Search results for: risk factor prevention paradigm

Authors: V. V. Lakshmi, Y. V. S. Annapurna

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Urinary tract infection (UTI) is one of the most common infectious diseases seen in the community. Susceptible individuals experience multiple episodes, and progress to acute pyelonephritis or uro-sepsis or develop asymptomatic bacteriuria (ABU). Ability to cause extraintestinal infections depends on several virulence factors required for survival at extraintestinal sites. Presence of virulence phenotypes enhances the pathogenicity of these otherwise commensal organisms and thus augments its ability to cause extraintestinal infections, the most frequent in urinary tract infections(UTI). The present study focuses on detection of the virulence characters exhibited by the uropathogenic organism and most common factors exhibited in the local pathogens. A total of 700 isolates of E.coli and Klebsiella spp were included in the study. These were isolated from patients from local hospitals reported to be suffering with UTI over a period of three years. Isolation and identification was done based on Gram character and IMVIC reactions. Antibiotic sensitivity profile was carried out by disc diffusion method and multi drug resistant strains with MAR index of 0.7 were further selected.. Virulence features examined included their ability to produce exopolysaccharides, protease- gelatinase production, hemolysin production, haemagglutination and hydrophobicity test. Exopolysaccharide production was most predominant virulence feature among the isolates when checked by congo red method. The biofilms production examined by microtitre plates using ELISA reader confirmed that this is the major factor contributing to virulencity of the pathogens followed by hemolysin production

Keywords: Escherichia coli, Klebsiella sp, Uropathogens, Virulence features.

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Authors: R. Padmini, G. V. Manoj Kumar

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Structural insulated panels (SIPs) are a high-performance building system for residential and light commercial construction. The panels consist of an insulating foam core sandwiched between two structural facings, typically oriented strand board (OSB). SIPs are manufactured under factory controlled conditions and can be fabricated to fit nearly any building design. The result is a building system that is extremely strong, energy efficient and cost effective. Building with SIPs will save you time, money and labor. Building with SIPs generally costs about the same as building with wood frame construction when you factor in the labor savings resulting from shorter construction time and less job-site waste. Other savings are realized because smaller heating and cooling systems are required with SIP construction. Structural insulated panels (SIPs) are one of the most airtight and well-insulated building systems available, making them an inherently green product. An airtight SIP building will use less energy to heat and cool, allow for better control over indoor environmental conditions, and reduce construction waste. Green buildings use less energy, reducing carbon dioxide emissions and playing an important role in combating global climate change. Buildings also use a tremendous amount of natural resources to construct and operate. Constructing green buildings that use these resources more efficiently, while minimizing pollution that can harm renewable natural resources, is crucial to a sustainable future.

Keywords: high performance, under factory controlled, wood frame, carbon dioxide emissions, natural resources

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Authors: Seyed Mohsen Samaei, Shirley Gato-Trinidad

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A pre-treatment stage prior to reverse osmosis (RO) is very important to ensure the long-term performance of the RO membranes in any wastewater treatment using RO. This study aims to evaluate the application of the Actiflo^® clarifier as part of a pre-treatment unit in mining operations. It involves performing analytical testing on RO feed water before and after installation of Actiflo^® unit. Water samples prior to RO plant stage were obtained on different dates from Costerfield mining operations in Victoria, Australia. Tests were conducted in an independent laboratory to determine the concentration of various compounds in RO feed water before and after installation of Actiflo^® unit during the entire evaluated period from December 2015 to June 2018. Water quality analysis shows that the quality of RO feed water has remarkably improved since installation of Actiflo^® clarifier. Suspended solids (SS) and turbidity removal efficiencies has been improved by 91 and 85 percent respectively in pre-treatment system since the installation of Actiflo^®. The Actiflo^® clarifier proved to be a valuable part of pre-treatment system prior to RO. It has the potential to conveniently condition the mining wastewater prior to RO unit, and reduce the risk of RO physical failure and irreversible fouling. Consequently, reliable and durable operation of RO unit with minimum requirement for RO membrane replacement is expected with Actiflo^® in use.

Keywords: ACTIFLO ® clarifier, mining wastewater, reverse osmosis, water treatment

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Authors: M. R. Mogarekar, Shraddha V. More, Pankaj Kumar

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Gastroenteritis, the third leading killer of children in India today is responsible for 13% of all deaths in children <5 years of age and kills an estimated 300,000 children in India each year. We decided to investigate parameters which can help in early disease detection and prompt treatment. Serum paraoxonase is calcium dependent esterase which is widely distributed among tissues such as liver, kidney, and intestine and is located in the chromosomal region 7q21.3 22.1. Studies show the presence of excessive reactive oxygen metabolites and antioxidant imbalance in the gastrointestinal tract leading to oxidative stress in gastroenteritis. To our knowledge, this is the first ever study done. The objective of present study is to investigate the role of paraoxonase 1 (PON 1) status i.e arylesterase and lactonase activities and Q192R polymorphism and conjugated dienes, in gastroenteritis of paediatric population. The study and control group consists of 40 paediatric patients with and without gastroenteritis. Paraoxonase arylesterase and lactonase activities were assessed and phenotyping was determined. Conjugated dienes were also assessed. PON 1 arylesterase activities in cases (61.494±13.220) and controls (70.942±15.385) and lactonase activities in cases (15.702±1.036) and controls (17.434±1.176) were significantly decreased (p<0.05). There is no significant difference of phenotypic distribution in cases and controls. Conjugated dienes were found significantly increased in patients (0.086±0.024) than the control group (0.064±0.019) (p<0.05). Paraoxonase 1 activities (arylesterase and lactonase) and conjugated dienes may be useful in risk assessment and management in gastroenteritis in paediatric population.

Keywords: paraoxonase 1 polymorphism, arylesterase, lactonase, conjugated dienes, p-nitrophenylacetate, DHC

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Authors: Norbert Magyar, Jozsef Kovacs, Peter Tanos, Balazs Trasy, Tamas Garamhegyi, Istvan Gabor Hatvani

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Water is one of the most important common resources, and as a result of urbanization, agriculture, and industry it is becoming more and more exposed to potential pollutants. The prevention of the deterioration of water quality is a crucial role for environmental scientist. To achieve this aim, the operation of monitoring networks is necessary. In general, these networks have to meet many important requirements, such as representativeness and cost efficiency. However, existing monitoring networks often include sampling sites which are unnecessary. With the elimination of these sites the monitoring network can be optimized, and it can operate more economically. The aim of this study is to illustrate the applicability of the CCDA (Combined Cluster and Discriminant Analysis) to the field of water quality monitoring and optimize the monitoring networks of a river (the Danube), a wetland-lake system (Kis-Balaton & Lake Balaton), and two surface-subsurface water systems on the watershed of Lake Neusiedl/Lake Fertő and on the Szigetköz area over a period of approximately two decades. CCDA combines two multivariate data analysis methods: hierarchical cluster analysis and linear discriminant analysis. Its goal is to determine homogeneous groups of observations, in our case sampling sites, by comparing the goodness of preconceived classifications obtained from hierarchical cluster analysis with random classifications. The main idea behind CCDA is that if the ratio of correctly classified cases for a grouping is higher than at least 95% of the ratios for the random classifications, then at the level of significance (α=0.05) the given sampling sites don’t form a homogeneous group. Due to the fact that the sampling on the Lake Neusiedl/Lake Fertő was conducted at the same time at all sampling sites, it was possible to visualize the differences between the sampling sites belonging to the same or different groups on scatterplots. Based on the results, the monitoring network of the Danube yields redundant information over certain sections, so that of 12 sampling sites, 3 could be eliminated without loss of information. In the case of the wetland (Kis-Balaton) one pair of sampling sites out of 12, and in the case of Lake Balaton, 5 out of 10 could be discarded. For the groundwater system of the catchment area of Lake Neusiedl/Lake Fertő all 50 monitoring wells are necessary, there is no redundant information in the system. The number of the sampling sites on the Lake Neusiedl/Lake Fertő can decrease to approximately the half of the original number of the sites. Furthermore, neighbouring sampling sites were compared pairwise using CCDA and the results were plotted on diagrams or isoline maps showing the location of the greatest differences. These results can help researchers decide where to place new sampling sites. The application of CCDA proved to be a useful tool in the optimization of the monitoring networks regarding different types of water bodies. Based on the results obtained, the monitoring networks can be operated more economically.

Keywords: combined cluster and discriminant analysis, cost efficiency, monitoring network optimization, water quality

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Authors: Jun Hong Lee

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Background: Alzheimer`s disease (AD) I: creases with age and is characterized by the premature progressive loss of neuronal cell. In contrast, cancer cells have inappropriate cell proliferation and resistance to cell death. Objective: We evaluated the association between cancer and AD and also examined the specific types of cancer. Patients and Methods/Material and Methods: This retrospective, nationwide, longitudinal study used National Health Insurance Service – Senior cohort (NHIS-Senior) 2002-2013, which was released by the KNHIS in 2016, comprising 550,000 random subjects who were selected from over than 60. The study included a cohort of 4,408 patients who were first diagnoses as AD between 2003 and 2005. To match each dementia patient, 19,150 subjects were selected from the database by Propensity Score Matching. Results: We enrolled 4,790 patients for analysis in this cohort and the prevalence of AD was higher in female (19.29%) than in male (17.71%). A higher prevalence of AD was observed in the 70-84 year age group and in the higher income status group. A total of 540 cancers occurred within the observation interval. Overall cancer was less frequent in those with AD (12.25%) than in the control (18.46%), with HR 0.704 (95% Confidence Intervals (CIs)=0.0.64-0.775, p-Value < 0.0001). Conclusion: Our data showed a decreased incidence of overall cancers in patients with AD similar to previous studies. Patients with AD had a significantly decreased risk of colon & rectum, lung and stomach cancer. This finding lower than but consistent with Western countries. We need further investigation of genetic evidence linking AD to cancer.

Keywords: Alzheimer, cancer, nationwide, longitudinal study

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Authors: H. T. Le Luong, C. Hénaux, F. Messine, G. Bueno-Mariani, S. Mollov, N. Voyer

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This paper presents a comparative study of different modular brushless wound rotor synchronous machine (MB-WRSM). The goal of the study is to highlight the structure which offers the best fault tolerant capability and the highest output performances. The fundamental winding factor is calculated by using the method based on EMF phasors as a significant criterion to select the preferred number of phases, stator slots, and poles. With the limited number of poles for a small machine (3.67kW/7000rpm), 15 different machines for preferred phase/slot/pole combinations are analyzed using two-dimensional (2-D) finite element method and compared according to three criteria: torque density, torque ripple and efficiency. The 7phase/7slot/6pole machine is chosen with the best compromise of high torque density, small torque ripple (3.89%) and high nominal efficiency (95%). This machine is then compared with a reference design surface permanent magnet synchronous machine (SPMSM). In conclusion, this paper provides an electromagnetic analysis of a new brushless wound-rotor synchronous machine using multiphase non-overlapping fractional slot double layer winding. The simulation results are discussed and demonstrate that the MB-WRSM presents interesting performance features, with overall performance closely matching that of an equivalent SPMSM.

Keywords: finite element method (FEM), machine performance, modular wound rotor synchronous machine, non-overlapping concentrated winding

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Authors: Ahmed Boufedah Badissi, Ahmed Beroual, Farid Boursas

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This research aims to elucidate the role of coarse aggregate in influencing the fresh properties of normal-strength concrete. Specifically, it is aimed to identify the optimal gradation of coarse aggregate to enhance workability. While existing literature discusses the impact of aggregate granularity on concrete workability, more numerical data or models need to quantify the relationship between workability, granularity, and coarse aggregate shape. The main objective is to create a model that describes how coarse aggregate morphology contributes to fresh concrete properties. To investigate the effect of coarse aggregate gradation on Normal Strength Concrete (NSC) workability, various combinations of coarse aggregates (4/22.4 mm) were produced in the laboratory, utilizing three elementary classes: finer coarse aggregate 4/8 mm (Fca), medium coarse aggregate 8/16 mm (Mca), and coarser coarse aggregate 16/22.4 mm (Cca). We introduced a factor, FCR (Finer to Coarser coarse aggregate Ratio), as a numerical parameter to provide a quantitative evaluation and more detailed results analysis. Quantitative characterization parameters for coarse aggregate morphology were established, exploring the influence of particle size distribution, specific surface, and aggregate shape on workability. The research findings are significant for establishing correlations between coarse aggregate morphology and concrete properties. FCR emerges as a valuable tool for predicting the impact of aggregate gradation variations on concrete. The results of this study create a valuable database for construction professionals and concrete producers, affirming that the fresh properties of NSC are intricately linked to coarse aggregate morphology, particularly gradation.

Keywords: morphology, coarse aggregate, workability, fresh properties, gradation

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Authors: Yuki Matsumoto, Yuma Ishimoto

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Cognitive Behavior Therapy (CBT) with children has shown effective application to various problems such as anxiety and depression. Although there are barriers to access to mental health services including lack of professional services in communities and parental concerns about stigma, school has a significant role to address children’s health problems. Schools are regarded as a suitable arena for prevention and early intervention of mental health problems. In this line, CBT can be adaptable to school education and useful to enhance students’ social and emotional skills. However, Japanese school curriculum is rigorous so as to limit available time for implementation of CBT in schools. This paper describes Brief Cognitive Behavior Therapy (BCBT) with children in a Japanese school setting. The program has been developed in order to facilitate acceptability of CBT in schools and aimed to enhance students’ skills to manage anxiety and difficult behaviors. The present research used a single arm design in which 30 students aged 9-10 years old participated. The authors provided teachers a CBT training workshop (two hours) at two primary schools in Tokyo metropolitan area and recruited participants in the research. A homeroom teacher voluntarily delivered a 6-session BCBT program (15 minutes each) in classroom periods which is called as Kaerinokai, a meeting before leaving school. Students completed a questionnaire sheet at pre- and post-periods under the supervision of the teacher. The sheet included the Spence Child Anxiety Scale (SCAS), the Depression Self-Rating Scale for Children (DSRS), and the Strengths and Difficulties Questionnaire (SDQ). The teacher was asked for feedback after the completion. Significant positive changes were found in the total and five of six sub-scales of the SCAS and the total difficulty scale of the SDQ. However, no significant changes were seen in Physical Injury Fear sub-scale of the SCAS, in the DSRS or the Prosocial sub-scale of the SDQ. The effect sizes are mostly between small and medium. The teacher commented that the program was easy to use and found positive changes in classroom activities and personal relationships. This preliminary research showed the feasibility of the BCBT in a school setting. The results suggest that the BCBT offers effective treatment for reduction in anxiety and in difficult behaviors. There is a good prospect of the BCBT suggesting that BCBT may be easier to be delivered than CBT by Japanese teachers to promote child mental health. The study has limitations including no control group, small sample size, or a short teacher training. Future research should address these limitations.

Keywords: brief cognitive behavior therapy, cognitive behavior therapy, mental health services in schools, teacher training workshop

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Authors: Mila Radovanovic, Jovana Jestrovic, Ivana Mihic

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Deciding whether to have a child is a complex psychological process, and the child's birth is an everlasting change in the life of the family. Researchers from all over the world have been recognized the importance of the motivation for parenthood in latter family life, but there is no very clear picture of factors which make the difference in this motivation. One of these factors can be the method of conception and results of the earlier studies are different- some showed the differences, but the others did not. The aim of this study was to determine the type and intensity of motivation for parenting among women in Serbia and to examine whether there are differences in motivation depend on the method of conception. The total sample consisted of 94 women- 57 pregnant women who conceive naturally and the same number of women in the process of in vitro fertilization, who still haven’t known the final result of the process- are they pregnant or no. The Child Study Inventory, which estimates four types of motivation for parenthood- altruistic, instrumental, narcissistic and fatalistic-was used for this purpose. Multivariate analysis of variance was used to answer the main question of the study. The results indicate that there is no statistically significant difference between the two groups of women, while the most common is the altruistic motivation that emphasizes the psychological value of the child, and sees the motivation for parenting as a desire to give love to the child. The results are encouraging because altruistic motivation is intrinsic one and the protective factor for latter family relations and care about child and sensitivity of parents. Altruistic motivation is showed like a good predictor in developing stable emotional relationship between mother and her baby but also is correlated with the higher satisfaction with marriage.

Keywords: development of parental role, in vitro fertilization, motivation for parenthood, pregnancy

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Authors: Luljeta Gashi, Naser Ramadani, Zana Deva, Dafina Gexha-Bunjaku

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The official HIV/AIDS data in Kosovo are based on HIV case reporting from health-care services, the blood transfusion system and Voluntary Counselling and Testing centres. Between 1986 and 2014, are reported 95 HIV and AIDS cases, of which 49 were AIDS, 46 HIV and 40 deaths. The majority (69%) of cases were men, age group 25 to 34 (37%) and route of transmission is: heterosexual (90%), MSM (7%), vertical transmission (2%) and IDU (1%). Based on existing data and the UNAIDS classification system, Kosovo is currently still categorised as having a low-level HIV epidemic. Even though with a low HIV prevalence, Kosovo faces a number of threatening factors, including increased number of drug users, a stigmatized and discriminated MSM community, high percentage of youth among general population (57% of the population under the age of 25), with changing social norms and especially the sexual ones. Methods: Data collection was done using self administered structured questionnaires amongst 249 high school students. Data were analysed using the Statistical Package for Social Sciences (SPSS). Results: The findings revealed that 68% of students know that HIV transmission can be reduced by having sex with only one uninfected partner who has no other partners, 94% know that the risk of getting HIV can be reduced by using a condom every time they have sex, 68% know that a person cannot get HIV from mosquito bites, 81% know that they cannot get HIV by sharing food with someone who is infected and 46% know that a healthy looking person can have HIV. Conclusions: Seventy one percent of high school students correctly identify ways of preventing the sexual transmission of HIV and who reject the major misconceptions about HIV transmission. The findings of the study indicate a need for more health education and promotion.

Keywords: Kosovo, KPAR, HIV, high school

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Authors: Cetin Arslan, Senol Tayan

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Social media is one of the most important and effective means of social interaction among people in which they create, share and exchange their ideas via photos, videos or voice messages. Although there are lots of communication tools, social media sites are the most prominent ones that allows the users articulate themselves in a matter of seconds all around the world with almost any expenses and thus, they became very popular and widespread after its emergence. As the usage of social media increases, it becomes an effective instrument in social matters. While it is possible to use social media to emphasize basic human rights and protest some failures of any government as in “Arab Spring”, it is also possible to spread propaganda and misinformation just to cause long lasting insurgency, upheaval, turmoil or disorder as an instrument of intervention to internal affairs and state sovereignty by some hostile groups or countries. It is certain that “social media” has positive effects on democracies letting people have chance to express themselves and to organize, but it is also obvious that the misuse of it, is very common that even a five-minute-long video can cause to wage a campaign against a country. Although it looks anti-democratic, when you consider the catastrophic effects of misuse of social media, it is a kind of area that serious precautions are to be taken without limiting democratic rights while allowing constant and perpetual share but preventing the criminal events. This article begins with the current developments in social media and gives some examples on misuse of it. Second part tries to put emphasize on the legal basis that can prevent criminal activities and the upheavals and insurgencies against state security. Last part makes comparison between democratic countries and international organizations’’ actions against such activities and proposes some further actions that are compatible with democratic norms.

Keywords: democracy, disorder, security, Social Media

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Authors: Nazanin Amanat, Alison Tayler, Steve Whyard

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While chemical insecticides effectively control many insect pests, they also harm many non-target species. Double-stranded RNA (dsRNA) pesticides, in contrast, can be designed to target unique gene sequences and thus act in a species-specific manner. DsRNA insecticides do not, however, work equally well for all insects, and for some species that are considered refractory to dsRNA, a primary factor affecting efficacy is the relative ease by which dsRNA can enter a target cell’s cytoplasm. In this study, we are examining how different structured dsRNAs (linear, hairpin, and paperclip) can enter mosquito and lepidopteran cells, as they represent dsRNA-sensitive and refractory species, respectively. To determine how the dsRNAs enter the cells, we are using chemical inhibitors and RNA interference (RNAi)-mediated knockdown of key proteins associated with different endocytosis processes. Understanding how different dsRNAs enter cells will ultimately help in the design of molecules that overcome refractoriness to RNAi or develop resistance to dsRNA-based insecticides. To date, we have conducted chemical inhibitor experiments on both cell lines and have evidence that linear dsRNAs enter the cells using clathrin-mediated endocytosis, while the paperclip dsRNAs (pcRNAs) can enter both species’ cells in a clathrin-independent manner to induce RNAi. An alternative uptake mechanism for the pcRNAs has been tentatively identified, and the outcomes of our RNAi-mediated knockdown experiments, which should provide corroborative evidence of our initial findings, will be discussed.

Keywords: dsRNA, RNAi, uptake, insecticides, dipteran, lepidopteran

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Authors: Mohsen Yaghmoor, Sima Radmanesh

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Rapid environmental changes have been threaten the life of many organizations .Enabling and productivity of human resource should be considered as the most important issue in order to increase performance and ensure survival of the organizations. In this research, the effectiveness of management factory in productivity & inability of human resource have been identified and reviewed at glance. Afterward there were two questions they are “what are the factors effecting productivity and enabling of human resource” . And ”what are the priority order based on effective management of human resource in Fars Poultry Complex". A specified questionnaire has been designed in order to priorities and effectiveness of the identified factors. Six factors specify to consist of: Individual characteristics, teaching, motivation, partnership management, authority or power submission and job development that have most effect on organization. Then specify a questionnaire for priority and effect measurement of specified factor that reach after collect information and using statistical tests of keronchbakh alpha coefficient r=0.792 that we can say the questionnaire has sufficient reliability. After information analysis of specified six factors by Friedman test categorize their effect. Measurement on organization respectively consists of individual characteristics, job development or enrichment, authority submission, partnership management, teaching and motivation. At last it has been indicated to approaches to increase making power full and productivity of manpower.

Keywords: productivity, empowerment, enrichment, authority submission, partnership management, teaching, motivation

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Authors: Sharon Yunger, Liat Altman, Yuval Garini, Yaron Shav-Tal

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Understanding the dynamics of transcription in living cells has improved since the development of quantitative fluorescence-based imaging techniques. We established a method for following transcription from a single copy gene in living cells. A gene tagged with MS2 repeats, used for mRNA tagging, in its 3' UTR was integrated into a single genomic locus. The actively transcribing gene was detected and analyzed by fluorescence in situ hybridization (FISH) and live-cell imaging. Several cell clones were created that differed in the promoter regulating the gene. Thus, comparative analysis could be obtained without the risk of different position effects at each integration site. Cells in S/G2 phases could be detected exhibiting two adjacent transcription sites on sister chromatids. A sharp reduction in the transcription levels was observed as cells progressed along the cell cycle. We hypothesized that a change in chromatin structure acts as a general mechanism during the cell cycle leading to down-regulation in the activity of some genes. We addressed this question by treating the cells with chromatin decondensing agents. Quantifying and imaging the treated cells suggests that chromatin structure plays a role both in regulating transcriptional levels along the cell cycle, as well as in limiting an active gene from reaching its maximum transcription potential at any given time. These results contribute to understanding the role of chromatin as a regulator of gene expression.

Keywords: cell cycle, living cells, nucleus, transcription

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Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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Authors: Elkington Sibusiso Mnguni

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In South Africa, mining has been a key economic sector since the discovery of gold in 1886 in the Witwatersrand region, where the city of Johannesburg is located. However, some mines have since been decommissioned, and the continuous pumping of acid mine drainage (AMD) also stopped causing the AMD to rise towards the ground surface. This posed a serious environmental risk to the groundwater resources and river systems in the region. This paper documents the development and extent of the environmental damage as well as the measures implemented by the government to alleviate such damage. The study will add to the body of knowledge on the subject of AMD treatment to prevent environmental degradation. The method used to gather and collate relevant data and information was the desktop study. The key findings include the social and environmental impact of the AMD, which include the pollution of water sources for domestic use leading to skin and other health problems and the loss of biodiversity in some areas. It was also found that the technical intervention of constructing a plant to pump and treat the AMD using the high-density sludge technology was the most effective short-term solution available while a long-term solution was being explored. Some successes and challenges experienced during the implementation of the project are also highlighted. The study will be a useful record of the current status of the AMD treatment interventions in the region.

Keywords: acid mine drainage, groundwater resources, pollution, river systems, technical intervention, high density sludge

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Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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Authors: Jailan Mohamed El Demerdash

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Millennials are a distinctive and dominant consumer group whose behavior, preferences and purchase decisions are broadly explored but not fully understood yet. Making up the largest market segment in the world, and in Egypt, they have the power to reinvent the hospitality industry and contribute to forming prospective demand for green hotels by showing willingness to adopting their environmental-friendly practices. The current study aims to enhance better understanding of Millennials' perception about sustainable initiatives and to increase the prediction power of their intentions regarding green hotel practices in Egypt. In doing so, the study is exploring the relation among different factors; Millennials' environmental awareness, their acceptance of green practices and their willingness to pay more for them. Millennials' profile, their preferences and environmental decision-making process are brought under light to stimulate actions of hospitality decision-makers and hoteliers. Bearing in mind that responsible consumerism is depending on understanding the different influences on consumption. The study questionnaire was composed of four sections and it was distributed to random Egyptian travelers' blogs and Facebook groups, with approximately 8000 members. Analysis of variance test (ANOVA) was used to examine the study variables. The findings indicated that Millennials' environmental awareness will not be a significant factor in their acceptance of hotel green practices, as well as, their willingness to pay more for them. However, Millennials' acceptance of the level of hotel green practices will have an impact on their willingness to pay more. Millennials were found to have a noticeable level of environmental awareness but lack commitment to tolerating hotel green practices and their associated high prices.

Keywords: millennials, environment, awareness, paying more

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Authors: Marcella De Filippo, Delio Colangelo, Luca Farnia

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In recent decades, the hyper-competition of tourism scenario has implicated the maturity of many businesses, attributing a central role to innovative processes and their dissemination in the economy of company management. At the same time, it has defined the need for monitoring the application of innovations, in order to govern and improve the performance of companies and destinations. The study aims to analyze and define the innovation in the tourism sector. The research actions have concerned, on the one hand, some in-depth interviews with experts, identifying innovation in terms of process and product, digitalization, sustainability policies and, on the other hand, to evaluate the interaction between these factors, in terms of substitutability and complementarity in management scenarios, in order to identify which one is essential to be competitive in the global scenario. Fuzzy measures and Choquet integral were used to elicit Experts’ preferences. This method allows not only to evaluate the relative importance of each pillar, but also and more interestingly, the level of interaction, ranging from complementarity to substitutability, between pairs of factors. The results of the survey are the following: in terms of Shapley values, Experts assert that Innovation is the most important factor (32.32), followed by digitalization (31.86), Network (20.57) and Sustainability (15.25). In terms of Interaction indices, given the low degree of consensus among experts, the interaction between couples of criteria on average could be ignored; however, it is worth to note that the factors innovations and digitalization are those in which experts express the highest degree of interaction. However for some of them, these factors have a moderate level of complementarity (with a pick of 57.14), and others consider them moderately substitutes (with a pick of -39.58). Another example, although outlier is the interaction between network and digitalization, in which an expert consider them markedly substitutes (-77.08).

Keywords: innovation, business model, tourism, fuzzy

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Authors: Anum Atiq, Haya Fatimah

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Lucid dream is a dream where one is aware that one is dreaming, and they also might be able to influence their dreaming states. Logically, since lucidity cues towards high awareness, it should be negatively associated with proneness to psychosis. However, this association is scarcely studied. Furthermore, although gender differences and similarities in psychopathology have been thoroughly studied, there is room for research in the influence of masculinity and femininity, regardless of one’s sex, on proneness to psychosis. The aim of this study is twofold: 1) We investigated if dream lucidity was negatively associated with psychosis proneness; and 2) We explored the influence of masculinity and femininity on psychosis proneness, over and above the sex. Data were collected by convenience sampling from the undergraduate students enrolled at the University of Management and Technology, Lahore. The sample consisted of 53 students among the age range of 18-26 (men=24, women=29). Masculinity and femininity were measured using the masculinity and femininity subscales of the Personality Attributes Questionnaire. Dream lucidity was measured with The Lucidity and Consciousness in Dreams Scale; and the reality testing sub scale of The Inventory of Personality Organization was used to measure proneness to psychosis. Pearson correlation analysis revealed that psychosis proneness was significantly and negatively correlated with dream lucidity-insight and negative emotion in dreams, but not with other aspects of dream lucidity. Furthermore, masculinity, in both men and women, was positively related with lucid dreaming, and negatively with psychosis proneness. Following this, linear regression analysis showed that psychosis proneness was negatively predicted by masculinity even after controlling for gender. Lucid dreamer and masculinity both have characteristic of independence, emotional control and internal locus of control. Therefore, masculinity makes lucid dreaming less risk of psychosis in both genders.

Keywords: lucid dreaming, psychosis, gender, masculinity and femininity

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Authors: Khaled A. shady, Fagr B. Bazeed, Nashwa K. Abousamra, Ihab H. Elberawe, Ashraf E. shaalan, Mohamed A. Sobh

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Physical activity activates a variety of adult stem cells which might be released into the circulation or might be activated in their organ-resident state. A variety of stimuli such as metabolic, mechanical, and hormonal stimuli might by responsible for the mobilization. This study was done to know the changes in hematopoietic stem cells and endothelial progenitor in athletes in the 24 hours following 30 min of aerobic exercise. Methods: Ten healthy male's athlete's (age 20.7± 0.61 y) performed moderate running with 30 min at 80% of velocity of The IAT. Blood samples taken pre-, and immediately, 30 min, 2h, 6h and 24h post-exercise were analyzed for hematopoietic stem cells (HSCs ), endothelial progenitor cells (EPCs(, vascular endothelial growth factor (VEGF), nitric oxide (NO), lactic acid (LA), and white blood cells . HSCs and EPCs were quantified by flow cytometry. Results: After 30min of aerobic exercise significant increases in HSCs, EPC, VEGF, NO, LA and WBCs (p ˂ 0.05). This increase will be at different rates according to the timing of taking blood sample and was in the maximum rate of increase after 30 min of aerobic exercise. HSCs, EPC, NO and WBCs were in the maximum rate of increase 2h post exercise. In addition, VEGF was in the maximum rate of increase immediately post exercise and LA concentration not affected after exercise. Conclusion: These data suggest that HSCs and EPCs increased after aerobic exercise due to increase of VEGF which play an important role in mobilization of stem cells and promotes NO increase which contributes to increase EPCs.

Keywords: physical activity, hematopoietic stem cells, mobilization, athletes

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Authors: Ali M. Subyani

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The increase in the greenhouse gas emission has had a severe impact on global climate change and is bound to affect the weather patterns worldwide. This climate change impacts are among the future significant effects on any society. Rainfall levels are drastically increasing with flash floods in some places and long periods of droughts in others, especially in arid regions. These extreme events are causes of interactions concerning environmental, socio-economic and cultural life and their implementation. This paper presents the detailed features of dry and wet spell durations and rainfall intensity series available (1971-2012) on daily basis for the Jeddah area, Western, Saudi Arabia. It also presents significant articles for combating the climate change impacts on this area. Results show trend changes in dry and wet spell durations and rainfall amount on daily, monthly and annual time series. Three rain seasons were proposed in this investigation: high rain, low rain, and dry seasons. It shows that the overall average dry spell durations is about 80 continuous days while the average wet spell durations is 1.39 days with an average rainfall intensity of 8.2 mm/day. Annual and seasonal autorun analyses confirm that the rainy seasons are tending to have more intense rainfall while the seasons are becoming drier. This study would help decision makers in future for water resources management and flood risk analysis.

Keywords: climate change, daily rainfall, dry and wet spill, Jeddah, Saudi Arabia

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Authors: Elif Ates, Naile Bilgili

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Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

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Authors: Pei Wang

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The concept of social-emotional learning (SEL) is becoming increasingly popular in both research and practical applications worldwide. However, there is a lack of empirical studies and implementation of SEL in China, particularly from the perspective of parents. This qualitative study examined how Chinese parents perceived SEL, how their views on SEL were shaped, and how these views affected their decisions regarding their children’s education programs. Using the Collaborative for Academic Social and Emotional Learning Interactive Wheel framework and Bronfenbrenner's bioecological theory, the study conducted interviews with eight parents whose children attended public, international, and private schools in China. All collected data were conducted a thematic analysis involving three coding phases. The findings revealed that interviewees perceived SEL as significant to children’s development but held diverse understandings and perspectives on SEL at school depending on the amount and the quality of SEL resources available in their children’s schools. Additionally, parents’ attitudes towards the exam-oriented education system and Chinese culture influenced their views on SEL in school. Nevertheless, their socioeconomic status (SES) was the most significant factor in their perspectives on SEL, which significantly impacted their choices in their children's educational programs. High-SES families had more options to pursue SEL resources by sending their children to international schools or Western countries, while lower middle-class SES families had limited SEL resources in public schools. This highlighted educational inequality in China and emphasized the need for greater attention and investment in SEL programs in Chinese public schools.

Keywords: Chinese, inequality, parent, school, social-emotional learning

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Authors: Abdel Rahman A. Alzandi

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The primary objectives of this investigation were to examine the interactive effects of three air quality treatments, ethylene-diurea (EDU) and two irrigation conditions on physiological characteristics of kidney beans (Phaseolus vulgaris L.) during its whole growth. These plants were grown in 12-open top chambers (OTC's). Ethylene-diurea (EDU) was used as a factor to evaluate O3 pollution impact on plant growth. The air quality treatments consisted of charcoal filtered (CF) air, nonfiltered (NF) air and ambient air (AA) were irrigated and non- irrigated. Leaf samples were collected from upper canopy positions six times (pre- EDU addition, week after four EDU's addition, at the time of harvesting). Maximal differences in leaf carbohydrate, N contents, pigments and total lipids were observed in response to moisture conditions in presence and absence of EDU applications. Significant reduction were noted for air quality treatments regarding carbohydrate and pigment fractions but not for all cases of leaf N and lipid contents under O3 effects only. Minimal differences were found for first EDU application while maximal ones were recorded at 200 mg l-1 of treatments. The EDU treatments stimulated carbohydrate and pigment contents at the upper canopy position with higher levels for both NF and AA compared to untreated conditions. The NF and AA treatments caused lower total carbohydrate and pigment contents in the canopy position before harvesting of EDU applications. The stimulation in leaf carbohydrates by the EDU treatment, compared to the non-treated EDU of AA and NF treatments, provides a rational explanation for the counteracting effects of EDU against moderate exposures to O3 regarding grain yields in C3 plants.

Keywords: leaf contents, moisture relations, EDU additions, global climate change, kidney bean

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Authors: Ferdinando Montemari, Antonio Vitale, Nicola Genito, Luca Garbarino, Urbano Tancredi, Domenico Accardo, Michele Grassi, Giancarmine Fasano, Anna Elena Tirri

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The development of guidance, navigation and control algorithms and avionic procedures requires the disposability of suitable analysis and verification tools, such as simulation environments, which support the design process and allow detecting potential problems prior to the flight test, in order to make new technologies available at reduced cost, time and risk. This paper presents a simulation environment for avionic software development and qualification, especially aimed at equipment for general aviation aircrafts and unmanned aerial systems. The simulation environment includes models for short and medium-range radio-navigation aids, flight assistance systems, and ground control stations. All the software modules are able to simulate the modeled systems both in fast-time and real-time tests, and were implemented following component oriented modeling techniques and requirement based approach. The paper describes the specific models features, the architectures of the implemented software systems and its validation process. Performed validation tests highlighted the capability of the simulation environment to guarantee in real-time the required functionalities and performance of the simulated avionics systems, as well as to reproduce the interaction between these systems, thus permitting a realistic and reliable simulation of a complete mission scenario.

Keywords: ADS-B, avionics, NAVAIDs, real-time simulation, TCAS, UAS ground control station

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Authors: Zayedali Shaikh

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Increasingly now more than ever, UV damage brings with it a litany of minor deformities that can range from mild lesions and discoloring to cataracts and blindness. Pluripotent stem cells in planaria and human skin can be used to treat wounds and skin damage, with the primary limitations being inadequate growth factors. Photobiomodulation therapy in the form of low-intensity red light therapy has been proven to provide helpful benefits in the healing of skin that displays some of the symptoms of UV damage, such as burns and lesions, along with stimulating the proliferation of stem cells in recellularizing tissue. This paper puts forth an alternate means by which to treat the effects of UV damage using the freshwater planarian model system, Dugesia dorotocephala, known for its regenerative abilities and abundance of pluripotent stem cells, which allow for the rapid growth and repair of missing or damaged structures. Our work consisted of exposing planaria to different types of light: red light, blue light, white light, darkness, red and blue light together, UV light, and finally, red and UV light together. The primary focus of this research was on the red and UV lights, with six controls acting as metrics to compare our findings. Through computer-assisted morphological analysis, the results show that there is no significant difference in the rates of regeneration of planaria treated with simultaneous exposure to red and UV light versus planaria in darkness (p > .05), a representation of their preferred natural habitat. Our research suggests the viability of red-light therapy in actively combating UV damage and expediting the growth of epidermal stem cells by acting as another growth factor.

Keywords: regenerative medicine, stem cells, planaria, photobiomodulation

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Authors: Javier Delgado-Gonzaga, Wilfrido Rivera, David Juárez-Romero

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Cooling and water purification are processes that have contributed to the economic and social development of the modern world. However, these processes require a significant amount of energy globally. Nowadays, absorption heat pumps have been studied with great interest since they are capable of producing cooling and/or purifying water from low-temperature energy sources such as industrial waste heat or renewable energy. In addition, absorption heat pumps require negligible amounts of electricity for their operation and generally use working fluids that do not represent a risk to the environment. The objective of this work is to evaluate a system that integrates an absorption heat transformer and an absorption cooling system to produce fresh water and cooling from a low-temperature heat source. Both cycles operate with the working pair LiBr-H2O. The integration is possible through the interaction of the LiBr-H2O solution streams between both cycles and also by recycling heat from the absorption heat transformer to the absorption cooling system. Mathematical models were developed to compare the performance of four different configurations. The results showed that the configuration in which the hottest streams of LiBr-H2O solution preheated the coldest streams in the economizers of both cycles was one that achieved the best performance. The interaction of the solution currents and the heat recycling analyzed in this work serves as a record of the possibilities of integration between absorption cycles for cogeneration.

Keywords: absorption heat transformer, absorption cooling system, water desalination, integrated system

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Authors: Parinaz Tavakoli Zaniani, Dimitrios Balomenos

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Mitochondrial reactive oxygen species (mROS) play a crucial role in macrophage pro-inflammatory activation, although a detailed understanding of the mechanism and kinetics by which mROS drive signaling molecules is still lacking. In general, it is thought that NF-κB activation drives mROS and general ROS production. Here, We performed a detailed kinetic analysis of mROS production during macrophage activation. We found early mROS generation after LPS (lipopolysaccharide) stimulation. Remarkably as early as 5 minutes, mROS signaling promoted initial NF-κB, MAPK activation and pro-inflammatory cytokine production, as established through inhibition or quenching of mROS. On the contrary, NF-κB inhibition had no effect on mROS production. Our findings point to a mechanism by which mROS increase TRAF-6 ubiquitination and, thus NF-κB activity. mROS inhibition reduced LPS-induced lethality in an in vivo septic shock model by controlling pro-inflammatory cytokine production. Overall, our research provides novel insights into the role of mROS as a primary messenger in the pathway of macrophage and as a regulator of inflammatory responses. We found that early mROS production promotes initial NF-κB, and MAPK activation by regulating TRAF-6 ubiquitination and that mROS inhibition can reduce LPS-induced inflammatory cytokines and lethality in a septic shock model. These findings might lead to novel immunotherapeutic strategies targeting early mROS production and control of extreme inflammation in the context of sepsis and other inflammatory diseases.

Keywords: mitochondria, reactive oxygen species, nuclear factor κB, lipopolysaccharide, macrophages

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