes of prolonged sitting. The rationale is the increase in blood flow and the positive effects this has on metabolic responses. The primary purpose of this study was to evaluate executive function changes following 6-minute bouts of walking and complete rest mid-session, compared to no break, during prolonged gameplay in competitive first-person shooter (FPS) esports players. Methods: This study was conducted virtually due to the Covid-19 pandemic and was approved by the New York Institute of Technology IRB. Twelve competitive FPS participants signed written consent to participate in this randomized pilot study. All participants held a gold ranking or higher. Participants were asked to play for 2 hours on three separate days. Outcome measures to test executive function included the Color Stroop and the Tower of London tests which were administered online each day prior to gaming and at the completion of gaming. All participants completed the tests prior to testing for familiarization. One day of testing consisted of a 6-minute walk break after 60-75 minutes of play. The Rate of Perceived Exertion (RPE) was recorded. The participant continued to play for another 60-75 minutes and completed the tests again. Another day the participants repeated the same methods replacing the 6-minute walk with lying down and resting for 6 minutes. On the last day, the participant played continuously with no break for 2 hours and repeated the outcome tests pre and post-play. A Latin square was used to randomize the treatment order. Results: Using descriptive statistics, the largest change in mean reaction time incorrect congruent pre to post play was seen following the 6-minute walk (662.0 (609.6) ms pre to 602.8 (539.2) ms post), followed by the 6-minute rest group (681.7(618.1) ms pre to 666.3 (607.9) ms post), and with minimal change in the continuous group (594.0(534.1) ms pre to 589.6(552.9) ms post). The mean solution time was fastest in the resting condition (7774.6(6302.8)ms), followed by the walk condition (7929.4 (5992.8)ms), with the continuous condition being slowest (9337.3(7228.7)ms). the continuous group 9337.3(7228.7) ms; 7929.4 (5992.8 ) ms 774.6(6302.8) ms. Conclusion: Short walking breaks improve blood flow and reduce the risk of venous thromboembolism during prolonged sitting. This pilot study demonstrated that a low intensity 6 -minute walk break, following 60 minutes of play, may also improve executive function in FPS gamers.

Keywords: executive function, FPS, physical activity, prolonged sitting

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Authors: Rosimeire Araújo Silva, Philip Martin Fearnside

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Extreme droughts and floods in the Amazon have serious consequences for natural ecosystems and the human population in the region. The frequency of these events has increased in recent years, and projections of climate change predict greater frequency and intensity of these events. Understanding the links between these extreme events and different patterns of sea surface temperature in the Atlantic and Pacific Oceans is essential, both to improve the modeling of climate change and its consequences and to support efforts of adaptation in the region. The relationship between sea temperatures and events in the Amazon is much more complex than is usually assumed in climatic models. Warming and cooling of different parts of the oceans, as well as the interaction between simultaneous temperature changes in different parts of each ocean and between the two oceans, have specific consequences for the Amazon, with effects on precipitation that vary in different parts of the region. Simplistic generalities, such as the association between El Niño events and droughts in the Amazon, do not capture this complexity. We investigated the variability of Sea Surface Temperature (SST) in the Tropical Pacific Ocean during the period 1950-2022, using Empirical Orthogonal Functions (FOE), spectral analysis coherence and wavelet phase. The two were identified as the main modes of variability, which explain about 53,9% and 13,3%, respectively, of the total variance of the data. The spectral and coherence analysis and wavelets phase showed that the first selected mode represents the warming in the central part of the Pacific Ocean (the “Central El Niño”), while the second mode represents warming in the eastern part of the Pacific (the “Eastern El Niño The effects of the 1982-1983 and 1976-1977 El Niño events in the Amazon, although both events were characterized by an increase in sea surface temperatures in the Equatorial Pacific, the impact on rainfall in the Amazon was distinct. In the rainy season, from December to March, the sub-basins of the Japurá, Jutaí, Jatapu, Tapajós, Trombetas and Xingu rivers were the regions that showed the greatest reductions in rainfall associated with El Niño Central (1982-1983), while the sub-basins of the Javari, Purus, Negro and Madeira rivers had the most pronounced reductions in the year of Eastern El Niño (1976-1977). In the transition to the dry season, in April, the greatest reductions were associated with the Eastern El Niño year for the majority of the study region, with the exception only of the sub-basins of the Madeira, Trombetas and Xingu rivers, which had their associated reductions to Central El Niño. In the dry season from July to September, the sub-basins of the Japurá Jutaí Jatapu Javari Trombetas and Madeira rivers were the rivers that showed the greatest reductions in rainfall associated with El Niño Central, while the sub-basins of the Tapajós Purus Negro and Xingu rivers had the most pronounced reductions. In the Eastern El Niño year this season. In this way, it is possible to conclude that the Central (Eastern) El Niño controlled the reductions in soil moisture in the dry (rainy) season for all sub-basins shown in this study. Extreme drought events associated with these meteorological phenomena can lead to a significant increase in the occurrence of forest fires. These fires have a devastating impact on Amazonian vegetation, resulting in the irreparable loss of biodiversity and the release of large amounts of carbon stored in the forest, contributing to the increase in the greenhouse effect and global climate change.

Keywords: sea surface temperature, variability, climate, Amazon

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Authors: Neelofar, Khursheed Alam, Jamal Ahmad

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Protein modification in diabetes mellitus may lead to early glycation products (EGPs) or amadori product as well as advanced glycation end products (AGEs). Early glycation involves the reaction of glucose with N-terminal and lysyl side chain amino groups to form Schiff’s base which undergoes rearrangements to form more stable early glycation product known as Amadori product. After Amadori, the reactions become more complicated leading to the formation of advanced glycation end products (AGEs) that interact with various AGE receptors, thereby playing an important role in the long-term complications of diabetes. Millard reaction or nonenzymatic glycation reaction accelerate in diabetes due to hyperglycation and alter serum protein’s structure, their normal functions that lead micro and macro vascular complications in diabetic patients. In this study, Human Serum Albumin (HSA) with a constant concentration was incubated with different concentrations of glucose at 370C for a week. At 4th day, Amadori product was formed that was confirmed by colorimetric method NBT assay and TBA assay which both are authenticate early glycation product. Conformational changes in native as well as all samples of Amadori albumin with different concentrations of glucose were investigated by various biophysical and biochemical techniques. Main biophysical techniques hyperchromacity, quenching of fluorescence intensity, FTIR, CD and SDS-PAGE were used. Further conformational changes were observed by biochemical assays mainly HMF formation, fructoseamine, reduction of fructoseamine with NaBH4, carbonyl content estimation, lysine and arginine residues estimation, ANS binding property and thiol group estimation. This study find structural and biochemical changes in Amadori modified HSA with normal to hyperchronic range of glucose with respect to native HSA. When glucose concentration was increased from normal to chronic range biochemical and structural changes also increased. Highest alteration in secondary and tertiary structure and conformation in glycated HSA was observed at the hyperchronic concentration (75mM) of glucose. Although it has been found that Amadori modified proteins is also involved in secondary complications of diabetes as AGEs but very few studies have been done to analyze the conformational changes in Amadori modified proteins due to early glycation. Most of the studies were found on the structural changes in Amadori protein at a particular glucose concentration but no study was found to compare the biophysical and biochemical changes in HSA due to early glycation with a range of glucose concentration at a constant incubation time. So this study provide the information about the biochemical and biophysical changes occur in Amadori modified albumin at a range of glucose normal to chronic in diabetes. Although many implicates currently in use i.e. glycaemic control, insulin treatment and other chemical therapies that can control many aspects of diabetes. However, even with intensive use of current antidiabetic agents more than 50 % of diabetic patient’s type 2 suffers poor glycaemic control and 18 % develop serious complications within six years of diagnosis. Experimental evidence related to diabetes suggests that preventing the nonenzymatic glycation of relevant proteins or blocking their biological effects might beneficially influence the evolution of vascular complications in diabetic patients or quantization of amadori adduct of HSA by authentic antibodies against HSA-EGPs can be used as marker for early detection of the initiation/progression of secondary complications of diabetes. So this research work may be helpful for the same.

Keywords: diabetes mellitus, glycation, albumin, amadori, biophysical and biochemical techniques

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Authors: Festus Okotie

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Nigeria is the giant of Africa with great and diverse transport potentials yet to be fully tapped into and explored.it is the most populated nation in Africa with nearly 200 million people, the sixth largest oil producer overall and largest oil producer in Africa with proven oil and gas reserves of 37 billion barrels and 192 trillion cubic feet, over 300 square kilometers of arable land and significant deposits of largely untapped minerals. A world bank indicator which measures trading across border ranked Nigeria at 183 out of 185 countries in 2017 and although different governments in the past made efforts through different interventions such as 2007 ports reforms led by Ngozi Okonjo-Iweala, a former minister of Finance and world bank managing director also attempted to resolve some of the challenges such as infrastructure shortcomings, policy and regulatory inconsistencies, overlapping functions and duplicated roles among the different MDA’S. It is one of the fundamental structures smart nations and cities are using to improve the living conditions of its citizens and achieving sustainability. Examples of some of its benefits includes tracking high pedestrian areas, traffic patterns, railway stations, planning and scheduling bus times, it also enhances interoperability, creates alerts of transport situation and has swift capacity to share information among the different platforms and transport modes. It also offers a comprehensive approach to risk management, putting emergency procedures and response capabilities in place, identifying dangers, including vandalism or violence, fare evasion, and medical emergencies. The Nigerian transport system is urgently in need of modern infrastructures such as ITS. Smart city transport technology helps cities to function productively, while improving services for businesses and lives of is citizens. This technology has the ability to improve travel across traditional modes of transport, such as cars and buses, with immediate benefits for city dwellers and also helps in managing transport systems such as dangerous weather conditions, heavy traffic, and unsafe speeds which can result in accidents and loss of lives. Intelligent transportation systems help in traffic control such as permitting traffic lights to react to changing traffic patterns, instead of working on a fixed schedule in traffic. Intelligent transportation systems is very important in Nigeria’s transportation sector and so would require trained personnel to drive its efficiency to greater height because the purpose of introducing it is to add value and at the same time reduce motor vehicle miles and traffic congestion which is a major challenge around Tin can island and Apapa Port, a major transportation hub in Nigeria. The need for the federal government, state governments, houses of assembly to organise a national transportation workshop to begin the process of addressing the challenges in our nation’s transport sector is highly expedient and so bills that will facilitate the implementation of policies to promote intelligent transportation systems needs to be sponsored because of its potentials to create thousands of jobs for our citizens, provide farmers with better access to cities and a better living condition for Nigerians.

Keywords: intelligent, transport, system, Nigeria

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Authors: Fabrizio Ascione, Martina Borrelli, Rosa Francesca De Masi, Silvia Ruggiero, Giuseppe Peter Vanoli

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The refurbishment of public buildings is one of the key factors of energy efficiency policy of European States. Educational buildings account for the largest share of the oldest edifice with interesting potentialities for demonstrating best practice with regards to high performance and low and zero-carbon design and for becoming exemplar cases within the community. In this context, this paper discusses the critical issue of dealing the energy refurbishment of a university building in heating dominated climate of South Italy. More in detail, the importance of using validated models will be examined exhaustively by proposing an analysis on uncertainties due to modelling assumptions mainly referring to the adoption of stochastic schedules for occupant behavior and equipment or lighting usage. Indeed, today, the great part of commercial tools provides to designers a library of possible schedules with which thermal zones can be described. Very often, the users do not pay close attention to diversify thermal zones and to modify or to adapt predefined profiles, and results of designing are affected positively or negatively without any alarm about it. Data such as occupancy schedules, internal loads and the interaction between people and windows or plant systems, represent some of the largest variables during the energy modelling and to understand calibration results. This is mainly due to the adoption of discrete standardized and conventional schedules with important consequences on the prevision of the energy consumptions. The problem is surely difficult to examine and to solve. In this paper, a sensitivity analysis is presented, to understand what is the order of magnitude of error that is committed by varying the deterministic schedules used for occupation, internal load, and lighting system. This could be a typical uncertainty for a case study as the presented one where there is not a regulation system for the HVAC system thus the occupant cannot interact with it. More in detail, starting from adopted schedules, created according to questioner’ s responses and that has allowed a good calibration of energy simulation model, several different scenarios are tested. Two type of analysis are presented: the reference building is compared with these scenarios in term of percentage difference on the projected total electric energy need and natural gas request. Then the different entries of consumption are analyzed and for more interesting cases also the comparison between calibration indexes. Moreover, for the optimal refurbishment solution, the same simulations are done. The variation on the provision of energy saving and global cost reduction is evidenced. This parametric study wants to underline the effect on performance indexes evaluation of the modelling assumptions during the description of thermal zones.

Keywords: energy simulation, modelling calibration, occupant behavior, university building

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Authors: Adi Sharabi, Dafna Marom-Golan

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Parents’ involvement in the care of their children with Autism Spectrum Disorder (ASD) and its beneficial effect on the children’s developmental and educational outcomes is well documented. At the same time, parents of children with ASD tend to experience greater psychological distress than parents of children with other developmental disabilities or with typical development. Positive social support is an important resource used by parents to reduce their psychological distress. The goal of the current research was to examine the contribution of formal and informal social support in explaining mothers’ and fathers’ involvement with their young children with ASD. The sample consisted of 107 parents who live in Israel (61 mothers and 46 fathers) of children aged between 2 and 7, all diagnosed with ASD and attending special kindergartens or special day care for children with ASD. Parental involvement and social support perception were assessed. Initial analysis focused on the relations between involvement, support, and demographic variables. In addition, analysis of variance (ANOVA) was conducted to test differences between mothers and fathers. Two hierarchical multiple regression analyses were performed to examine the predicted factors in the involvement model while controlling for group (mothers/fathers). Results indicate that mothers reported significantly higher levels of parenting involvement than fathers. Mothers reported higher levels of general involvement and all sub-types of involvement. For example, mothers reported that they were more interested in and have higher levels of attendance in their child’s educational program. They were also more collaborative in their child’s educational therapeutic program, and socialized with other parents of children from their child’s kindergarten than fathers. Mothers’ involvement was found to be related to their informal support (non-formal relatives). Findings also reveal significant differences between mothers and fathers on the formal support subscale measure of specializes services. Fathers, more than mothers, reported more specializes services support such as social workers or professional therapists. Separate hierarchical multiple regression analyses revealed a unique gender difference in the factors that explained parental involvement. Specifically, informal support only had a unique positive contribution in explaining mothers’, but not fathers’ involvement. This study highlights the central role of mothers in maintaining constant contact with the educational system and the professionals who help care for their child with ASD. At the same time, this research emphasizes the crucial role of both mothers and fathers in their child's development and well-being at every development stage, particularly in early development. Further, different kinds of social support seem to relate to the different kinds of parental involvement. It is in the best interest of educators and family therapists who work with families with children with ASD to support the cohesiveness of the family and the collaboration of the parents by understanding and respecting the way each member addresses the responsibilities of parenting a child with ASD, and her or his need for different types of social support.

Keywords: parental differences, parental involvement, social support, specialized support services

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Authors: Rasmita Mishra, Chander Shekher

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Background: Population ageing is an inevitable outcome of demographic transition. Due to increased life expectancy, the old age population in India and worldwide has increased, and it will continue to grow more alarmingly in the near future. There are redundant austerity that has been bestowed upon the widows, thus, the life of widows is never been easy in India. The loss of spouse along with other disadvantaged socioeconomic intermediaries like illiteracy and poverty often make the life of widows more difficult to live. Methodology: Ethical statement: The study used secondary data available in the public domain for its wider use in social research. Thus, there was no requirement of ethical consent in the present study. Data source: Building a Knowledge Base on Population Aging in India (BKPAI), 2011 dataset is used to fulfill the objectives of this study. It was carried out in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal – having a higher percentage of the population in the age group 60 years and above compared to the national average. Statistical analysis: Descriptive and inferential statistics were used to understand the level of elderly widows and incidence of abuse against them in India and selected states. Bivariate and Trivariate analysis were carried out to check the pattern of abuse by selected covariates. Chi-Square test is used to verify the significance of the association. Further, Discriminant Analysis (DA) is carried out to understand which factor can separate out group of neglect and non-neglect elderly. Result: With the addition of 27 million from 2001 to 2011, the total elderly population in India is more than 100 million. Elderly females aged 60+ were more widows than their counterpart elderly males. This pattern was observed across selected states and at national level. At national level, more than one tenth (12 percent) of elderly experienced abuse in their lifetime. Incidence of abuse against elderly widows within family was considerably higher than the outside the family. This pattern was observed across the selected place and abuse in the study. In discriminant analysis, the significant difference between neglected and non-neglected elderly on each of the independent variables was examined using group mean and ANOVA. Discussion: The study is the first of its kind to assess the incidence of abuse against elderly widows using large-scale survey data. Another novelty of this study is that it has assessed for those states in India whereby the proportion of elderly is higher than the national average. Place and perpetrators involved in the abuse against elderly widows certainly envisaged the safeness in the present living arrangement of elderly widows. Conclusion: Due to the increasing life expectancy it is expected that the number of elderly will increase much faster than before. As biologically women live longer than men, there will be more women elderly than men. With respect to the living arrangement, after the demise of the spouse, elderly widows are more likely to live with their children who emerged as the main perpetrator of abuse.

Keywords: elderly abuse, emotional abuse physical abuse, material abuse, psychological abuse, quality of life

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Authors: Hakimeh Masoudigavgani

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Since manufacturing firms deplete non-renewable resources and pollute air, soil, and water in greatly unsustainable manner, industrial activities or production of products are considered to be a key contributor to adverse environmental impacts. Hence, management strategies and approaches that involve an effective supply chain decision process in a manufacturing sector could be extremely significant to the application of environmental initiatives. Green manufacturing (GM) is one of these strategies which minimises negative effects on the environment through reducing greenhouse gas emissions, waste, and the consumption of energy and natural resources. This paper aims to explore what greening methods and mechanisms could be applied in the manufacturing supply chain and what are the outcomes of adopting these methods in terms of abating environmental burdens? The study is an interpretive research with an exploratory approach, using thematic analysis by coding text, breaking down and grouping the content of collected literature into various themes and categories. It is found that green supply chain could be attained through execution of some pre-production strategies including green building, eco-design, and green procurement as well as a number of in-production and post-production strategies involving green manufacturing and green logistics. To achieve an effective GM, the pre-production strategies are suggested to be employed. This paper defines GM as (1) the analysis of the ecological impacts generated by practices, products, production processes, and operational functions, and (2) the implementation of greening methods to reduce damaging influences of them on the natural environment. Analysis means assessing, monitoring, and auditing of practices in order to measure and pinpoint their harmful impacts. Moreover, greening methods involved within GM (arranged in order from the least to the most level of environmental compliance and techniques) consist of: •product stewardship (e.g. less use of toxic, non-renewable, and hazardous materials in the manufacture of the product; and stewardship of the environmental problems with regard to the product in all production, use, and end-of-life stages); •process stewardship (e.g. controlling carbon emission, energy and resources usage, transportation method, and disposal; reengineering polluting processes; recycling waste materials generated in production); •lean and clean production practices (e.g. elimination of waste, materials replacement, materials reduction, resource-efficient consumption, energy-efficient usage, emission reduction, managerial assessment, waste re-use); •use of eco-industrial parks (e.g. a shared warehouse, shared logistics management system, energy co-generation plant, effluent treatment). However, the focus of this paper is only on methods related to the in-production phase and needs further research on both pre-production and post-production environmental innovations. The outlined methods in this investigation may possibly be taken into account by policy/decision makers. Additionally, the proposed future research direction and identified gaps can be filled by scholars and researchers. The paper compares and contrasts a variety of viewpoints and enhances the body of knowledge by building a definition for GM through synthesising literature and categorising the strategic concept of greening methods, drivers, barriers, and successful implementing tactics.

Keywords: green manufacturing (GM), product stewardship, process stewardship, clean production, eco-industrial parks (EIPs)

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Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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