Search results for: proximity impact

Authors: Catia S. A. Sima, K. Bousson

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Congestion in the Terminal Maneuvering Areas (TMAs) of larger airports impacts all aspects of air traffic flow, not only at national level but may also induce arrival delays at international level. Hence, there is a need to monitor appropriately the air traffic flow in TMAs so that efficient decisions may be taken to manage their occupancy rates. It would be desirable to physically increase the existing airspace to accommodate all existing demands, but this question is entirely utopian and, given this possibility, several studies and analyses have been developed over the past decades to meet the challenges that have arisen due to the dizzying expansion of the aeronautical industry. The main objective of the present paper is to propose concepts to manage and reduce the degree of uncertainty in the air traffic operations, maximizing the interest of all involved, ensuring a balance between demand and supply, and developing and/or adapting resources that enable a rapid and effective adaptation of measures to the current context and the consequent changes perceived in the aeronautical industry. A central task is to emphasize the increase in air traffic flow management capacity to the present day, taking into account not only a wide range of methodologies but also equipment and/or tools already available in the aeronautical industry. The efficient use of these resources is crucial as the human capacity for work is limited and the actors involved in all processes related to air traffic flow management are increasingly overloaded and, as a result, operational safety could be compromised. The methodology used to answer and/or develop the issues listed above is based on the advantages promoted by the application of Markov Chain principles that enable the construction of a simplified model of a dynamic network that describes the air traffic flow behavior anticipating their changes and eventual measures that could better address the impact of increased demand. Through this model, the proposed concepts are shown to have potentials to optimize the air traffic flow management combined with the operation of the existing resources at each moment and the circumstances found in each TMA, using historical data from the air traffic operations and specificities found in the aeronautical industry, namely in the Portuguese context.

Keywords: air traffic flow, terminal maneuvering area, TMA, air traffic management, ATM, Markov chains

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Authors: Renu Pattanshetty

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The aim of this narrative review is to highlight the impact of menopause on osteoporosis and weight gain. The review also aims to summarize physiotherapeutic strategies to combat the same.A thorough literature search was conducted using electronic databases like MEDline, PUBmed, Highwire Press, PUBmed Central for English language studies that included search terms like menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies from the year 2000 till date. Out of 157 studies that included metanalyses, critical reviews and randomized clinical trials, a total of 84 were selected that met the inclusion criteria. Prevalence of obesity is increasing world - wide and is reaching epidemic proportions even in the menopausal women. Prevalence of abdominal obesity is almost double than that general obesity with rates in the US with 65.5% in women ages 40-59 years and 73.8 in women aged 60 years or more. Physical activities and exercises play a vital role in prevention and treatment of osteoporosis and weight gain related to menopause that aim to boost the general well-being and any symptoms brought about by natural body changes. Endurance exercises lasting about 30 minutes /day for 5 days/ week has shown to decrease weight and prevent weight gain. In addition, strength training with at least 8 exercises of 8-12 repetitions working for whole body and for large muscle groups has shown to result positive outcomes. Hot flashes can be combatted through yogic breathing and relaxation exercises. Prevention of fall strategies and resistance training are key to treat diagnosed cases of osteoporosis related to menopause. One to three sets with five to eight repetitions of four to six weight bearing exercises have shown positive results. Menopause marks an important time for women to evaluate their risk of obesity and osteoporosis. It is known fact that bone benefit from exercises are lost when training is stopped, hence, practicing bone smart habits and strict adherence to recommended physical activity programs are recommended which are enjoyable, safe and effective.

Keywords: menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies

Procedia PDF Downloads 297

Authors: Sirajdin Olagoke Adeshina, Haidi Ibrahim, Akeem Salawu

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large lecture theatres cannot be covered by a single camera but rather by a multicamera setup because of their size, shape, and seating arrangements. Although, classroom capture is achievable through a single camera. Therefore, a design and implementation of a multicamera setup for a large lecture hall were considered. Researchers have shown emphasis on the impact of class attendance taken on the academic performance of students. However, the traditional method of carrying out this exercise is below standard, especially for large lecture theatres, because of the student population, the time required, sophistication, exhaustiveness, and manipulative influence. An automated large classroom attendance system is, therefore, imperative. The common approach in this system is face detection and recognition, where known student faces are captured and stored for recognition purposes. This approach will require constant face database updates due to constant changes in the facial features. Alternatively, face counting can be performed by cropping the localized faces on the video or image into a folder and then count them. This research aims to develop a face localization-based approach to detect student faces in classroom images captured using a multicamera setup. A selected Haar-like feature cascade face detector trained with an asymmetric goal to minimize the False Rejection Rate (FRR) relative to the False Acceptance Rate (FAR) was applied on Raspberry Pi 4B. A relationship between the two factors (FRR and FAR) was established using a constant (λ) as a trade-off between the two factors for automatic adjustment during training. An evaluation of the proposed approach and the conventional AdaBoost on classroom datasets shows an improvement of 8% TPR (output result of low FRR) and 7% minimization of the FRR. The average learning speed of the proposed approach was improved with 1.19s execution time per image compared to 2.38s of the improved AdaBoost. Consequently, the proposed approach achieved 97% TPR with an overhead constraint time of 22.9s compared to 46.7s of the improved Adaboost when evaluated on images obtained from a large lecture hall (DK5) USM.

Keywords: automatic attendance, face detection, haar-like cascade, manual attendance

Procedia PDF Downloads 63

Authors: I. A. Yola

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Impact of poultry dropping, cow dung and rumen content on utilization and proximate composition of Oreochromis niliticus, Clarias gariepinus and Cyprinus capio in a polyculture system were studied. The research was conducted over a period of 52 weeks. Poultry droppings (PD), cow dung (CD) and rumen content (RC) were applied at three levels 30g,60g and 120g/m2/week, 25g,50g and 100g/m2/week and 22g, 44g and 88g/m2/week treatment, respectively. The control only conventional feed with 40% CP without manure application was used. Physicochemical and biological properties measured were higher in manure pond than control. The difference was statistically significant (P < 0.05) between and within treatments with exception of temperature with a combined mean of 27.900C. The water was consistently alkaline with mean values for pH of 6.61, transparency 22.6cm, conductivity 35.00µhos/cm, dissolved oxygen 4.6 mg/l, biological oxygen demand 2.8mg/l, nitrate and phosphates 0.9mg/l and 0.35mg/l, respectively. The three fish species increase in weight with increased manure rate, with a higher value in PD treatment on C. capio record 340g, O. niloticus weighed 310g and C. gariepinus 280g over the experimental period. Fishes fed supplementary diet (control) grew bigger with highest value on C. capio (685g) O. niloticus (620g) and then C. gariepinus (526g). The differences were statistically significant (P < 0.05). The result of whole body proximate analysis indicated that various manures and rates had an irregular pattern on the protein and ash gain per 100g of fish body weight gain. The combined means for whole fish carcass protein, lipids, moisture, ash and gross energy were 11.84, 2.43, 74.63, 3.00 and 109.9 respectively. The notable exceptions were significant (p < 0.05) increases in body fat and gross energy gains in all fish species accompanied by decreases in percentages of moisture as manure rates increased. Survival percentage decreases from 80% to 70%. It is recommended to use poultry dropping as manure/feeds at the rate of 120kg/ha/week for good performances in polyculture.

Keywords: organic manure, Nile tilapia, African mud fish, common carp, proximate composition

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Authors: Mosito Jonas Seabela

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Breastfeeding in public has become a contentious issue in contemporary society. Mothers are often subjected to unfair discrimination and harassment for simply responding to their maternal instinct to breastfeed their infants. The unwillingness of society to accept public breastfeeding as a natural, non-sexual act is partly influenced by the imposition of a pornified and hypersexualised Western culture, which was imported to Africa through colonisation, enforced by the apartheid regime, and is now perpetuated by Western media. The imposition of the modern nuclear family on Africans, and the coerced aspiration to subscribe to bourgeois values, has eroded the moral standing of the traditional African family and its cultural values. Western-centric perceptions of African women have altered the experience of motherhood for many, commodifying the practice of breastfeeding. As a result, the use of bottles and infant formulas is often perceived as the preferred method, while breastfeeding in public is viewed as primitive, immoral, and unacceptable. This normative study seeks to answer the question of what ought to be done to preserve the dignity of African motherhood and protect their right to breastfeed in public. The African philosophy of Ubuntu is employed to advocate for the right to breastfeed in public. This moral philosophy posits that the western perception of a person seeks to isolate people from their environment and culture, thereby undermining the process of acquiring humanity, which fosters social cohesion. The Ubuntu philosophy embodies the aphorism, “umuntu ngumuntu nga bantu”, meaning “a person is a person through other persons”, signifying people’s interconnectedness and interdependence. The application of the key principles of Ubuntu, such as “survival, the spirit of solidarity, compassion, respect, and dignity” can improve human interaction and unite the public to support the government’s efforts to increase exclusive breastfeeding rates and reduce infant mortality rates. A doctrine called “Ubuntu Lactivism” is what the author proposes as a means to advocate for breastfeeding rights in fulfilment of African traditional values.

Keywords: ubuntu, breastfeeding, Afrocentric, colonization, culture, motherhood, imperialism, objectification

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Authors: Mannika Garg, N. Srinivas Murthy, Sunish Nair

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TeamIndus is only Indian team participated in the Google Lunar X Prize (GLXP). GLXP is an incentive prize space competition which is organized by the XPrize Foundation and sponsored by Google. The main objective of the mission is to soft land a rover on the moon surface, travel minimum displacement of 500 meters and transmit HD and NRT videos and images to the Earth. Team Indus is designing a Lunar Lander which carries Rover with it and deliver onto the surface of the moon with a soft landing. For lander to survive throughout the mission, energy is required to operate all attitude control sensors, actuators, heaters and other necessary components. Photovoltaic solar array systems are the most common and primary source of power generation for any spacecraft. The scope of this paper is to provide a system-level approach for designing the solar array systems of the lander to generate required power to accomplish the mission. For this mission, the direction of design effort is to higher efficiency, high reliability and high specific power. Towards this approach, highly efficient multi-junction cells have been considered. The design is influenced by other constraints also like; mission profile, chosen spacecraft attitude, overall lander configuration, cost effectiveness and sizing requirements. This paper also addresses the various solar array design challenges such as operating temperature, shadowing, radiation environment and mission life and strategy of supporting required power levels (peak and average). The challenge to generate sufficient power at the time of surface touchdown, due to low sun elevation (El) and azimuth (Az) angle which depends on Lunar landing site, has also been showcased in this paper. To achieve this goal, energy balance analysis has been carried out to study the impact of the above-mentioned factors and to meet the requirements and has been discussed in this paper.

Keywords: energy balance analysis, multi junction solar cells, photovoltaic, reliability, spacecraft attitude

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Authors: Rajinder Singh, Ram Valluru

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Chain Ladder (CL) method, Expected Loss Ratio (ELR) method and Bornhuetter-Ferguson (BF) method, in addition to more complex transition-rate modeling, are commonly used actuarial reserving methods in general insurance. There is limited published research about their relative performance in the context of Mortgage Insurance (MI). In our experience, these traditional techniques pose unique challenges and do not provide stable claim estimates for medium to longer term liabilities. The relative strengths and weaknesses among various alternative approaches revolve around: stability in the recent loss development pattern, sufficiency and reliability of loss development data, and agreement/disagreement between reported losses to date and ultimate loss estimate. CL method results in volatile reserve estimates, especially for accident periods with little development experience. The ELR method breaks down especially when ultimate loss ratios are not stable and predictable. While the BF method provides a good tradeoff between the loss development approach (CL) and ELR, the approach generates claim development and ultimate reserves that are disconnected from the ever-to-date (ETD) development experience for some accident years that have more development experience. Further, BF is based on subjective a priori assumption. The fundamental shortcoming of these methods is their inability to model exogenous factors, like the economy, which impact various cohorts at the same chronological time but at staggered points along their life-time development. This paper proposes an alternative approach of parametrizing the loss development curve and using logistic regression to generate the ultimate loss estimate for each homogeneous group (accident year or delinquency period). The methodology was tested on an actual MI claim development dataset where various cohorts followed a sigmoidal trend, but levels varied substantially depending upon the economic and operational conditions during the development period spanning over many years. The proposed approach provides the ability to indirectly incorporate such exogenous factors and produce more stable loss forecasts for reserving purposes as compared to the traditional CL and BF methods.

Keywords: actuarial loss reserving techniques, logistic regression, parametric function, volatility

Procedia PDF Downloads 117

Authors: Urrutia Fernando, López Jessica, Sánchez Carlos, San Antonio Thalía

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Ecuador, as a signatory country of the convention of the rights of persons with disabilities (CRPD) has, in the recent years, strengthened the structures and legal framework required to protect this minority comprised of 13.2% of its total population. However, the reality is that this group has disproportionately low earnings and low educational attainment in comparison with the general population. The main struggles, to promote job placement of wheelchairs users, are environmental discrimination caused by accessibility in structures and transportation, this mainly due to the cost, for private and public entities, of performing the reasonable accommodation they require. It is widely known that product development and production is needed to support effective implementation of the CRPD and that walking and standing are the major life activities, in this context the objective of this investigation is to promote job placement of wheelchair user in the province of Tungurahua by means of the design, production and marketing of a customized stand up wheelchair. Exploratory interviews and measurements were performed in a representative sample of working age wheelchairs users that develop their disability after achieving their physical maturity and that are capable of performing professional activities with their upper limbs, this in order to detect the user’s preference and determine the local economic and anthropometric parameters to be included in the wheelchair design. The findings reveal factors that uniquely impact quality of life and development for people with a mobility disability within the context of the province, first that transportation is a big issue since public buses does not have accessibility for wheelchair users and the absence of curb cuts and the presence of trash bins over the sidewalks among other hinders an economic independent mobility, second that the proposal based in the idea of modifying the wheelchairs to make it able to overcome certain obstacles helps people in wheelchair to improve their independent living and by reducing the costs of modification for the employer could improve their chances of finding work.

Keywords: anthropometrics, job placement, stand up wheelchair, user centered design

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

Procedia PDF Downloads 133

Authors: Prasad Pokkunuri

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Visco-elastic materials combine the stress response properties of both solids and fluids and have found use in a variety of damping applications – both vibrational and acoustic. Defense and automotive applications, in particular, are subject to high impact and shock loading – for example: aircraft landing gear, firearms, and shock absorbers. Field responsive fluids – a class of smart materials – are the preferred choice of energy absorbents because of their controllability. These fluids’ stress response can be controlled by the application of a magnetic or electric field, in a closed loop. Their rheological properties – elasticity, plasticity, and viscosity – can be varied all the way from that of a liquid such as water to a hard solid. This work presents a simplified model to study the impulse response behavior of such fluids for use in recoil damping systems. The well-known Burger’s equation, in conjunction with various visco-elastic constitutive models, is used to represent fluid behavior. The Kelvin-Voigt, Upper Convected Maxwell (UCM), and Oldroyd-B constitutive models are implemented in this study. Using these models in a one-dimensional framework eliminates additional complexities due to geometry, pressure, body forces, and other source terms. Using a finite difference formulation to numerically solve the governing equation(s), the response to an initial impulse is studied. The disturbance is confined within the problem domain with no-inflow, no-outflow boundary conditions, and its decay characteristics studied. Visco-elastic fluids typically involve a time-dependent stress relaxation which gives rise to interesting behavior when subjected to an impulsive load. For particular values of viscous damping and elastic modulus, the fluid settles into a stable oscillatory state, absorbing and releasing energy without much decay. The simplified formulation enables a comprehensive study of different modes of system response, by varying relevant parameters. Using the insights gained from this study, extension to a more detailed multi-dimensional model is considered.

Keywords: Burgers Equation, Impulse Response, Recoil Damping Systems, Visco-elastic Fluids

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Authors: Kremena Ivanona, Bistra Kunovska, Jana Djunova, Desislava Djunakova, Zdenka Stojanovska

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In recent decades, the general public has become increasingly interested in the impact of air pollutions on their health. Currently, numerous studies are aimed at identifying pollutants in the indoor environment where they carry out daily activities. Internal pollutants can be of both natural and artificial origin. With regard to natural pollutants, special attention is paid to natural radioactivity. In recent years, radon has been one of the most studied indoor pollutants because it has the greatest contribution to human exposure to natural radionuclides. It is a known fact that lung cancer can be caused by radon radiation and it is the second risk factor after smoking for the onset of the disease. The main objective of the study under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018 is to evaluate the indoor radon as an important air pollutant in school buildings in order to reduce the exposure to children. The measurements were performed in 48 schools located in 55 buildings in one Bulgarian administrative district (Kardjaly). The nuclear track detectors (CR-39) were used for measurements. The arithmetic and geometric means of radon concentrations are AM = 140 Bq/m3, and GM = 117 Bq/m3 respectively. In 51 school rooms, the radon levels were greater than 200 Bq/m3, and in 28 rooms, located in 17 school buildings, it exceeded the national reference level of 300 Bq/m3, defined in the Bulgarian ordinance on radiation protection (or 30% of the investigated buildings). The statistically significant difference in the values of radon concentration by municipalities (KW, р < 0.001) obtained showed that the most likely reason for the differences between the groups is the geographical location of the buildings and the possible influence of the geological composition. The combined effect of the year of construction (technical condition of the buildings) and the energy efficiency measures was considered. The values of the radon concentration in the buildings where energy efficiency measures have been implemented are higher than those in buildings where they have not been performed. This result confirms the need for investigation of radon levels before conducting the energy efficiency measures in buildings. Corrective measures for reducing the radon levels have been recommended in school buildings with high radon levels in order to decrease the children's exposure.

Keywords: air pollution, indoor radon, children exposure, schools

Procedia PDF Downloads 163

Authors: Dau Lal Bohra, Sradha Vyas

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Bird species are already showing climate-related changes in the dates they migrate and breed, and in the timing of other key life-history events. Treats of feeding managements raptors have performed important ecological, traditional and aesthetic functions throughout the Indian subcontinent. The declines in India result from elevated adult and juvenile mortality, and low breeding success. The widespread and rapid pattern of declines, i.e. in all areas irrespective of habitat or protection status suggest that persecution through shooting or poisoning, whilst important at a local scale, are unlikely to have caused the declines. A mass killing of several species of vultures in the Indian subcontinent over the last two decades is largely blamed on the presence of a drug. Veterinary diclofenac caused an unprecedented decline in South Asia’s Gyps vulture populations, with some species declining by more than 97% between 1992 and 2007. Veterinary diclofenac causes renal failure in vultures, and killed tens of millions of such birds in the Indian sub-continent. The drug was finally banned there for veterinary purposes in 2006. This drug is now ‘a global problem’ threatening many vulnerable birds of prey. Recently, stappe eagles are also susceptible to veterinary diclofenac, effectively increasing the potential threat level, and the risks for European biodiversity. Steppe eagles are closely related with golden eagles (Aquila chrysaetus), imperial eagles (Aquila heliaca) and Spanish imperial eagles (Aquila adalberti), and all these species scavenge opportunistically on carcasses throughout their range. The Spanish imperial eagle, considered Vulnerable at global level, is now particularly at risk, due to the availability of diclofenac in Spain. These findings strengthen the case for banning veterinary diclofenac across. From year 2011 to 2014 more than 300 hundred birds dead in jorbeer, Bikaner. Now, with unequivocal evidence that this veterinary drug can cause a much wider impact on Europe´s biodiversity, it is time for action – please ban diclofenac human brand also in multi-dose vial from market.

Keywords: mortility, prey of birds, diclofenac, Rajasthan

Procedia PDF Downloads 361

Authors: Norazilawati Binti Md Dahlal, Nabiila Binti Mat Yusoff, Anis Najiha Binti Ahmad

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With the increasing demand for halal products, there is a growing emphasis on ensuring their quality and adherence to halal standards. However, the vulnerability of halal goods to fraud and adulteration poses a significant challenge to the integrity of the halal industry. Whistleblowers play a pivotal role in safeguarding the safety and integrity of halal food by exposing wrongdoings, misconduct, and fraudulent practices. This study explores the implementation of whistleblowing practices aligned with halal and toyyib principles to effectively address halal food fraud issues. Whistleblowing is defined as the act of disclosing information about misconduct, immorality, or unlawful activities to relevant authorities or the public. Although whistleblowing is universally recognized as beneficial, it exposes whistleblowers to substantial risks, including career setbacks, reputation damage, and personal safety threats. Despite legal protections, whistleblowers often face retaliation and hesitancy to come forward. By integrating the principles of halal and toyyib, which encompass the physical and spiritual as well as material and supernatural elements, effective whistleblowing practices can be developed. These principles include the physical characteristic of the product in accordance with Shari’ah law (P1); products that are sourced ethically and responsibly (P2); Products that meet high standard of quality and safety (P3); functioning as servant and caliph of Allah in managing according to Allah's commands and prohibitions (P4); not excessively wasteful or extravagant (P5); positive moral and spiritual implications associated with the product (P6); and aimed at achieving prosperity in both this life and the Hereafter (P7). Employing a quantitative research approach, this study examines Islamic primary data sources and secondary data sources to investigate the prevalence and impact of whistleblowing in the halal industry. By analyzing the principles of halal and toyyib and exploring the importance of whistleblowing effective whistleblowing practices, this research aims to enhance our understanding of promoting accountability and justice within the halal industry from an Islamic perspective.

Keywords: whistleblowing, halal and toyyib, food fraud, halal integrity, Islamic practices

Procedia PDF Downloads 117

Authors: Yuqiao Zhou

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The Sapir-Whorf hypothesis (SWH) emphasizes the effect produced by language on people’s minds. According to linguistic relativity, language has evolved over the course of human life on earth, and, in turn, the acquisition of language shapes learners’ thoughts. Despite much attention drawn by SWH, few scholars have attempted to analyse people’s thoughts via their literary works. And yet, the linguistic choices that create a narrative can enable us to examine its writer’s thoughts. Still, less work has been done on the impact of language on the minds of bilingual people. Internationalization has resulted in an increasing number of bilingual and multilingual individuals. In China, where more than one hundred languages are used for communication, most people are bilingual in Mandarin Chinese (the official language of China) and their own dialect. Taking as its corpus the ethnic minority myth of Ge Sa-er Wang by Alai and its English translation by Goldblatt and Lin, this paper aims to analyse the effects of culture on bilingual people’s minds. It will first analyse Alai’s thoughts on using the original version of Ge Sa-er Wang; next, it will examine the thoughts of the two translators by looking at translation choices made in the English version; finally, it will compare the cultural influences evident in the thoughts of Alai, and Goldblatt and Lin. Whereas Alai can speak two Sino-Tibetan languages – Mandarin Chinese and Tibetan – Goldblatt and Lin can speak two languages from different families – Mandarin Chinese (a Sino-Tibetan language) and English (an Indo-European language). The results reveal two systems of thought existing in the translators’ minds; Alai’s text, on the other hand, does not reveal a significant influence from North China, where Mandarin Chinese originated. The findings reveal the inconsistency of a second language’s influence on people’s minds. Notably, they suggest that the more different the two languages are, the greater the influence produced by the second language culture on people’s thoughts. It is hoped that this research will expand the scope of SWH as well as shed light on future translation studies on ethnic minority literature.

Keywords: Sapir-Whorf hypothesis, cultural translation, cultural-specific items, Ge Sa-er Wang, ethnic minority literature, Tibet

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Authors: Mark Davies, Carolyn Wallace, Christina Lloydwin, Tom Powell

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Background: Frailty is increasingly recognized as a public health problem within an aging population. It is often characterized as an accumulation of clinical symptoms with progressive decline. We contend that dehydration is potentially the missing link driving the cycle of frailty; it contributes to malnutrition and cognitive decline and is a risk factor for other conditions. Frailty may also impact on fluid intake in cognitively intact older adults, indicating the cyclical nature of dehydration contributing to increasing frailty. Aim: To examine the relationships between fluid, hydration, and frailty in older adults in order to determine what works, for whom, how, why, and in what circumstances. Methods: A Realist Synthesis was first undertaken with n=50 studies, leading to the development of a Refined Programme Theory (RPT) articulating what hydration interventions work, for whom, to what degree, in what contexts, and how & why. Within the subsequent evaluation, the RPT was further confirmed/refuted/refined following semi-structured interviews with n=8 participants (healthcare professionals and patients). The RAMESES Quality Standards were followed throughout the study. Results: The Refined Programme Theory (RPT) highlighted three factors that result in optimized hydration for frail older people, i.e., Developing an Understanding Around Hydration, Empowering Participation, and System Reconfiguration. Our RPT indicates that hydration interventions work by developing an understanding of the importance of hydration, mitigating physical & cognitive barriers, increasing the agency of the patient, using a prompting process to reinforce drinking behavior, and routinizing hydration as a dimension of overall care. Conclusion: The study indicates that a greater understanding of the importance of hydration is required for all parties. Patients also require physical and psychological support if they are to be active agents in meeting their hydration needs. At a wider ‘system’ level, organizations must work in an integrated manner introducing processes that enable continuing professional development (CPD), encourage ongoing holistic assessment, and routinize hydration support.

Keywords: frailty, dehydration, older adults, realist review, realist evaluation

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Authors: Ari Prasetyo, Taufik Faturohman

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The COVID-19 pandemic in Indonesia is part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was confirmed to have spread to Indonesia on 2 March 2020. Moreover, the government of Indonesia has been conducting a local lockdown to limit people's movement from one city to another city. Therefore, this situation has impact on business operation, especially on highway companies listed on the Indonesia stock exchange. This study evaluates and measures three companies’ financial performance and health conditions before and during the COVID-19 pandemic from 2016 – 2020. The measurement is conducted by using financial ratio analysis and the Altman Z-score method. The ratio used to measure the financial ratio analysis is taken from the decree of the Ministry of SOE’s KEP-100/MBU/2002 about the company’s health level condition. From the decree, there are eight financial ratios used such as return on equity (ROE), return on investment (ROI), current ratio, cash ratio, collection period, inventory turnover, total asset turnover, and total equity to total asset. Altman Z-score is used to calculate the financial distress condition. The result shows that the highway companies for the period 2016 – 2020 are as follows: PT Jasa Marga (Persero) Tbk (AA, BB, BB, BB, C), PT Citra Marga Nusaphala Persada Tbk (BB, AA, BB, BBB, C), and PT Nusantara Infrastructure Tbk (BB, BB, AA, BBB, C). In addition, the Altman Z-score assessment performed in 2016-2020 shows that PT Jasa Marga (Persero) Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020. PT Citra Marga Nusaphala Persada Tbk was in the grey zone area for 2015-2019 and in the distress zone for 2020. PT Nusantara Infrastructure Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020.

Keywords: financial performance, financial ratio, Altman Z-score, financial distress, highway company

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Authors: Cha-ah C. N., Awah N. J., Mouiche M. M. M.

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Brucellosis is a neglected zoonotic disease of animals and man caused by bacteria of genus Brucella. Though eradicated in some parts of the world, it remains endemic in sub-Saharan Africa including Cameroon. The aim of this study was to contribute to the epidemiology of brucellosis in the North-West region of Cameroon by detecting the presence of anti-Brucella antibodies in bovine bulk milk as this serves as a route of transmission from animals to man. A cross sectional study was conducted to determine the prevalence of Brucella abortus antibodies in bovine bulk milk in the peri-urban zones of Bamenda. One hundred bulk milk samples were collected from 100 herds and tested by milk I-ELISA test. The conducted study revealed the presence of anti-Brucella abortus antibodies in bovine bulk milk. The study revealed that bovine brucellosis is widespread in animal production systems in this area. The animal infection pressure in these systems has remained strong due to movement of livestock in search of pasture, co-existence of animal husbandry, communal sharing of grazing land, concentration of animals around water points, abortions in production systems, locality of production systems and failure to quarantine upon introduction of new animals. The circulation of Brucella abortus antibodies in cattle farms recorded in the study revealed potential public health implication and suggest economic importance of brucellosis to the cattle industry in the Northwest region of Cameroon. The risk for re-emergence and transmission of brucellosis is evident as a result of the co-existence of animal husbandry activities and social-cultural activities that promote brucellosis transmission. Well-designed countrywide, evidence-based studies of brucellosis are needed. These could help to generate reliable frequency and potential impact estimates, to identify Brucella reservoirs, and to propose control strategies of proven efficacy.

Keywords: brucellosis, bulk milk, northwest region Cameroon, prevalence

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Authors: Megumi Nishida, Naoya Motegi, Takurou Kikuchi, Tomoko Tokumura

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In recent years, power system has been changed and flexible power pricing system such as demand response has been sought in Japan. The demand response system is simple in the household sector and the owner, decision-maker, can gain the benefits of power saving. On the other hand, the execution of the demand response in the office building is more complex than household because various people such as owners, building administrators and occupants are involved in making decisions. While the owners benefit from the demand saving, the occupants are forced to be exposed to demand-saved environment certain benefits. One of the reasons is that building systems are usually centralized control and each occupant cannot choose either participate demand response event or not, and contribution of each occupant to demand response is unclear to provide incentives. However, the recent development of IT and building systems enables the personalized control of office environment where each occupant can control the lighting level or temperature around him or herself. Therefore, it can be possible to have a system which each occupant can make a decision of demand response participation in office building. This study investigates the personal behavior upon demand response requests, under the condition where each occupant can adjust their brightness individually in their workspace. Once workers participate in the demand response, their task lights are automatically turned off. The participation rates in the demand response events are compared between four groups which are divided by different motivation, the presence or absence of incentives and the way of participation. The result shows that there are the significant differences of participation rates in demand response event between four groups. The way of participation has a large effect on the participation rate. ‘Opt-out’ group, where the occupants are automatically enrolled in a demand response event if they don't express non-participation, will have the highest participation rate in the four groups. The incentive has also an effect on the participation rate. This study also reports that the impact of low illumination office environment on the occupants, such as stress or fatigue. The electrocardiogram and the questionnaire are used to investigate the autonomic nervous activity and subjective symptoms about the fatigue of the occupants. There is no big difference between dim workspace during demand response event and bright workspace in autonomic nervous activity and fatigue.

Keywords: demand response, illumination, questionnaire, electrocardiogram

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Authors: P. Dhesi, R. Burns

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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.

Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK

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Authors: Samhita Mummadi, Sree Divya Nagalli, Harshini Vemuri, Saketh Charan Nakka, Sumesh K. J.

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One of the most significant challenges faced by people in today’s digital era is an alarming increase in fraudulent activities on online platforms. The fascination with online shopping to avoid long queues in shopping malls, the availability of a variety of products, and home delivery of goods have paved the way for a rapid increase in vast online shopping platforms. This has had a major impact on increasing fraudulent activities as well. This loop of online shopping and transactions has paved the way for fraudulent users to commit fraud. For instance, consider a store that orders thousands of products all at once, but what’s fishy about this is the massive number of items purchased and their transactions turning out to be fraud, leading to a huge loss for the seller. Considering scenarios like these underscores the urgent need to introduce machine learning approaches to combat fraud in online shopping. By leveraging robust algorithms, namely KNN, Decision Trees, and Random Forest, which are highly effective in generating accurate results, this research endeavors to discern patterns indicative of fraudulent behavior within transactional data. Introducing a comprehensive solution to this problem in order to empower e-commerce administrators in timely fraud detection and prevention is the primary motive and the main focus. In addition to that, sentiment analysis is harnessed in the model so that the e-commerce admin can tailor to the customer’s and consumer’s concerns, feedback, and comments, allowing the admin to improve the user’s experience. The ultimate objective of this study is to ramp up online shopping platforms against fraud and ensure a safer shopping experience. This paper underscores a model accuracy of 84%. All the findings and observations that were noted during our work lay the groundwork for future advancements in the development of more resilient and adaptive fraud detection systems, which will become crucial as technologies continue to evolve.

Keywords: behavior analysis, feature selection, Fraudulent pattern recognition, imbalanced classification, transactional anomalies

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Authors: Haobin Zheng, Xiang Zhang, Yong Shen, Hongxin Zou

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The research focuses on mode-locked fiber lasers with a non-linear amplifying loop mirror (NALM). Although these lasers have shown potential, they still have limitations in terms of low repetition rate. The self-starting of mode-locking in NALM is influenced by the cross-phase modulation (XPM) effect, which has not been thoroughly studied. The aim of this study is two-fold. First, to overcome the difficulties associated with increasing the repetition rate in mode-locked fiber lasers with NALM. Second, to analyze the influence of XPM on self-starting of mode-locking. The power distributions of two counterpropagating beams in the NALM and the differential non-linear phase shift (NPS) accumulations are calculated. The analysis is conducted from the perspective of NPS accumulation. The differential NPSs for continuous wave (CW) light and pulses in the fiber loop are compared to understand the inverse saturable absorption (ISA) mechanism during pulse formation in NALM. The study reveals a difference in differential NPSs between CW light and pulses in the fiber loop in NALM. This difference leads to an ISA mechanism, which has not been extensively studied in artificial saturable absorbers. The ISA in NALM provides an explanation for experimentally observed phenomena, such as active mode-locking initiation through tapping the fiber or fine-tuning light polarization. These findings have important implications for optimizing the design of NALM and reducing the self-starting threshold of high-repetition-rate mode-locked fiber lasers. This study contributes to the theoretical understanding of NALM mode-locked fiber lasers by exploring the ISA mechanism and its impact on self-starting of mode-locking. The research fills a gap in the existing knowledge regarding the XPM effect in NALM and its role in pulse formation. This study provides insights into the ISA mechanism in NALM mode-locked fiber lasers and its role in selfstarting of mode-locking. The findings contribute to the optimization of NALM design and the reduction of self-starting threshold, which are essential for achieving high-repetition-rate operation in fiber lasers. Further research in this area can lead to advancements in the field of mode-locked fiber lasers with NALM.

Keywords: inverse saturable absorption, NALM, mode-locking, non-linear phase shift

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Authors: Marianys Fernandez

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Gastronomic experiences generate a positive impact on the dynamization of the economy when they are managed in a sustainable manner, given that they value the identity of the destination, strengthen cooperation between stakeholders in the sector, contribute to the preservation of gastronomic heritage, and encourage the implementation of competitive and sustainable public policies. Having as its main aim the analysis of sustainable management of gastronomic experiences, this study analyses different elements associated with the promotion of the local economy. For this purpose, a systematic literature review was carried out to identify, select, synthesise, and evaluate the studies that respond to the research objectives in order to select more reliable articles for research and reduce the potential for bias within the review of literature. To obtain reliable, updated and relevant sources for scientific research, the Web of Science and Scopus databases were used, taking into account the following key words: (1) experiential tourism, (2) gastronomy experience, (3) sustainable destination management, (4) sustainable gastronomy, (5) sustainable economy, in which we obtained a final list of 76 articles. The analysis of the literature allowed us to identify the most pertinent elements referring to the objective of the study: (a) need for competitive policies in the gastronomic sector to promote sustainable local economic development, (b) incentive for cooperation between stakeholders in the gastronomic sector, to guarantee the competitiveness of the destination, (c) propose sustainable standards in the gastronomic tourism sector that link the local economy. Gastronomic experiences constitute a dynamic element of the local economy and promote sustainable tourism. We can highlight that sustainability is a mechanism for the preservation of regional identity in the gastronomic sector through the valuation of the attributes of gastronomy, promotion of the local economy, strengthening of strategic alliances between the stakeholders of the gastronomic sector and its relevant contribution to the competitiveness of the destination. The theoretical implications of the study are focused on suggesting planning, management, and policy criteria to promote the sustainable management of gastronomic experiences in order to promote the local economy. In the practical context, research integrates different approaches, tools, and methods to encourage the active participation of local actors in the promotion of the local economy through the sustainable management of gastronomic tourism.

Keywords: experiential tourism, gastronomy experience, sustainable destination management, sustainable economy, sustainable gastronomy

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Authors: Yasmeen Coaxum

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The year 2020 became synonymous with the words “Emergency Remote Teaching,” which was imposed upon educators during the COVID-19 pandemic. Consequently, teachers were compelled to find new and engaging ways to educate their students outside of the face-to-face classroom setting. Now online instruction has become more of the norm rather than a way to manage educational expectations during a crisis. Therefore, implementing a strategic way to create online environments for students to thrive, create, and fully engage in their learning process is essential. The Synchronous Online Flipped Learning Approach or SOFLA® is a distance learning model that most closely replicates actual classroom teaching. SOFLA® includes structured, interactive, multimodal activities in an eight-step learning cycle with both asynchronous and synchronous components that foster autonomous and interactive learning among today’s online learners. The results of a pilot study in an Intensive English Program at a university, using SOFLA® methodology to facilitate podcasting in an online learning environment will be shared. Previous findings on student-produced podcasting projects have shown that students felt they improved their pronunciation, vocabulary, and speaking skills. However, few if any studies have been conducted on using a structured online flipped learning approach to facilitate such projects. Therefore, the purpose of this study is to assess the effect of using the SOFLA® framework to enhance optimum engagement in the online environment while using podcasts as the primary tool of instruction. Through data from interviews, questionnaires, and the results of formative and summative assessments, this study also investigates the affective and academic impact this flipped learning method combined with podcasting has on the students in terms of speaking confidence and vocabulary retention, and production. The steps of SOFLA will be illustrated, a video demonstration of the Anchor podcasting app will be shown, and final student projects and questionnaire responses will be shared. The specific context is a 14-week advanced level conversation and listening class. Participants vary in age but are all adult language learners representing a diverse array of countries.

Keywords: mall online flipped learning, podcasting, productive vocabulary

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Authors: Djurdjica Perovic, Sanja Pekovic, Tatjana Stanovcic, Jovana Vukcevic

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Tourism development in rural areas calls for a discussion of strategies that would attract more tourists. Several scholars argue that rural areas may become more attractive to tourists by leveraging their cultural heritage. The present paper explores the development of sustainable heritage tourism practices in transitional societies of the Western Balkans, specifically targeting Montenegrin rural areas. It addresses the sustainable tourism as a shift in business paradigm, enhancing the centrality of the host community, fostering the encounters with local culture, customs and heritage and minimizing the environmental and social impact. Disseminating part of the results of the interdisciplinary KATUN project, the paper explores the diversification of economic activities related to the cultural heritage of katuns (temporary settlements in Montenegrin mountainous regions where the agricultural households stay with livestock during the summer season) through sustainable agro-tourism. It addresses the role of heritage tourism in creating more dynamic economy of under-developed mountain areas, new employment opportunities, sources of income for the local community and more balanced regional development, all based on the principle of sustainability. Based on the substantial field research (including interviews with over 50 households and tourists, as well as the number of stakeholders such as relevant Ministries, business communities and media representatives), the paper analyses the strategies employed in raising the awareness and katun-sensitivity of both national and international tourists and stimulating their interest in sustainable agriculture, rural tourism and cultural heritage of Montenegrin mountain regions. Studying the phenomena of responsible tourism and tourists’ consumerist consciousness in Montenegro through development of katuns should allow evaluating stages of sustainability and cultural heritage awareness, closely intertwined with the EU integration processes in the country. Offering deeper insight at the relationship between rural tourism, sustainable agriculture and cultural heritage, the paper aims to understand if cultural heritage of the area is valuable for agro-tourism development and in which context.

Keywords: heritage tourism, sustainable tourism, added value, Montenegro

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Authors: Khemakhem Nahed, Hammami Fatma, Trabelsi Houaida, Neji Sourour, Sellami Hayet, Makni Fattouma, Turki Hamida, Ayadi Ali

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Dermatophytoses are considered a public health problem and represent 10% of dermatological consultations in our region. Their epidemiology is influenced by various factors, such as lifestyle, human migration patterns, changes in the environment and the host relationship. The understanding of epidemiology has a major impact on their prevention and treatment. The aim of the study is to determine the prevalence pattern of aetiological agents and to describe the clinical characteristics of dermatophytoses between 1999 and 2019. Out of 65 059 subjects suspected to have superficial mycoses, 36 220 (55.67%) were affected with dermatophytoses. The mean age was 40.1 years (range: 10 days to 99 years). The sex ratio was 0.8. Our patients were from urban regions in 80.9% of cases. The most common type of infection was onychomycosis (42.64%), followed by tinea pedis (20.8%), intertrigo (18.3%), tinea corporis (8.48%) and tinea capitis (7.87%). The most isolated dermatophyte was Trichophyton rubrum (76.5%), followed by T. mentagrophytes complex (6.3%), Microsporum canis (5.8%), T. violaceum (5.3%), T. verrucosum (0.83%) and Epidermophyton floccosum (0.3%). Zoophilic agents have become more prevalent and their frequency has been increased from 6.46% in 1999 to 13% in 2019. It is interesting to note that M. canis has been on the rise since 2010 and it was the first etiological agent of tinea capitis (48%), while infections caused by T. violaceum continued to decrease from 1999 (16.2%) to 2019 (4.7%). Other dermatophytes have been rarely isolated: T. tonsurans (9 cases), T. schoenleinii (3 cases), T. soudanense (2 cases), M. fulvum (1 case), M. audouinii (1 case) and M. ferrugineum (2 cases).T. mentagrophytes var. quinckeanum was isolated from an inflammatory tinea capitis lesion in an a-3-year-old girl. T. mentagrophytes var. erinacei was isolated from the first case of tinea manuum, in-a-10-year-old girl. The same fungus was isolated from the hair and scales of the hedgehog. Our study showed significant changes in the dermatophytes spectrum in our region. The prevalence of zoophilic species increased in recent years due to people's behavioral changes with the adoption of pets and animal husbandry in urban settings. Molecular methods are often crucial that help us to refine the identification strains of dermatophytes and to identify their origin of the contamination.

Keywords: dermatophytoses, PCR-sequencing, spectrum, Sfax, Tunisia

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Authors: Priyanka Agrawal, Janou Koskamp, Amir Raoof, Mariette Wolthers

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Calcite is the main mineral found in carbonate rocks, which form significant hydrocarbon reservoirs and subsurface repositories for CO2 sequestration. The injected CO2 mixes with the reservoir fluid and disturbs the geochemical equilibrium, triggering calcite dissolution. Different combinations of fluid chemistry and injection rate may therefore result in different evolution of porosity, permeability and dissolution patterns. To model the changes in porosity and permeability Kozeny-Carman equation K∝〖(∅)〗^n is used, where K is permeability and ∅ is porosity. The value of n is mostly based on experimental data or pore network models. In pore network models, this derivation is based on accuracy of relation used for conductivity and pore volume change. In fact, at a single pore scale, this relationship is the result of the pore shape development due to dissolution. We have prepared a new reactive transport model for a single pore which simulates the complex chemical reaction of carbonic-acid induced calcite dissolution and subsequent pore-geometry evolution at a single pore scale. We use COMSOL Multiphysics package 5.3 for the simulation. COMSOL utilizes the arbitary-Lagrangian Eulerian (ALE) method for the free-moving domain boundary. We examined the effect of flow rate on the evolution of single pore shape profiles due to calcite dissolution. We used three flow rates to cover diffusion dominated and advection-dominated transport regimes. The fluid in diffusion dominated flow (Pe number 0.037 and 0.37) becomes less reactive along the pore length and thus produced non-uniform pore shapes. However, for the advection-dominated flow (Pe number 3.75), the fast velocity of the fluid keeps the fluid relatively more reactive towards the end of the pore length, thus yielding uniform pore shape. Different pore shapes in terms of inlet opening vs overall pore opening will have an impact on the relation between changing volumes and conductivity. We have related the shape of pore with the Pe number which controls the transport regimes. For every Pe number, we have derived the relation between conductivity and porosity. These relations will be used in the pore network model to get the porosity and permeability variation.

Keywords: single pore, reactive transport, calcite system, moving boundary

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Authors: Polina Prokopovich

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Despite the well-established dependence of cartilage mechanical properties on the frequency of the applied load, most research in the field is carried out in either load-free or constant load conditions because of the complexity of the equipment required for the determination of time-dependent properties. These simpler analyses provide a limited representation of cartilage properties thus greatly reducing the impact of the information gathered hindering the understanding of the mechanisms involved in this tissue replacement, development and pathology. More complex techniques could represent better investigative methods, but their uptake in cartilage research is limited by the highly specialised training required and cost of the equipment. There is, therefore, a clear need for alternative experimental approaches to cartilage testing to be deployed in research and clinical settings using more user-friendly and financial accessible devices. Frequency dependent material properties can be determined through rheometry that is an easy to use requiring a relatively inexpensive device; we present how a commercial rheometer can be adapted to determine the viscoelastic properties of articular cartilage. Frequency-sweep tests were run at various applied normal loads on immature, mature and trypsinased (as model of osteoarthritis) cartilage samples to determine the dynamic shear moduli (G*, G′ G″) of the tissues. Moduli increased with increasing frequency and applied load; mature cartilage had generally the highest moduli and GAG depleted samples the lowest. Hydraulic permeability (KH) was estimated from the rheological data and decreased with applied load; GAG depleted cartilage exhibited higher hydraulic permeability than either immature or mature tissues. The rheometer-based methodology developed was validated by the close comparison of the rheometer-obtained cartilage characteristics (G*, G′, G″, KH) with results obtained with more complex testing techniques available in literature. Rheometry is relatively simpler and does not require highly capital intensive machinery and staff training is more accessible; thus the use of a rheometer would represent a cost-effective approach for the determination of frequency-dependent properties of cartilage for more comprehensive and impactful results for both healthcare professional and R&D.

Keywords: tissue, rheometer, biomaterial, cartilage

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Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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Authors: Nur R. Daut

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The objective of this paper is to offer an insight on how political power inequality has contributed and exacerbated the political violence towards the Rohingya ethnic group in Myanmar. In particular, this paper attempts to illustrate how power inequality in the country has prevented Myanmar’s leader Aung San Suu Kyi from taking effective measures on the issue. The research centers on the question of why Aung San Suu Kyi has been seen as not doing enough to stop the persecution of the Rohingya ethnic group ever since she was appointed the State Counsellor to the Myanmar government. As a Nobel Peace Prize laureate, Suu Kyi’s lack of action on the matter has come under severe criticism by the international community. Many have seen this as Suu Kyi’s failure to establish democracy and allowing mass killing to spread in the country. The real question that many perhaps should be asking, however, is how much power Suu Kyi actually holds within the government which is still heavily controlled by the military or Tatmadaw. This paper argues that Suu Kyi’s role within the government is limited which hinders constructive and effective measures to be taken on the Rohingya issue. Political power in this research is being measured by 3 factors: control over events such as burning of Rohingya villages, control over resources such as land ownership and media and control over actors such the Tatmadaw, police force and civil society who are greatly needed to ease and resolve the conflict. In order to illustrate which individuals or institution have control over all the 3 above factors, this paper will first study the constitution of Myanmar. The constitution will also be able to show the asymmetrical power relations as it will provide evidence as to how much political power Suu Kyi holds within the government in comparison to other political actors and institutions. Suu Kyi’s role as a state counsellor akin to a prime minister is a newly created position as the current constitution of Myanmar bars anyone with a foreign spouse from holding the post of a president in the country. This is already an indication of the inequality of political power between Suu Kyi and the military. Apart from studying the constitution of Myanmar, Suu Kyi’s speeches and various interviews are also studied in order to answer the research question. Unfortunately, Suu Kyi’s limited political power also involves the Buddhist monks in Myanmar who have held significant influence throughout the history of the country. This factor further prevents Suu Kyi from preserving the sanctity of human rights in Myanmar.

Keywords: Aung San Suu Kyi, constitution of Myanmar, inequality, political power, political violence, Rohingya, Tatmadaw

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Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

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Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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