Search results for: regional anesthesia

Authors: A. S. CohenMiller, Jenifer Lewis, Gwen McEvoy, Kristy Kelly

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This international, interdisciplinary study presents the first stage of a gender mainstreaming project within one university as a microcosm of society in Kazakhstan to make concrete policy recommendations and set up the potential for new research to monitor change over time. Local, regional, and UN representatives have noted the critical need and interest in gender related issues in Kazakhstan. Gender mainstreaming has been noted as a strategy to understand and address gender equality and equity such as within the academy in exploring and examining organizational/management issues, university decision-making and leadership, assessing the overall academic climate, discrimination issues, hiring and promotion, and student recruitment and retention. This presentation provides preliminary findings from the university gender audit, highlighting key elements for moving forward in gender mainstreaming. The full study analyzes findings from the full gender audit including interview with key stakeholders, time-use surveys, participant-observations and interviews with female students, staff and faculty, and reviews of formal organizational policies and practices.

Keywords: academia, equity, Eurasia, gender audit, gender mainstreaming, Kazakhstan, policy, time-use survey

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Authors: Yousif Mohamed Y. Abdallah, Eltayeb Wagi Allah Eltayeb, Mohamed E. Gar-elnabi, Mohamed Ahmed Ali

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To characterize coronary artery obstruction and related findings in ischemic heart patients using cardiac scintigraphy for the identification of myocardial ischemia, 146 patients were studied at basal conditions and also asked for fasting after night till the intravenous injection of the radiopharmaceutical. After the injection time about 15 to 20 minutes, the patient should eat a fatty meal and chocolate for the good excretion of the gall bladder, to evaluate the performance and regional wall motion of the left ventricle (LV). The results showed that the body mass index percentage in this sample was in range of 43.05 to 61.05. The number of patients who were catheter candidates were 56 with 43% and the patients that were not candidate to cathode were 74 patients with 57% of all patients. For the group of patients where type of ischemia was assessed, 29.5% of patients had reversible posterior and inferior wall, 15.1% of patients had fixed large from apex to base, 9.6% of patients had mild basal inferior wall, 4.8 % of patients had mild anterior wall, 6.2% of patients had antro-septal and 34.9% of patients had moderate ischemia.

Keywords: myocardial ischemia, myocardial scintigraphy, contrast ventriculography, coronary artery obstruction

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Authors: Amit Bhattacharyya

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The economic scenario of any region does not show the real picture for the measurement of overall development. Therefore, economic development must be accompanied by social development to be able to make an assessment to measure the level of development. The spatial variation with respect to social development has been discussed taking into account the quality of functioning of a social system in a specific area. In this paper, an attempt has been made to study the spatial distribution of social infrastructural facilities and analyze the magnitude of regional disparities at inter- block level in Barddhman district. It starts with the detailed account of the selection process of social infrastructure indicators and describes the methodology employed in the empirical analysis. Analyzing the block level data, this paper tries to identify the disparity among the blocks in the levels of social development. The results have been subsequently explained using both statistical analysis and geo spatial technique. The paper reveals that the social development is not going on at the same rate in every part of the district. Health facilities and educational facilities are concentrated at some selected point. So overall development activities come to be concentrated in a few centres and the disparity is seen over the blocks.

Keywords: disparity, inter-block, social development, spatial variation

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Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

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Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

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Authors: Halima Benazzouz

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It is often believed that British English and American English are the foremost varieties of the English Language serving as reference norms for other varieties;that is the reason why they have obviously been compared and contrasted.Meanwhile,the terms “British English” and “American English” are used differently by different people to refer to: 1) Two national varieties each subsuming regional and other sub-varieties standard and non-standard. 2) Two national standard varieties in which each one is only part of the range of English within its own state, but the most prestigious part. 3) Two international varieties, that is each is more than a national variety of the English Language. 4) Two international standard varieties that may or may not each subsume other standard varieties.Furthermore,each variety serves as a reference norm for users of the language elsewhere. Moreover, without a clear identification, as primarily belonging to one variety or the other, British English(Br.Eng) and American English (Am.Eng) are understood as national or international varieties. British English and American English are both “variants” and “varieties” of the English Language, more similar than different.In brief, the following may justify general categories of difference between Standard American English (S.Am.E) and Standard British English (S.Br.e) each having their own sociolectic value: A difference in pronunciation exists between the two foremost varieties, although it is the same spelling, by contrast, a divergence in spelling may be recognized, eventhough the same pronunciation. In such case, the same term is different but there is a similarity in spelling and pronunciation. Otherwise, grammar, syntax, and punctuation are distinctively used to distinguish the two varieties of the English Language. Beyond these differences, spelling is noted as one of the chief sources of variation.

Keywords: Greek, Latin, French pronunciation expert, varieties of English language

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Authors: Adetoun Adedotun Amubode

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Nigeria's Textile Industry was the second largest in Africa after Egypt, with above 250 vibrant factories and over 50 percent capacity utilization contributing to foreign exchange earnings and employment generation. Currently, multifaceted challenges such as epileptic power supply, inconsistent government policies, growing digitalization, smuggling of foreign textiles, insecurity and the inability of the local industries to compete with foreign products, especially Chinese textile, has created a hostile environment for the sector. This led to the closure of most of the textile industries. China's textile industry has experienced institutional change and industrial restructuring, having 30% of the world's market share. This paper examined the strategies adopted by China in transforming her textile and clothing industries and designed a model for the integration of these strategies to improve the competitive strength and growth of the Nigerian textile and clothing industries in a dynamic and changing market. The paper concludes that institutional support, regional production, export-oriented policy, value-added and branding cultivation, technological upgrading and enterprise resource planning be integrated into the Nigerian clothing and textile industries.

Keywords: clothing, industry, integration, Nigerian, textile, transformation.

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Authors: Margaret S. Wright

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Background/Significance: During many recent public health emergencies/disasters, public health nursing data has been missing or delayed, potentially impacting the decision-making and response. Data used as evidence for decision-making in response, planning, and mitigation has been erratic and slow, decreasing the ability to respond. Methodology: Applying best practices in data management and data use in public health settings, and guided by the concepts outlined in ‘Disaster Standards of Care’ models leads to the development of recommendations for a model of best practices in data management and use in public health disasters/emergencies by public health nurses. As the ‘patient’ in public health disasters/emergencies is the community (local, regional or national), guidelines for patient documentation are incorporated in the recommendations. Findings: Using model public health nurses could better plan how to prepare for, respond to, and mitigate disasters in their communities, and better participate in decision-making in all three phases bringing public health nursing data to the discussion as part of the evidence base for decision-making.

Keywords: data management, decision making, disaster planning documentation, public health nursing

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Authors: Paul Ojeaga

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Can the level of innovation use drive un-validated business models across regions? To what extent does industrial sector attractiveness drive firm’s success across regions at the time of start-up? This study examines the role of innovation on start-up success in six regions of the world (namely Sub Saharan Africa, the Middle East and North Africa, Latin America, South East Asia Pacific, the European Union and the United States representing North America) using macroeconomic variables. While there have been studies using firm level data, results from such studies are not suitable for national policy decisions. The need to drive a regional innovation policy also begs for an answer, therefore providing room for this study. Results using dynamic panel estimation show that innovation counts in the early infancy stage of new business life cycle. The results are robust even after controlling for time fixed effects and the study present variance-covariance estimation robust standard errors.

Keywords: industrial economics, un-validated business models, scalable models, entrepreneurship

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Authors: Rajkumar Ghosh

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The paper presents a comprehensive study of the structural analysis of the Chaura Thrust in Himachal Pradesh, India. The research focuses on several key aspects, including the activation timing of the Main Central Thrust (MCT) and the South Tibetan Detachment System (STDS), the identification and characterization of mylonitised zones through microscopic examination, and the understanding of box fold characteristics and their implications in the regional geology of the Himachal Himalaya. The primary objective of the study is to provide field documentation of the Chaura Thrust, which was previously considered a blind thrust with limited field evidence. Additionally, the research aims to characterize box folds and their signatures within the broader geological context of the Himachal Himalaya, document the temperature range associated with grain boundary migration (GBM), and explore the overprinting structures related to multiple sets of Higher Himalayan Out-of-Sequence Thrusts (OOSTs). The research methodology employed geological field observations and microscopic studies. Samples were collected along the Jhakri-Chaura transect at regular intervals of approximately 1 km to conduct strain analysis. Microstructural studies at the grain scale along the Jhakri-Wangtu transect were used to document the GBM-associated temperature range. The study reveals that the MCT activated in two parts, as did the STDS, and provides insights into the activation ages of the Main Boundary Thrust (MBT) and the Main Frontal Thrust (MFT). Under microscopic examination, the study identifies two mylonitised zones characterized by S-C fabric, and it documents dynamic and bulging recrystallization, as well as sub-grain formation. Various types of crenulated schistosity are observed in photomicrographs, including a rare occurrence where crenulation cleavage and sigmoid Muscovite are found juxtaposed. The study also notes the presence of S/SE-verging meso- and micro-scale box folds around Chaura, which may indicate structural upliftment. Kink folds near Chaura are visible, while asymmetric shear sense indicators in augen mylonite are predominantly observed under microscopic examination. Moreover, the research highlights the documentation of the Higher Himalayan Out-of-Sequence Thrust (OOST) in Himachal Pradesh, which activated the MCT and occurred within a zone south of the Main Central Thrust Upper (MCTU). The presence of multiple sets of OOSTs suggests a zigzag pattern of strain accumulation in the area. The study emphasizes the significance of understanding the overprinting structures associated with OOSTs. Overall, this study contributes to the understanding of the structural analysis of the Chaura Thrust and its implications in the regional geology of the Himachal Himalaya. The research underscores the importance of microscopic studies in identifying mylonitised zones and various types of crenulated schistosity. Additionally, the study documents the GBM-associated temperature range and provides insights into the activation of the Higher Himalayan Out-of-Sequence Thrust (OOST) in Himachal Pradesh. The findings of the study were obtained through geological field observations, microscopic studies, and strain analysis, offering valuable insights into the activation timing, mylonitization characteristics, and overprinting structures related to the Chaura Thrust and the broader tectonic framework of the region.

Keywords: Main Central Thrust, Jhakri Thrust, Chaura Thrust, Higher Himalaya, Out-of-Sequence Thrust, Sarahan Thrust

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Authors: Farah Benbouabdellah

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This research examines the shifting portrayal of tigers in visual media, particularly cinema, to explore how cultural, political, and ecological perspectives influence animal symbolism. Through an interdisciplinary approach combining film studies, anthropology, art history, and material culture, this study investigates tiger representations in static and moving images, from early art forms to 20th-century films. The research highlights how the film has perpetuated, transformed, and politicised tiger imagery across contexts by analysing colonialism, identity, and ecological change themes. With a comprehensive focus on Indian and Western cinema, this study illustrates the tiger's enduring role as a cultural symbol and its impact on visual narratives, exploring techniques in cinematography, audience reception, and narratives that helped shape the animal's iconic status. This research aims to provide a comprehensive view of tiger representations in media, addressing the intersection of animal symbolism and sociocultural values across historical and regional landscapes.

Keywords: tiger representation, visual media, anthropology media, material culture, film studies, comparative analysis

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Authors: K. Thakkar, C. Ghenai

Abstract:

An integrated modeling approach was used in this study to (1) track energy consumption, production, and resource extraction, (2) track greenhouse gases emissions and (3) analyze emissions for local and regional air pollutions. The model was used in this study for short and long term energy and GHG emissions reduction analysis for the state of Florida. The integrated modeling methodology will help to evaluate the alternative energy scenarios and examine emissions-reduction strategies. The mitigation scenarios have been designed to describe the future energy strategies. They consist of various demand and supply side scenarios. One of the GHG mitigation scenarios is crafted by taking into account the available renewable resources potential for power generation in the state of Florida to compare and analyze the GHG reduction measure against ‘Business As Usual’ and ‘Florida State Policy’ scenario. Two more ‘integrated’ scenarios, (‘Electrification’ and ‘Efficiency and Lifestyle’) are crafted through combination of various mitigation scenarios to assess the cumulative impact of the reduction measures such as technological changes and energy efficiency and conservation.

Keywords: energy planning, climate change mitigation assessment, integrated modeling approach, energy alternatives, and GHG emission reductions

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Authors: Yongmei Li, Chang-Gun Park

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China-Japan-South Korea (CJK) trilateral cooperation has experienced historical challenges in recent years, which negatively influenced the development of their relationship. Results of the interviews with three citizens on trilateral relations illustrate that most people are concerned with the historical conflicts among CJK. This paper specifically focuses on managing historical issues, including comfort women issues, territorial disputes, and divergence in historical education. Accordingly, the effectiveness of management of tensions productively provides a method for detecting historical concerns, managing issues, and connecting the three countries and citizens through advocating for fair media reporting, effective network institutionalization, and active local government cooperation. Furthermore, this paper contributes to providing government solutions for reinforcing the CJK partnership. It specially involves history education, East Asian identity and mutual trust establishment, East Asia intra-regional exchange programs, and reorganization of the role of the Trilateral Cooperation Secretariat (TCS).

Keywords: China-Japan-South Korea, trilateral cooperation, government solutions, effectiveness of management, historical conflicts

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Authors: C. Bamrungbutr, J. Sillitoe

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Maritime transportation has been a crucial part of world economics. Recently, researchers have put effort into studying the mechanisms of how a regional port, in the shadow of a nearby predominant port, can compete and grow. However, limited research has focused on the competition issues for a shadow port which is a capital city port. This study will thus focus on this question of the growth of a capital city port which is under the shadow of the adjacent capital city port by using the two capital city ports of Thailand; Bangkok port (the former main port) and Laem Chabang port (the current main port). For this work, a framework of opportunity capture will be used, and five groups of port development experts (government, council, logistics provider, academia and industry) will be interviewed. The responses will be analysed using the noticing, collecting and thinking model. The resulting analysis will be appropriate for use in developing guidelines for the future management of a range of shadow ports established in a capital city, enabling them to operate in a competitive environment more effectively. The resultant growth of these ports will be a significant factor in increasing the competitiveness of a nation’s maritime transport industry and eventually lead to a boost in the national economy.

Keywords: shadow port, Bangkok Port, Laem Chabang Port, port competition

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Authors: Fatemeh Sadat Sharifi, A. A. Bidokhti, M. Ezam, F. Ahmadi Givi

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This study focuses on the tidal oscillation and its speed to create a general pattern in seas. The purpose of the analysis is to find out the amplitude and phase for several important tidal components. Therefore, Regional Ocean Models (ROMS) was rendered to consider the correlation and accuracy of this pattern. Finding tidal harmonic components allows us to predict tide at this region. Better prediction of these tides, making standard platform, making suitable wave breakers, helping coastal building, navigation, fisheries, port management and tsunami research. Result shows a fair accuracy in the SSH. It reveals tidal currents are highest in Hormuz Strait and the narrow and shallow region between Kish Island. To investigate flow patterns of the region, the results of limited size model of FVCOM were utilized. Many features of the present day view of ocean circulation have some precedent in tidal and long- wave studies. Tidal waves are categorized to be among the long waves. So that tidal currents studies have indeed effects in subsequent studies of sea and ocean circulations.

Keywords: barotropic tide, FVCOM, numerical model, OTPS, ROMS

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Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

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The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

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Authors: Gilang Maulana Majid

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If a government program remains scientifically uncontested for a long time, it is likely that its effects will be far from expected as there is no concrete evaluation of the steps being taken. This article identifies how such a theory aptly describes the case of the 'tourism ambassador' program in Indonesia. Being set out as one of the tourism promotional means of many regional governments in Indonesia, this program is heavily criticized for being ineffective despite a large number of budgets being spent on an annual basis. Taking the program as a case study, this article applies content analysis, SWOT analysis, and TOPSIS as data analysis methods, with a total of 56 tourism ambassadors invited to become coders, respondents, and/or interviewees in this research. The study reveals the SWOT of the program, recognizes four strategies that can be taken to optimize the program's effects and prioritizes a strategy based on the preferences of the involved tourism ambassadors using TOPSIS. It is found that incorporation of technology such as the creation of an online platform is, among others, the most expected approach to be taken to solve the problems concerning tourism ambassador program. However, based on the costs and benefits of each strategy presented in the current study, each alternative appears to have trade-offs between one and another.

Keywords: Indonesia, optimization strategies, 'Tourism Ambassador' program, SWOT-TOPSIS

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Authors: Sergio Perez Rodriguez

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Coltan Artisanal and Small-Scale Mining (ASM) production from Africa's Great Lakes region has previously been addressed at large scales, notably from regional to country levels. The current findings address the unresolved issue of a production model of ASM of coltan ore by an average Democratic Republic of Congo (DRC) mineworker, which can be used as a reference for a similar characterization of the daily labor of counterparts from other countries in the region. To that end, the Fundamental Equation of Mineral Production has been applied, considering a miner's average daily output of coltan, estimated in the base of gross statistical data gathered from reputable sources. Results indicate daily yields of individual miners in the order of 300 g of coltan ore, with hourly peaks of production in the range of 30 to 40 g of the mineral. Yields are expected to be in the order of 5 g or less during the least productive hours. These outputs are expected to be achieved during the halves of the eight to ten hours of daily working sessions that these artisanal laborers can attend during the mining season.

Keywords: coltan, mineral production, production to reserve ratio, artisanal mining, small-scale mining, ASM, human work, Great Lakes region, Democratic Republic of Congo

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Authors: Deretha Bester

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This research employs a theoretical framework to investigate the interplay between factors that lead from predatory governance and predatory rule to military coups, utilizing the frustration-aggression theory as its guiding lens. It adopts a case-oriented approach and employs thematic analysis to examine the socio-economic, governance, and political environment that precipitated the August 2020 Malian military coup. Presenting seven key themes, it reveals how predatory rule and its manifestation in the Malian context was a critical factor in paving the way for the military coup. The study provides critical reflections into the historical, regional, and political dynamics reshaping Africa’s changing political landscape. It presents a conceptual model to comprehend how predatory governance fosters conditions favorable for military coups. Insights from the Malian case study offer valuable perspectives for analyzing events in comparable contexts. This understanding is crucial for grasping the precursors and impact of predatory rule and popular frustrations in contexts where military coups emerge.

Keywords: predatory rule, military coups, socio-political analysis, frustration-aggression theory, Mali

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Authors: Kholil Kholil, Soecahyadi Soecahyadi

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Geographically, Padang Panjang Regency which located in the heart of Western Sumatra has great potentials for the tourism industry. However, these potentials have not been strategically developed for increasing local economic development and people's welfare. The purpose of this research is to design the strategy of sustainable tourism area development using Strategic Assumption Surfacing and Testing (SAST) and Exponential Rank Method (ERM). Result study showed, there are four aspects which importance and certainly for developing tourism area destination in Padang Panjang Regency; (1) tourist information center and promotion, (2) regional cooperation development; (3) minangese center as a center of excellence; and (4) building the center of the public market. To build an attractive tourist area required action plan includes the construction of an information center, center of excellence of minangese, and tourist infrastructure; and public participation is a key success factor for ensuring sustainability of tourism development in Padang Panjang Regency.

Keywords: local economic development, tourism attraction, SAST, ERM

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Gholamreza Namavar, Ali Bayati

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Nowadays according to increasing the population all around the world, consuming of fossil fuels increased dramatically. Many believe that most of the atmospheric pollution comes by using fossil fuels. The process of natural sources entering cities show one of the large challenges in consumption sources management. Nowadays, everyone considered about the consumption of fossil fuels and also reduction of consumption civil energy in megacities that play a key role in solving serious problems such as air pollution, producing greenhouse gasses, global warming and damage ozone layer. In construction industry we should use the materials with the lowest need to energy for making and carrying them, and also the materials which need the lowest energy and expenses to recycling. In this way, the kind of usage material, the way of processing, regional materials and the adaption with environment is critical. Otherwise, the isolation should be use and mention in long term. Accordingly, in this article we investigates the new ways in order to reduce environmental pollution and save more energy by using materials that are not harmful to the environment, fully insulated materials in buildings, sustainable and diversified buildings, suitable urban design and using solar energy more efficiently in order to reduce energy consumption.

Keywords: architectural design, insulation, sustainable construction, reducing energy consumption

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Authors: Laura Dembovska, Diana Bajare, Vitalijs Lusis, Genadijs Sahmenko, Aleksandrs Korjakins

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This study focused on the mechanical properties of the fibre reinforced High Performance Concrete. The most important benefits of addition of fibres to the concrete mix are the hindrance of the development of microcracks, the delay of the propagation of microcracks to macroscopic cracks and the better ductility after microcracks have been occurred. This work presents an extensive comparative experimental study on six different types of fibres (alkali resistant glass, polyvinyl alcohol fibres, polypropylene fibres and carbon fibres) with the same binding High Performance Concrete matrix. The purpose was to assess the influence of the type of fibre on the mechanical properties of Fibre Reinforced High Performance Concrete. Therefore, in this study three main objectives have been chosen: 1) analyze the structure of the bulk cementitious matrix, 2) determine the influence of fibres and distribution in the matrix on the mechanical properties of fibre reinforced High Performance Concrete and 3) characterize the microstructure of the fibre-matrix interface. Acknowledgement: This study was partially funded by European Regional Development Fund project Nr.1.1.1.1/16/A/007 “A New Concept for Sustainable and Nearly Zero-Energy Buildings” and COST Action TU1404 Conference grants project.

Keywords: high performance concrete, fibres, mechanical properties, microstructure

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Authors: Mohammadreza Azarnoush, Ali Bayati, Jamileh Azarnoush

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Nowadays according to increasing the population all around the world, consuming of fossil fuels increased dramatically. Many believe that most of the atmospheric pollution comes by using fossil fuels. The process of natural sources entering cities shows one of the large challenges in consumption sources management. Nowadays, everyone considers the consumption of fossil fuels and also reduction of consumption civil energy in megacities as playing a key role in solving serious problems such as air pollution, producing greenhouse gasses, global warming, and damage ozone layer. In the construction industry, we should use the materials with the lowest need to energy for making and carrying them, and also the materials which need the lowest energy and expenses to recycling. In this way, the kind of usage material, the way of processing, regional materials, and the adoption to the environment is critical. Otherwise, the isolation should be use and mention in the long term. Accordingly, in this article, we investigate the new ways in order to reduce environmental pollution and save more energy by using materials that are not harmful to the environment, fully insulated materials in buildings, sustainable and diversified buildings, suitable urban design and using solar energy more efficiently in order to reduce energy consumption.

Keywords: building design, construction masonry, insulation, sustainable construction

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Authors: Vijay nandmer, Ajay Nandmer

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Stigmatized psycho-social perception poses a serious challenge and source of discrimination which impedes stroke patients from attaining a satisfactory quality of life. The present study was aimed to obtain information on knowledge, attitudes and practices (KAP) of stroke patients in the institute. We included 1000 people in our random sampling survey. Demographic details and responses to a questionnaire assessing the knowledge, attitude and practices were recorded. Although the majority of the patients belonged to low socioeconomic strata, the literacy rate was reasonably high (96.3%). A large majority (91.3%) of people had heard about stroke and (85.2%) knew that stroke can be treated with modern drugs. However, a negative attitude was reflected in the belief that stroke happens due to supernatural powers (hawa lagne se) (50.6%). Analysis of the data revealed regional differences in KAP which could be attributed to local Factors, such as literacy, awareness about stroke, and practice of different systems of medicine. Some of the differences can also be attributed to a category of study population whether it included patients or non-stroke individuals since the former are likely to have less negative attitudes than the public. There is a need to create awareness about stroke on a nation-wide basis to dispel the misconceptions and stigma through effective and robust programs with the aim to lessen the disease burden.

Keywords: epidemiology, sroke, literacy, stroke

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Authors: Mohsen Davarzani, Ehsan Lame, Mohammad Taghi Hassan Zadeh

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Language is considered as a powerful and outstanding feature of ethnicity. However, humiliating and prohibiting using human language is one the most heinous and brutal acts in the form of racism. In other words, racism can be a product of physiological humiliations and discrimination, such as skin color, and can also be resulted from ethnic humiliation and discrimination such as language, customs and so on. Ethnic and racial discrimination is one of the main problems of the world that minorities and occasionally the majority have suffered from. Nowadays, few states can be found in which all individuals and its citizens are of the same race and ethnicity, culture and language. In these countries, referred to as the multinational states, (eg, Iran, Switzerland, India, etc.), there are the communities and groups which have their own linguistic, cultural and historical characteristics. Characteristics of human rights issues, diversity of issues and plurality of meanings indicate that they appear in various aspects. The states are obliged to respect, as per national and international obligations, the rights of all citizens from different angles, especially different groups that require special attention in order of the particular aspects such as ethnicity, religious and political minorities, children, women, workers, unions and in case the states are in breach of any of these items, they are faced with challenges in local, regional or international fields.

Keywords: law, language, minorities, ethnicity

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Authors: Michal Stelmach

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The aim of this paper is a critical analysis of the security policy in the field of the fight against transnational criminal groups in Central America in XXI century. We are analyzing all taken issues from several perspectives: political, anthropological, sociological and legal which allows me to confront behavior and the attitudes of the political elites against official legislative changes and declared actions, strategies and policies against practice. In the first part of paper we would like to present the genesis and characteristic of transnational gangs, called maras and next we would like to present their activities and roles within chosen sectors of organized crimes. In the second part we will analyze the government’s policy towards transnational criminal groups. The analysis will be concentrated on public safety policy implemented in specific Central American countries as well as regional international cooperation. The main intention of the author is to present the state of the security in Central America in XXI century by emphasizing failures and successes in the fight against transnational criminal organizations. Additionally we want to present and define the challenges currently facing the region now and to show the prediction of the situation’s development within next future and to define the recommendations on the design of public security policies in Central American countries.

Keywords: maras, public security, human rights, Central America

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Authors: Ajay Kumar

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Using data from census of India, sample registration system and national family health survey (NFHS-3), this paper traces spatial pattern, trends and the factors which have played their role differently in fertility transition in Uttar Pradesh and Tamil Nadu. For the purpose spatial variation analysis, trend line and binary logistic regression analysis has been carried out. There exist considerable regional disparities in terms of fertility decline in northern and southern states. The pace of fertility decline has been faster in southern and coastal regions, and at a slow pace in backward northern state. In Tamil Nadu fertility declined substantially among the women of lower and higher age groups in comparison to Uttar Pradesh characterized by low literacy, low female age at marriage, poor health infrastructure and low status of women. The Study shows that Fertility rates have been higher among the most vulnerable and deprived sections of the society like Illiterate women, women belong to scheduled caste, scheduled tribe and women residing in rural areas.

Keywords: age specific fertility rate, fertility transition, replacement level, total fertility rate

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Authors: Vriddhi Prasad

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The paper briefly outlines the nature of contemporary Architecture Education in India and its present challenges with theoretically feasible solutions. It explores in detail the arduous position of architecture education owing to, privatization of higher education institutes in India, every changing demand of the technology driven industry and discipline, along with regional and cultural resources that should be explored academically for the enrichment of graduates. With the government's education policy of supporting privatization, a comprehensive role for the regulating body of Architecture Education becomes imperative. The paper provides key insights through empirical research into the nature of these roles and the areas which need attention in light of the problems. With the aid of critically acclaimed education model like Design Build, contextual retrofits for Indian institutes can be stressed for inclusion in the curriculum. The pairing of a private institute and public industry/research body and vice versa can lead to pro-economic and pro-social research environment. These reforms if stressed by an autonomous nationwide regulating body rather than the state will lead to uniformity and flexibility of curriculum which promotes the creation of fresh graduates who are adaptable to the changing needs.

Keywords: architecture education, building information modelling, design build, pedagogy

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Authors: Paulo Roberto Vasconcellos-Silva

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The "Janeiro Roxo" (Purple January) campaign in Brazil aims to promote awareness of leprosy and its early symptoms. The COVID-19 pandemic has adversely affected institutional campaigns, mostly considering leprosy a neglected disease by the media. Google Trends (GT) is a tool that tracks user searches on Google, providing insights into the popularity of specific search terms. Our prior research has categorized online searches into two types: "Reactive searches," driven by transient campaign-related stimuli, and "Proactive searches," driven by personal interest in early symptoms and self-diagnosis. Using GT we studied: (i) the impact of "Janeiro Roxo" on public interest in leprosy (assessed through reactive searches) and its early symptoms (evaluated through proactive searches) over the past five years; (ii) changes in public interest during and after the COVID-19 pandemic; (iii) patterns in the dynamics of reactive and proactive searches Methods: We used GT's "Relative Search Volume" (RSV) to gauge public interest on a scale from 0 to 100. "HANSENÍASE" (HAN) was a proxy for reactive searches, and "HANSENÍASE SINTOMAS" (leprosy symptoms) (H.SIN) for proactive searches (interest in leprosy or in self-diagnosis). We analyzed 261 weeks of data from 2018 to 2023, using polynomial trend lines to model trends over this period. Analysis of Variance (ANOVA) was used to compare weekly RSV, monthly (MM) and annual means (AM). Results: Over a span of 261 weeks, there was consistently higher Relative Search Volume (RSV) for HAN compared to H.SIN. Both search terms exhibited their highest (MM) in January months during all periods. COVID-19 pandemic: a decline was observed during the pandemic years (2020-2021). There was a 24% decrease in RSV for HAN and a 32.5% decrease for H.SIN. Both HAN and H.SIN regained their pre-pandemic search levels in January 2022-2023. Breakpoints indicated abrupt changes - in the 26th week (February 2019), 55th and 213th weeks (September 2019 and 2022) related to September regional campaigns (interrupted in 2020-2021). Trend lines for HAN exhibited an upward curve between 33rd-45th week (April to June 2019), a pandemic-related downward trend between 120th-136th week (December 2020 to March 2021), and an upward trend between 220th-240th week (November 2022 to March 2023). Conclusion: The "Janeiro Roxo" campaign, along with other media-driven activities, exerts a notable influence on both reactive and proactive searches related to leprosy topics. Reactive searches, driven by campaign stimuli, significantly outnumber proactive searches. Despite the interruption of the campaign due to the pandemic, there was a subsequent resurgence in both types of searches. The recovery observed in reactive and proactive searches post-campaign interruption underscores the effectiveness of such initiatives, particularly at the national level. This suggests that regional campaigns aimed at leprosy awareness can be considered highly successful in stimulating proactive public engagement. The evaluation of internet-based campaign programs proves valuable not only for assessing their impact but also for identifying the needs of vulnerable regions. These programs can play a crucial role in integrating regions and highlighting their needs for assistance services in the context of leprosy awareness.

Keywords: health communication, leprosy, health campaigns, information seeking behavior, Google Trends, reactive searches, proactive searches, leprosy early identification

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Authors: Irakli Gamkrelidze, David Shengelia, Giorgi Chichinadze, Tamara Tsutsunava, Giorgi Beridze, Tamara Tsamalashvili, Ketevan Tedliashvili, Irakli Javakhishvili

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The Caucasus is situated between the Eurasian and Africa-Arabian plates and represents a component of the Mediterranean (Alpine-Himalayan) collision belt. The Loki crystalline massif crops out within one of the terranes of the Caucasus – Baiburt-Sevanian terrane. By the end of 2018, a digital geological map (1:50 000) of the Loki massif was compiled. The presented map is of great importance for the region since there is no large-scale geological map which reflects the present standards of the geological study of the massif up to the last time. The existing State Geological Map of the Loki massif is very outdated. A new map drown by using GIS (Geographic Information System) technology is loaded with multi-informative details that include: specified contours of geological units and separate tectonic scales, key mineral assemblages and facies of metamorphism, temperature conditions of metamorphism, ages of metamorphism events and the massif rocks, genetic-geodynamic types of magmatic rocks. Explanatory note, attached to the map includes the large specter of scientific information. It contains characterization of the geological setting, composition and petrogenetic and geodynamic models of the massif formation. To create a geological map of the Loki crystalline massif, appropriate methodologies were applied: a sampling of rocks, GIS technology-based mapping of geological units, microscopic description of the material, composition analysis of rocks, microprobe analysis of minerals and a new interpretation of obtained data. To prepare a digital version of the map the appropriated activities were held including the creation of a common database. Finally, the design was created that includes the elaboration of legend and the final visualization of the map. The results of the study presented in the explanatory note are given below. The autochthonous gneissose quartz diorites of normal alkalinity and sub-alkaline gabbro-diorites included in them belong to different phases of magmatism. They represent “igneous” granites corresponding to mixed mantle-crustal type granites. Four tectonic plates of the allochthonous metamorphic complex–Lower Gorastskali, Sapharlo–Lok-Jandari, Moshevani, and Lower Gorastskali differ from each other by structure and degree of metamorphism. The initial rocks of these plates are formed in different geodynamic conditions and during the Early Bretonian orogeny while overthrusting due to tectonic compression they form a thick tectonic sheet. The Lower Gorastskali overthrust sheet is a fragment of ophiolitic association corresponding to the Paleotethys oceanic crust. The protolith of the ophiolitic complex basites corresponds to the tholeiitic series of basalts. The Sapharlo–Lok-Jandari overthrust sheet is metapelites, metamorphosed in conditions of greenschist facies of regional metamorphism. The regional metamorphism of Moshevani overthrust sheet crystalline schists quartzites corresponds to a range from greenschist to hornfels facies. The “mélange” is built of rock fragments and blocks of above-mentioned overthrust sheets. Sub-alkaline and normal alkaline post-metamorphic granites of the Loki crystalline massif belong to “igneous” and rarely to “sialic” and “anorogenic” types of granites.

Keywords: digital geological map, 1:50 000 scale, crystalline massif, the caucasus

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