Search results for: options counseling

Authors: Maho Komura

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The purpose of this study was to determine from a questionnaire survey of teachers the status of implementation of individualized support for the pupils with suspected developmental disabilities in regular elementary school classes in Japan. In inclusive education, the goal is for all pupils to learn in the same place as much as possible by receiving the individualized support they need. However, in the Japanese school culture, strong "homogeneity" sometimes surfaces, and it is pointed out that it is difficult to provide individualized support from the viewpoint of formal equality. Therefore, we decided to conduct this study in order to examine whether there is a difference in the frequency of implementation depending on the content of individualized support and to consider the direction of future individualized support. The subjects of the survey were 196 public elementary school teachers who had been in charge of regular classes within the past five years. In the survey, individualized support was defined as individualized consideration including rational consideration, and did not include support for the entire class or all pupils enrolled in the class (e.g., reducing the amount of homework for pupils who have trouble learning, changing classroom rules, etc.). (e.g., reducing the amount of homework for pupils with learning difficulties, allowing pupils with behavioral concerns to use the library or infirmary when they are unstable). The respondents were asked to choose one answer from four options, ranging from "very much" to "not at all," regarding the degree to which they implemented the nine individual support items that were set up with reference to previous studies. As a result, it became clear that the majority of teachers had pupils with developmental disabilities or pupils who require consideration in terms of learning and behavior, and that the majority of teachers had experience in providing individualized support to these pupils. Investigating the content of the individualized support that had been implemented, it became clear that the frequency with which it was implemented varied depending on the individualized support. Individualized support that allowed pupils to perform the same learning tasks was implemented more frequently, but individualized support that allowed different learning tasks or use of places other than the classroom was implemented less frequently. It was suggested that flexible support methods tailored to each pupil may not have been considered.

Keywords: inclusive education, ndividualized support, regular class, elementary school

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Authors: Wale Agbaje

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The aim of this research study is to assess the impact of financial statement fraud on profitability of some selected Nigerian manufacturing firms covering (2002-2016). The specific objectives focused on to ascertain the effect of incorrect asset valuation on return on assets (ROA) and to ascertain the relationship between improper expense recognition and return on assets (ROA). To achieve these objectives, descriptive research design was used for the study while secondary data were collected from the financial reports of the selected firms and website of security and exchange commission. The analysis of covariance (ANCOVA) was used and STATA II econometric method was used in the analysis of the data. Altman model and operating expenses ratio was adopted in the analysis of the financial reports to create a dummy variable for the selected firms from 2002-2016 and validation of the parameters were ascertained using various statistical techniques such as t-test, co-efficient of determination (R2), F-statistics and Wald chi-square. Two hypotheses were formulated and tested using the t-statistics at 5% level of significance. The findings of the analysis revealed that there is a significant relationship between financial statement fraud and profitability in Nigerian manufacturing industry. It was revealed that incorrect assets valuation has a significant positive relationship and so also is the improper expense recognition on return on assets (ROA) which serves as a proxy for profitability. The implication of this is that distortion of asset valuation and expense recognition leads to decreasing profit in the long run in the manufacturing industry. The study therefore recommended that pragmatic policy options need to be taken in the manufacturing industry to effectively manage incorrect asset valuation and improper expense recognition in order to enhance manufacturing industry performance in the country and also stemming of financial statement fraud should be adequately inculcated into the internal control system of manufacturing firms for the effective running of the manufacturing industry in Nigeria.

Keywords: Althman's Model, improper expense recognition, incorrect asset valuation, return on assets

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Authors: Parya Tabei, Maryam Habibifar

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Decision-making is an important cognitive function that can be defined as the process of choosing an option among available options to achieve a specific goal. Consumer ‘need’ is the main reason for purchasing decisions. Human decision-making while buying products online is subject to various factors, one of which is the quality and effect of advertising photos. Advertising photo editing can have a significant impact on people's virtual purchase decisions. This technique helps improve the quality and overall appearance of photos by adjusting various aspects such as brightness, contrast, colors, cropping, resizing, and adding filters. This study, by examining the effect of editing advertising photos on the virtual purchase decision using EEG data, tries to investigate the effect of edited images on the decision-making of customers. A group of 30 participants were asked to react to 24 edited and unedited images while their EEG was recorded. Analysis of the EEG data revealed increased alpha wave activity in the occipital regions (O1, O2) for both edited and unedited images, which is related to visual processing and attention. Additionally, there was an increase in beta wave activity in the frontal regions (FP1, FP2, F4, F8) when participants viewed edited images, suggesting involvement in cognitive processes such as decision-making and evaluating advertising content. Gamma wave activity also increased in various regions, especially the frontal and parietal regions, which are associated with higher cognitive functions, such as attention, memory, and perception, when viewing the edited images. While the visual processing reflected by alpha waves remained consistent across different visual conditions, editing advertising photos appeared to boost neural activity in frontal and parietal regions associated with decision-making processes. These Findings suggest that photo editing could potentially influence consumer perceptions during virtual shopping experiences by modulating brain activity related to product assessment and purchase decisions.

Keywords: virtual purchase decision, advertising photo, EEG parameters, decision Making

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Authors: Rohan Bhasin

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Agrammatism in non-fluent Aphasia Cases can be defined as a language disorder wherein a patient can only use content words ( nouns, verbs and adjectives ) for communication and their speech is devoid of functional word types like conjunctions and articles, generating speech of with extremely rudimentary grammar . Past approaches involve Speech Therapy of some order with conversation analysis used to analyse pre-therapy speech patterns and qualitative changes in conversational behaviour after therapy. We describe this approach as a novel method to generate functional words (prepositions, articles, ) around content words ( nouns, verbs and adjectives ) using a combination of Natural Language Processing and Deep Learning algorithms. The applications of this approach can be used to assist communication. The approach the paper investigates is : LSTMs or Seq2Seq: A sequence2sequence approach (seq2seq) or LSTM would take in a sequence of inputs and output sequence. This approach needs a significant amount of training data, with each training data containing pairs such as (content words, complete sentence). We generate such data by starting with complete sentences from a text source, removing functional words to get just the content words. However, this approach would require a lot of training data to get a coherent input. The assumptions of this approach is that the content words received in the inputs of both text models are to be preserved, i.e, won't alter after the functional grammar is slotted in. This is a potential limit to cases of severe Agrammatism where such order might not be inherently correct. The applications of this approach can be used to assist communication mild Agrammatism in non-fluent Aphasia Cases. Thus by generating these function words around the content words, we can provide meaningful sentence options to the patient for articulate conversations. Thus our project translates the use case of generating sentences from content-specific words into an assistive technology for non-Fluent Aphasia Patients.

Keywords: aphasia, expressive aphasia, assistive algorithms, neurology, machine learning, natural language processing, language disorder, behaviour disorder, sequence to sequence, LSTM

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Authors: Shilu Deepa Thomas, P. Jayaprakash, Dorota Łazewska, Katarzyna Kieć-Kononowicz, B. Sadek

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A large body of evidence suggests the involvement of cognitive impairment, increased levels of inflammation and oxidative stress in the pathogenesis of autism spectrum disorder (ASD). ASD commonly coexists with psychiatric conditions like anxiety and cognitive challenges, and individuals with ASD exhibit significant levels of inflammation and immune system dysregulation. Previous Studies have identified elevated levels of pro-inflammatory markers such as IL-1β, IL-6, IL-2 and TNF-α, particularly in young children with ASD. The current therapeutic options for ASD show limited effectiveness, signifying the importance of exploring an efficient drugs to address the core symptoms. The role of histamine H3 receptors (H3Rs) in memory and the prospective role of H3R antagonists in pharmacological control of neurodegenerative disorders, e.g., ASD, is well-accepted. Hence, the effects of chronic systemic administration of H3R antagonist E159 on autistic-like repetitive behaviors, social deficits, memory and anxiety parameters, as well as neuroinflammation in Black and Tan BRachyury (BTBR) mice, were evaluated using Y maze, Barnes maze, self-grooming, open field and three chamber social test. E159 (2.5, 5 and 10 mg/kg, i.p.) dose-dependently ameliorated repetitive and compulsive behaviors by reducing the increased time spent in self-grooming and improved reduced spontaneous alternation in BTBR mice. Moreover, treatment with E159 attenuated disturbed anxiety levels and social deficits in tested male BTBR mice. Furthermore, E159 attenuated oxidative stress by significantly increasing GSH, CAT, and SOD and decreasing the increased levels of MDA in the cerebellum as well as the hippocampus. In addition, E159 decreased the elevated levels of proinflammatory cytokines (tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and IL-6). The observed results show that H3R antagonists like E159 may represent a promising novel pharmacological strategy for the future treatment of ASD.

Keywords: histamine H3 receptors, antagonist E159, autism, behaviors, mice

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Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

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Authors: Ali Zaker, Zhi Chen

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Due to the concerns about the depletion of fossil fuel sources and the deteriorating environment, the attempt to investigate the production of renewable energy will play a crucial role as a potential to alleviate the dependency on mineral fuels. In this respect, biofuels are measured as a vital nominee for national energy security and energy sustainability. Sewage sludge (SS), as an alternative source of renewable energy with a complex composition, is a major waste generated during wastewater treatment. Stricter legislation is continuously refining the requirements for the level of removal of various pollutants in treated water, causing continuous growth of sludge production, which has become a global challenge. In general, there are two main procedures for dealing with SS: incineration and landfill. However, there are a variety of limitations in these options (e.g., production of greenhouse gases and restrictive environmental regulations) in regard to negative social and economic impacts. Pyrolysis is a feasible and cost-effective technology that can simultaneously tackle boundaries concerning the current disposal routes while retrieving bioenergy. Pyrolysis of SS has drawn vigorous interest in research due to the ability of high mass yield of pyrolytic liquid production. Nonetheless, the presence of high molecular weight hydrocarbons and oxygenated- and nitrogenated compounds poses a considerable challenge. In this context, catalytic pyrolysis is another attainable route in order to upgrade the bio-oil quality. Among different catalysts (i.e., zeolites) studied for sewage sludge pyrolysis, activated chars are eco-friendly and low-cost alternatives. The beneficial features comprise comparatively large surface area, long-term stability, and enriched surface functional groups. In light of these premises, this research attempts to investigate the catalytic pyrolysis of sewage sludge with a high-performance sludge-based activated char in contrast to HZSM5 from a theoretical and experimental point of view.

Keywords: catalytic pyrolysis, sewage sludge, char, HZSM5, bio-oil.

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Emmanuel Dele Balogun

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This paper analyzes, using descriptive statistics and econometrics data which span the period 1981 to 2014 to gauge the effects of trade policy incentives on economic growth in Nigeria. It argues that the provided incentives penalize economic growth during pre-trade liberalization eras, but stimulated a rapid increase in total factor productivity during the post-liberalization period of 2000 to 2014. The trend analysis shows that Nigeria maintained high tariff walls in economic regulation eras which became low in post liberalization era. The protections were in favor of infant industries, which were mainly appendages of multinationals but against imports of competing food and finished consumer products. The trade openness index confirms the undue exposure of Nigeria’s economy to the vagaries of international market shocks; while banking sector recapitalization and new listing of telecommunications companies deepened the financial markets in post-liberalization era. The structure of economic incentives was biased in favor of construction, trade and services, but against the real sector despite protectionist policies. Total Factor Productivity (TFP) estimates show that the Nigerian economy suffered stagnation in pre-liberalization eras, but experienced rapid growth rates in post-liberalization eras. The regression results relating trade policy incentives to TFP growth rate yielded a significant but negative intercept suggesting that a non-interventionist policy could be detrimental to economic progress, while protective tariff which limits imports of competing products could spur productivity gains in domestic import substitutes beyond factor growth with market liberalization. The main constraint to the effectiveness of trade policy incentives is the failure of benefiting industries to leverage on the domestic factor endowments of the nation. This paper concludes that there is the need to review the current economic transformation strategies urgently with a view to provide policymakers with a better understanding of the most viable options that could make for rapid success.

Keywords: economic growth, macroeconomic incentives, total factor productivity, trade policies

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Authors: Rashed Shah, Jeanne Koepsell, Dixmer Rivera, Eric Swedberg, David Marsh

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Success of primary health care goals of health promotion and disease prevention may well be determined by community based health workers’ overall job satisfaction. It is also important to understand the ways community health workers perceive their jobs and the importance they give to the various factors influencing their job satisfaction, which is critical before making a decision for task-shifting and for expanding their scope of work. Although brigadistas are unpaid volunteers, they are formally recognized and receive support and supervision from the Ministry of Health in Nicaragua. Brigadistas are responsible for classifying and diagnosing illnesses, administering treatment, counseling mothers and care givers within the community, encouraging referral in case of serious illness and making follow-up visits at home. Some brigadistas provide more technically advanced services, including treatment for pneumonia, diarrhea, malaria and tuberculosis and/or distribution of contraceptives. Expanding brigadistas’ duties could threaten their heretofore ‘job satisfaction’. This study primarily aims to report on job satisfaction of brigadistas in Nicaragua before expanding the scope of their work by adding more responsibilities. The study was guided by the following research questions: 1) What aspects of their job made the brigadistas satisfied or dissatisfied? 2) What is the job satisfaction level of brigadistas in Nicaragua? This cross-sectional study was conducted during March – July 2014, to assess brigadistas’ job satisfaction, prior to deciding on inclusion of care for sick newborns and young infants (<2 months of age) to brigadistas’ existing service package of community case management for children of 2-59 months of age. Following stratified random sampling strategy, 15 brigadistas were randomly selected from each of the following four strata: [(1) females under 25 years of age, (2) females over 30 years of age, (3) males under 25 years of age, and (4) males over 30 years of age. Out of 45 completed in-person interview with eligible and available brigadistas, 20 (44.4%) were with female and 25 (55.6%) were with male respondents; the mean age (±sd) was found as 32.0 (±3.2) years. About 53% (24/45) brigadista mentioned “Training” as the most helpful for performing their job. Another 31% (14/45) mentioned that “feeling of doing good, supporting community, women and children” was helpful to perform their job well. When asked about difficulty, about 35.5% (16/45) brigadistas mentioned about “Lack of time” due to their responsibilities in family, farm, other work places, study and such time constraint made their job performance difficult. Measured on a 0-5 scale, estimated average job satisfaction was 4.2. Current trends in task-shifting and integrated program delivery require community health workers (like the brigadistas) to deliver several essential services, including maternal, newborn and child health, and family planning, and thereby increasing their responsibilities. Given the reported level of job satisfaction among brigadistas (4.2 out of 5), and the mentioned difficulty in performing their current job (as ‘Lack of Time’) in this study results, the policy makers and program managers in MOH should be cautious enough before making a decision to expand current scope of work for brigadistas in Nicaragua.

Keywords: Brigadisata, job satisfaction, Nicaragua, task-shifting

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Authors: Alejandra Sierra, Gloria Valadez, Adriana Dávalos, Mirliana Ramírez

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For years, the Pan American Health Organization/World Health Organization and other organizations have made efforts to the improve access and the quality of prenatal care as part of comprehensive programs for maternal and neonatal health, the standards of care have been renewed in order to migrate from a medical perspective to a holistic perspective. However, despite the efforts currently antenatal care models have not been verified by a scientific evaluation in order to determine their effectiveness. The teenage pregnancy is considered as a very important phenomenon since it has been strongly associated with inequalities, poverty and the lack of gender quality; therefore it is important to analyze the antenatal care that’s been given, including not only the clinical intervention but also the activities surrounding the advertising and the health education. In this study, the objective was to describe if the previously established activities (on the prenatal care models) are being performed in the care of pregnant teenagers attending prenatal care in health institutions in two cities in México and Chile during 2013. Methods: Observational and descriptive study, of a transversal cohort. 170 pregnant women (13-19 years) were included in prenatal care in two health institutions (100 women from León-Mexico and 70 from Chile-Coquimbo). Data collection: direct survey, perinatal clinical record card which was used as checklists: WHO antenatal care model WHO-2003, Official Mexican Standard NOM-007-SSA2-1993 and Personalized Service Manual on Reproductive Process- Chile Crece Contigo; for data analysis descriptive statistics were used. The project was approved by the relevant ethics committees. Results: Regarding the fulfillment of interventions focused on physical, gynecological exam, immunizations, monitoring signs and biochemical parameters in both groups was met by more than 84%; the activities of guidance and counseling pregnant teenagers in Leon compliance rates were below 50%, on the other hand, although pregnant women in Coquimbo had a higher percentage of compliance, no one reached 100%. The topics that less was oriented were: family planning, signs and symptoms of complications and labor. Conclusions: Although the coverage of the interventions indicated in the prenatal care models was high, there were still shortcomings in the fulfillment of activities to orientation, education and health promotion. Deficiencies in adherence to prenatal care guidelines could be due to different circumstances such as lack of registration or incomplete filling of medical records, lack of medical supplies or health personnel, absences of people at prenatal check-up appointments, among many others. Therefore, studies are required to evaluate the quality of prenatal care and the effectiveness of existing models, considering the role of the different actors (pregnant women, professionals and health institutions) involved in the functionality and quality of prenatal care models, in order to create strategies to design or improve the application of a complete process of promotion and prevention of maternal and child health as well as sexual and reproductive health in general.

Keywords: adolescent health, health systems, maternal health, primary health care

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Authors: O. Fatemi

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Considering growing building construction industry in developing countries and sustainable development concept, as well as the importance of taking care of the future generations, codifying buildings scoring system based on environmental criteria, has always been a subject for discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables. In this article, the most important common LEED (Leadership in Energy and Environmental Design) and BREEAM (Building Research Establishment Environmental Assessment Method) common and Global environmental scoring systems, used in UK, USA, and Japan, respectively, have been discussed and compared with a special focus on CASBEE (Comprehensive Assessment System for Built Environment Efficiency), to credit assigning field (weighing and scores systems) as well as sustainable development criteria in each system. Then, converging and distinct fields of the foregoing systems are examined considering National Iranian Building Code. Furthermore, the common credits in the said systems not mentioned in National Iranian Building Code have been identified. These credits, which are generally included in well-known fundamental principles in sustainable development, may be considered as offered options for the Iranian building environmental scoring system. It is suggested that one of the globally and commonly accepted systems is chosen considering national priorities in order to offer an effective method for buildings environmental scoring, and then, a part of credits is added and/or removed, or a certain credit score is changed, and eventually, a new scoring system with a new title is developed for the country. Evidently, building construction industry highly affects the environment, economy, efficiency, and health of the relevant occupants. Considering the growing trend of cities and construction, achieving building scoring systems based on environmental criteria has always been a matter of discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables.

Keywords: scoring system, sustainability assessment, water efficiency, national Iranian building code

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Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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Authors: Anne Y. Faxer, Ellen Olausson, Jens Hagman, Ana Magazinius, Jenny J. Stier, Tommy Fransson, Oscar Enerback

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While electric vehicles (both battery electric vehicles and plug-in hybrids) have been on the market for around 6 years, they are still far from mainstream and the knowledge of them is still low among the public. This is likely one of the reasons that Sweden, having one of the highest penetrations of electric vehicles in Europe, still has a long way to go in reaching a fossil free vehicle fleet. Car dealerships are an important medium that connects consumers to vehicles, but somehow, their role in introducing electric vehicles has not yet been thoroughly studied. Research from other domains shows that salespeople can affect customer decisions in their choice of products. The aim of this study is to explore the role of car dealerships when it comes to promoting electric vehicles. The long-term goal is to understand how they could be a key in the effort of achieving a mass introduction of electric vehicles in Sweden. By emulating the customer’s experience, this study investigates the interaction between car salespeople and customers, particularly examining whether they present electric vehicles as viable options. Covert participatory observations were conducted for data collection from four different brands at in total twelve car dealers. The observers worked in pairs and played the role of a customer with needs that could be matched by an electric vehicle. The data was summarized in observation protocols and analyzed using thematic coding. The result shows that only one of twelve salespeople offered an electric vehicle as the first option. When environmental factors were brought up by the observers, the salespeople followed up with lower fuel consumption internal combustion engine vehicles rather than suggesting an electric vehicle. All salespeople possessed at least basic knowledge about electric vehicles but their interest of selling them were low in most cases. One of the reasons could be that the price of electric vehicles is usually higher. This could be inferred from the finding that salespeople tend to have a strong focus on price and economy in their dialogues with customers, regardless which type of car they were selling. In conclusion, the study suggests that car salespeople have the potential to help the market to achieve mass introduction of electric vehicles; however, their potential needs to be exploited further. To encourage salespeople to prioritize electric vehicles in the sales process, right incentives need to be in place.

Keywords: car dealerships, covert participatory observation, customer perspective , electric vehicle, market penetration

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Authors: Frida Carrillo Morales, Maria Maricela Carrasco Yépez, Saúl Rojas Hernández

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Naegleria fowleri is the causative agent of primary amebic meningoencephalitis, this disease is acute and fulminant that affects humans. It has been reported that despite the existence of therapeutic options against this disease, its mortality rate is 97%. Therefore, the need arises to have vaccines that confer protection against this disease and, in addition to developing adjuvants to enhance the immune response. In this regard, in our work group, we obtained a peptide designed from the membrane protein MP2CL5 of Naegleria fowleri called Smp145 that was shown to be immunogenic; however, it would be of great importance to enhance its immunological response, being able to co-administer it with a non-toxic adjuvant. Therefore, the objective of this work was to carry out the bioinformatic design of a peptide of the Naegleria fowleri membrane protein MP2CL5 conjugated with a non-toxic modified adjuvant from the native A1 structure of Cholera Toxin. For which different bioinformatics tools were used to obtain a model with a modification in amino acid 61 of the A1 subunit of the CT (CTA1), to which the Smp145 peptide was added and both molecules were joined with a 13-glycine linker. As for the results obtained, the modification in CTA1 bound to the peptide produces a reduction in the toxicity of the molecule in in silico experiments, likewise, the prediction in the binding of Smp145 to the receptor of B cells suggests that the molecule is directed in specifically to the BCR receptor, decreasing its native enzymatic activity. The stereochemical evaluation showed that the generated model has a high number of adequately predicted residues. In the ERRAT test, the confidence with which it is possible to reject regions that exceed the error values was evaluated, in the generated model, a high score was obtained, which determines that the model has a good structural resolution. Therefore, the design of the conjugated peptide in this work will allow us to proceed with its chemical synthesis and subsequently be able to use it in the mouse meningitis protection model caused by N. fowleri.

Keywords: immunology, vaccines, pathogens, infectious disease

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Authors: Radim Sip, Denisa Denglerova

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It’s impossible to capture complex phenomena, such as inclusion, with reductionism. The most common form of reductionism is the objectivist approach, where processes and relationships are reduced to entities and clearly outlined phases, with a consequent search for relationships between them. Constructivism as a paradigm and situational analysis as a methodological research portfolio represent a way to avoid the dominant objectivist approach. They work with a situation, i.e. with the essential blending of actors and their environment. Primary transactions are taking place between actors and their surroundings. Researchers create constructs based on their need to solve a problem. Concepts therefore do not describe reality, but rather a complex of real needs in relation to the available options how such needs can be met. For examination of a complex problem, corresponding methodological tools and overall design of the research are necessary. Using an original research on inclusion in the Czech Republic as an example, this contribution demonstrates that inclusion is not a substance easily described, but rather a relationship field changing its forms in response to its actors’ behaviour and current circumstances. Inclusion consists of dynamic relationship between an ideal, real circumstances and ways to achieve such ideal under the given circumstances. Such achievement has many shapes and thus cannot be captured by description of objects. It can be expressed in relationships in the situation defined by time and space. Situational analysis offers tools to examine such phenomena. It understands a situation as a complex of dynamically changing aspects and prefers relationships and positions in the given situation over a clear and final definition of actors, entities, etc. Situational analysis assumes creation of constructs as a tool for solving a problem at hand. It emphasizes the meanings that arise in the process of coordinating human actions, and the discourses through which these meanings are negotiated. Finally, it offers “cartographic tools” (situational maps, socials worlds / arenas maps, positional maps) that are able to capture the complexity in other than linear-analytical ways. This approach allows for inclusion to be described as a complex of phenomena taking place with a certain historical preference, a complex that can be overlooked if analyzed with a more traditional approach.

Keywords: constructivism, situational analysis, objective realism, reductionism, inclusion

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Authors: Sisay Negash, Zebene Asfaw, Kibreselassie Daniel, Michael Zech

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A significant portion of the Ethiopian landscape features scattered trees that are deliberately managed in crop fields to enhance soil fertility and crop yield in which the compatibility of crops with these trees varies depending on location, tree species, and annual crop type. This study aimed to examine the effects of scattered Vachellia tortilis and Vachellia nilotica trees on selected physico-chemical properties of the soil, as well as the yield and yield components of sorghum in Ethiopia. Vachellia tortilis and Vachellia nilotica were selected on abundance occurrence and managed in crop fields. A randomized complete block design was used, with a distance from the tree canopy (middle, edge, and outside) as a treatment, and five trees of each species served as replications. Sorghum was planted up to 15 meters in the east, west, south, and north directions from the tree trunk to assess growth and yield. Soil samples were collected from the two tree species, three distance factors, three soil depths(0-20cm, 20-40cm, and 40-60cm), and five replications, totaling 45 samples for each tree species. These samples were analyzed for physical and chemical properties. The results indicated that both V. tortilis and V. nilotica significantly affected soil physico-chemical properties and sorghum yield. Specifically, soil moisture content, EC, total nitrogen, organic carbon, available phosphorus and potassium, CEC, sorghum plant height, panicle length, biomass, and yield decreased with increasing distance from the canopy. Conversely, bulk density and pH increased. Under the canopy, sorghum yield increased by 66.4% and 53.5% for V. tortilis and V. nilotica, respectively, due to higher soil moisture and nutrient availability. The study recommends promoting trees in crop fields, management options for new saplings, and further research on root decomposition and nutrient supply.

Keywords: canopy, crop yield, soil nutrient, soil organic matter, yield components

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Authors: Zuhal Mohammed, Khalid Siddig, Harald Grethe

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Vocational training (VT) has been identified as a potential engine for achieving economic and social development, particularly in developing countries, while during the last two decades it is deemed as an essential determinant of human capital accumulation. Furthermore, it has a crucial role in reducing inequality, wage gaps and unemployment and in promoting skill decomposition. Government plays an important role in the human capital formulation by providing finance for education. In some countries, a large portion of the public educational investment is devoted to academic education (primary, secondary and tertiary). This is reflected in disproportionately increasing investment in various education sectors other than vocational education and VT. Nevertheless, the finance of VT system is not likely to increase or even remain at its existing level. This paper conducts an in-depth analysis to quantify the impacts of various options for expanding the public expenditure on education as well as vocational training in the Sudan. The study uses a recursive dynamic CGE modelling framework that accommodates VT and allows depicting the impact of various policies targeting the vocational training system with special focus on the agricultural sector. This allows for depicting the potential effects of various resource allocation policies not only among education versus non-education sectors, but also between the various types of education and training. Moreover, the study assesses the role of VT system in the economy through its influence on workers’ skill improvement and their movement across sectors. The results show that an increase in the public educational investment will lead to decrease the supply of low and high educated workers as results of increasing the school participation of the students in the short run. While in the medium to long run, this measure guides to increase the productivity of the labour and thus the growth rate of the gross domestic product (GDP). Therefore, the findings of the study provide Sudanese policymakers with needed information to help to adopt measures to reduce unemployment, enhance workers’ skill and ultimately improve livelihoods.

Keywords: vocational training, recursive dynamic CGE, skill level, labour market, economic growth, Sudan

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Authors: Randall E. Osborne

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A four-step ‘humanities’ thought model has been used in an interdisciplinary course for almost two decades and has been proven to aid in student abilities to become more inclusive in their world view. Lack of tolerance for ambiguity can interfere with this progression so we developed an assignment that seems to have assisted students in developing more tolerance for ambiguity and, therefore, opened them up to make more progress on the critical thought model. A four-step critical thought model (built from a humanities education approach) is used in an interdisciplinary course on prejudice, discrimination, and hate in an effort to minimize egocentrism and promote sociocentrism in college students. A fundamental barrier to this progression is a lack of tolerance for ambiguity. The approach to the course is built on the assumption that Tolerance for Ambiguity (characterized by a dislike of uncertain, ambiguous or situations in which expected behaviors are uncertain, will like serve as a barrier (if tolerance is low) or facilitator (if tolerance is high) of active ‘engagement’ with assignments. Given that active engagement with course assignments would be necessary to promote an increase in critical thought and the degree of multicultural attitude change, tolerance for ambiguity inhibits critical thinking and, ultimately multicultural attitude change. As expected, those students showing the least amount of decrease (or even an increase) in intolerance across the semester, earned lower grades in the course than those students who showed a significant decrease in intolerance, t(1,19) = 4.659, p < .001. Students who demonstrated the most change in their Tolerance for Ambiguity (showed an increasing ability to tolerate ambiguity) earned the highest grades in the course. This is, especially, significant because faculty did not know student scores on this measure until after all assignments had been graded and course grades assigned. An assignment designed to assist students in making their assumption and inferences processes visible so they could be explored, was implemented with the goal of this exploration then promoting more tolerance for ambiguity, which, as already outlined, promotes critical thought. The assignment offers students two options and then requires them to explore what they have learned about inferences and/or assumptions This presentation outlines the assignment and demonstrates the humanities model, what students learn from particular assignments and how it fosters a change in Tolerance for Ambiguity which, serves as the foundational component of critical thinking.

Keywords: critical thinking, humanities education, sociocentrism, tolerance for ambiguity

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Eda K. Murathan, Gulten Manioglu

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In the building design process, reducing heating and cooling energy consumption according to the climatic region conditions of the building are important issues to be considered in order to provide thermal comfort conditions in the indoor environment. Applying a phase-change material (PCM) on the surface of a building envelope is the new approach for controlling heat transfer through the building envelope during the year. The transparency ratios of the window are also the determinants of the amount of solar radiation gain in the space, thus thermal comfort and energy expenditure. In this study, a simulation-based evaluation was carried out by using Energyplus to determine the effect of coupling PCM and transparency ratio when integrated into the building envelope. A three-storey building, a 30m x 30m sized floor area and 10m x 10m sized courtyard are taken as an example of the courtyard building model, which is frequently seen in the traditional architecture of hot climatic regions. 8 zones (10m x10m sized) with 2 exterior façades oriented in different directions on each floor were obtained. The percentage of transparent components on the PCM applied surface was increased at every step (%30, %40, %50). For every zone differently oriented, annual heating, cooling energy consumptions, and thermal comfort based on the Fanger method were calculated. All calculations are made for the zones of the intermediate floor of the building. The study was carried out for Diyarbakır provinces representing the hot-dry climate region and Antalya representing the hot-humid climate region. The increase in the transparency ratio has led to a decrease in heating energy consumption but an increase in cooling energy consumption for both provinces. When PCM is applied to all developed options, It was observed that heating and cooling energy consumption decreased in both Antalya (6.06%-19.78% and %1-%3.74) and Diyarbakır (2.79%-3.43% and 2.32%-4.64%) respectively. When the considered building is evaluated under passive conditions for the 21st of July, which represents the hottest day of the year, it is seen that the user feels comfortable between 11 pm-10 am with the effect of night ventilation for both provinces.

Keywords: building envelope, heating and cooling energy consumptions, phase change material, transparency ratio

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Authors: Claudia Aguilar, Amen Farooq

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Among other cities in the United States, the city of Atlanta is experiencing levels of growth that surpass anything we have witnessed in the last century. With the surge of population influx, the available housing is practically bursting at the seams. Supply is low, and demand is high. In effect, the average one-bedroom apartment runs for 1,800 dollars per month. The city is desperately seeking new opportunities to provide affordable housing at an expeditious rate. This has been made evident by the recent updates to the city’s zoning. With the recent influx in the housing market, young professionals, in particular millennials, are desperately looking for alternatives to stay within the city. To remedy Atlanta’s affordable housing crisis, the city of Atlanta is planning to introduce 40 thousand of new affordable housing units by 2026. To achieve the urgent need for more affordable housing, the architectural response needs to adapt to overcome this goal. A method that has proven successful in modern housing is to practice modular means of development. A method that has been constrained to the dimensions of the max load for an eighteen-wheeler. This approach has diluted the architect’s ability to produce site-specific, informed design and rather contributes to the “cookie cutter” stigma that the method has been labeled with. This thesis explores the design methodology for modular housing by revisiting its constructability and adaptability. This research focuses on a modular housing type that could break away from the constraints of transport and deliver adaptive reconfigurable assemblies. The adaptive assemblies represent an integrated design strategy for assembling the future of affordable dwelling units. The goal is to take advantage of a component-based system and explore a scalable solution to modular housing. This proposal aims specifically to design a kit of parts that are made to be easily transported and assembled but also gives the ability to customize the use of components to benefit all unique conditions. The benefits of this concept could include decreased construction time, cost, on-site labor, and disruption while providing quality housing with affordable and flexible options.

Keywords: adaptive assemblies, modular architecture, adaptability, constructibility, kit of parts

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Authors: Saeed Farhadypour, Majid Azadi, Habibolla Sayyari, Mahmood Mosavi, Shahram Irani, Aliakbar Bidokhti, Omid Alizadeh Choobari, Ziba Hamidi

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In the recent decades, frequencies of dust events have increased significantly in west and south west of Iran. First, a survey on the dust events during the period (1990-2013) is investigated using historical dust data collected at 6 weather stations scattered over west and south-west of Iran. After statistical analysis of the observational data, one of the most severe dust storm event that occurred in the region from 3rd to 6th July 2009, is selected and analyzed. WRF-Chem model is used to simulate the amount of PM10 and how to transport it to the areas. The initial and lateral boundary conditions for model obtained from GFS data with 0.5°×0.5° spatial resolution. In the simulation, two aerosol schemas (GOCART and MADE/SORGAM) with 3 options (chem_opt=106,300 and 303) were evaluated. Results of the statistical analysis of the historical data showed that south west of Iran has high frequency of dust events, so that Bushehr station has the highest frequency between stations and Urmia station has the lowest frequency. Also in the period of 1990 to 2013, the years 2009 and 1998 with the amounts of 3221 and 100 respectively had the highest and lowest dust events and according to the monthly variation, June and July had the highest frequency of dust events and December had the lowest frequency. Besides, model results showed that the MADE / SORGAM scheme has predicted values and trends of PM10 better than the other schemes and has showed the better performance in comparison with the observations. Finally, distribution of PM10 and the wind surface maps obtained from numerical modeling showed that the formation of dust plums formed in Iraq and Syria and also transportation of them to the West and Southwest of Iran. In addition, comparing the MODIS satellite image acquired on 4th July 2009 with model output at the same time showed the good ability of WRF-Chem in simulating spatial distribution of dust.

Keywords: dust storm, MADE/SORGAM scheme, PM10, WRF-Chem

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Authors: May Phyo Wai, Tanyawan Suantawee

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The positive correlation between unhealthy diets (high in fats, sugars, carbohydrates, and low fibers) and the risk of non-communicable diseases (NCDs) like obesity, hypertension, diabetes, and heart diseases has led to a growing interest in healthier lifestyles and diets. Consequently, people are opting for foods rich in fiber and phytochemicals. Wolffia globosa, also known as duckweed or watermeal, is the smallest plant with high nutritional value, including protein, fiber, phytochemicals, and antioxidant properties. It offers numerous health benefits, such as improving gut health and lowering blood glucose levels, and it is widely available in Thailand. The purpose of this study was to develop nutritionally enhanced breadsticks utilizing vacuum heat-dried Wolffia globosa power (WP). Various concentrations of WP (0% as control, 5%, 10%, and 15 % w/w/) were added, and then the breadsticks’ physical properties (hardness, fracturability, and color), phytochemicals (total phenolic compounds: TPC and total flavonoid contents: TFC), and antioxidant properties (DPPH radical scavenging activity (DPPH) and ferric reducing antioxidant power (FRAP) assay) were investigated. Experiments were done by triplicates and data was analyzed by one-way ANOVA. The results showed that the hardness, measured by a texture analyzer, increased significantly (p<0.05) with higher WP concentrations, reaching 2,897.01 ± 77.31 g at 15% WP from 1,314.41 ± 32.52 g of the control. In contrast, the lightness (L*), redness (a*), and yellowness (b*) of the breadsticks significantly decreased (p < 0.05) in a dose-dependent manner with added WP. Incorporating WP, rich in phytochemicals and antioxidants, into the flour significantly enhanced the TPC and TFC of the breadsticks (p<0.05), with TPC and TFC increasing dose-dependently rising to 1.8-fold and 3.5-fold at 15% WP, respectively. The antioxidant power, assessed by DPPH and FRAP assays, also showed a similar trend, with significantly higher values at 10% and 15% WP (p<0.05). These results indicate that adding WP significantly boosted the TPC, TFC, DPPH, and FRAP values of the developed breadsticks. Therefore, incorporating WP into breadsticks might be a promising strategy for creating food products enriched with phytochemicals and antioxidants, offering consumers healthier options in the market.

Keywords: antioxidant properties, breadsticks, phytochemicals, Wolffia globosa

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Authors: David Holton, Michelle Dickinson, Giovanni Carta

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The principle of geological disposal is to isolate higher-activity radioactive wastes deep inside a suitable rock formation to ensure that no harmful quantities of radioactivity reach the surface environment. To achieve this, wastes will be placed in an engineered underground containment facility – the geological disposal facility (GDF) – which will be designed so that natural and man-made barriers work together to minimise the escape of radioactivity. Internationally, various multi-barrier concepts have been developed for the disposal of higher-activity radioactive wastes. High-heat-generating wastes (HLW, spent fuel and Pu) provide a number of different technical challenges to those associated with the disposal of low-heat-generating waste. Thermal management of the disposal system must be taken into consideration in GDF design; temperature constraints might apply to the wasteform, container, buffer and host rock. Of these, the temperature limit placed on the buffer component of the engineered barrier system (EBS) can be the most constraining factor. The heat must therefore be managed such that the properties of the buffer are not compromised to the extent that it cannot deliver the required level of safety. The maximum temperature of a buffer surrounding a container at the centre of a fixed array of heat-generating sources, arises due to heat diffusing from neighbouring heat-generating wastes, incrementally contributing to the temperature of the EBS. A range of strategies can be employed for managing heat in a GDF, including the spatial arrangements or patterns of those containers; different geometrical configurations can influence the overall thermal density in a disposal facility (or area within a facility) and therefore the maximum buffer temperature. A semi-analytical thermal dimensioning tool and methodology have been applied at a generic stage to explore a range of strategies to manage the disposal of high-heat-generating waste. A number of examples, including different geometrical layouts and chequer-boarding, have been illustrated to demonstrate how these tools can be used to consider safety margins and inform strategic disposal options when faced with uncertainty, at a generic stage of the development of a GDF.

Keywords: buffer, geological disposal facility, high-heat-generating waste, spent fuel

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Authors: Marriette Sakah, Christoph Kuhn, Samuel Gyamfi

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Global electricity demand of households in 2005 is estimated to double by 2025 and nearly double again in 2030. The residential sector promises considerable demand growth through infrastructural and equipment investments, the majority of which is projected to occur in developing countries. This lays bare the urgency for enhanced efficiency in all energy systems combined with exploitation of local potential for renewable energy systems. This study explores options for reducing energy consumption, particularly in residential buildings and providing robust, decentralized and renewable energy supply for African cities. The potential of energy efficiency measures and the potential of harnessing local resources for renewable energy supply are quantitatively assessed. The scale of research specifically addresses the city level, which is regulated by local authorities. Local authorities can actively promote the transition to a renewable-based energy supply system by promoting energy efficiency and the use of alternative renewable fuels in existing buildings, and particularly in planning and development of new settlement areas through the use of incentives, regulations, and demonstration projects. They can also support a more sustainable development by shaping local land use and development patterns in such ways that reduce per capita energy consumption and are benign to the environment. The subject of the current case study, Tema, is Ghana´s main industrial hub, a port city and home to 77,000 families. Residential buildings in Tema consumed 112 GWh of electricity in 2013 or 1.45 MWh per household. If average household electricity demand were to decline at an annual rate of just 2 %, by 2035 Tema would consume only 134 GWh of electricity despite an expected increase in the number of households by 84 %. The work is based on a ground survey of the city’s residential sector. The results show that efficient technologies and decentralized renewable energy systems have great potential for meeting the rapidly growing energy demand of cities in developing countries.

Keywords: energy efficiency, energy saving potential, renewable energy integration, residential buildings, urban Africa

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Authors: Kumar Y., Suman D., Sumathi

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Introduction: Burns to the face account for between one-fourth and one-third of all burns. The loss of an eyebrow due to a burn or infection can have negative physical and psychological consequences for patients because eyebrows have a critical functional and aesthetic role on the face. Plastic surgeons face unique challenges in reconstructing eyebrows due to their complex anatomy and variations within genders. As a general rule, there are three techniques for reconstructing the eyebrow: superficial temporal artery island flap, a composite graft from the scalp, and mini or micro follicular grafts from the scalp. In situations where a sufficient amount of subcutaneous tissue is not available and the defect is big such as the case of burns, flaps like the superficial temporal artery scalp flap remain reliable options. In 2018, a 17-year-old female patient presented to the department of Burns Plastic and reconstructive Surgery of Guru Teg Bahadur Hospital, Delhi, India. A scald-burn injury to the face occurred two years before admission, resulting in bilateral eyebrow loss. We reconstructed the bilateral eyebrows using bilateral scalp island flaps based on the posterior branch of the superficial temporal artery. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance, which was consistent with preoperative expectations and the patient stated that she was more comfortable with her social relationships. Among the current treatment procedures, the superficial temporal artery island flap continues to be a versatile option for reconstructing the eyebrows after alopecia, especially in cases of burns. Results: During the 30 days follow-up period, the scalp island flap remained vascularised with normal hair growth, without complications. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance; the patient stated that she was more comfortable with her social relationships. Conclusion: In this case report, we demonstrated how scalp island flaps pedicled by the superficial temporal artery could be performed very safely and reliably to create new eyebrows.

Keywords: alopecia, burns, eyebrow, flap, superficial temporal artery

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Authors: Nyong Princely Awazi, Gadinga Walter Forje, Barnabas Neba Nfornkah, Ndzifon Jude Kimengsi

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Ecotourism is documented as a sustainable measure of bridging conservation goals and livelihood sustenance around protected areas, due to its ability of not just providing alternative livelihood, but also in providing the necessary resources that can help finance conservation initiatives. In Cameroon, all ecotourism activities around national parks are aimed at generating revenue through the conservation service while providing sustainable livelihood options to the local population. There exists an information lacuna regarding the contribution of ecotourism finances to conservation efforts in the country. This study was aimed at establishing the contribution of ecotourism finances to conservation initiatives in and around the Campo Ma’an National Park (CMNP). Data were collected through the administering of 120 structured questionnaires to ecotourism actors and 15 key/expert interviews with tourism and conservation actors in the Campo Ma’an landscape. Chi-square test, Spearman’s rank correlation and regressions were used for data analysis. The study revealed that the main sources of ecotourism financing to the park service are through entrance fees, cameras and vehicle fees paid by tourists as well as ecotourism project financing through NGOs. Calculations from the tourism register of the park showed that the park was able to raise as much as 1,576,000 FCFA (US$ 3,152) annually. It was further established that ecotourism revenue has not greatly supported conservation, with 54% of respondents perceiving ecotourism not contributing to biodiversity conservation. Chi Square test results highlighted poor ecotourism governance, low level of ecotourism development, corruption from park management staff, obsolete nature of the current finance law on the management of protected area revenue as key factors hindering ecotourism financing in conservation. For ecotourism financing to contribute to biodiversity conservation in the CMNP and in Cameroon’s protected areas, the government needs to revise the finance law on the management of revenue generated from protected areas, improve park governance to fight corruption and enhance transparency, invest in the development and marketing of the Campo Ma’an national park as a tourism destination in the country.

Keywords: Cameroon, Campo Ma’an National Park, conservation, ecotourism, ecotourism financing

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Authors: V. S. Manivasagam, R. Nagarajan

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Modeling the soil, water and crop growth interactions are attaining major importance, considering the future climate change and water availability for agriculture to meet the growing food demand. Progress in understanding the crop growth response during water stress period through crop modeling approach provides an opportunity for improving and sustaining the future agriculture water use efficiency. An attempt has been made to evaluate the potential use of crop modeling approach for assessing the minimal supplementary irrigation requirement for crop growth during water limited condition and its practical significance in sustainable improvement of crop yield and water productivity. Among the numerous crop models, water driven-AquaCrop model has been chosen for the present study considering the modeling approach and water stress impact on yield simulation. The study has been evaluated in rainfed maize grown area of semi-arid Shanmuganadi watershed (a tributary of the Cauvery river system) located in southern India during the rabi cropping season (October-February). In addition to actual rainfed maize growth simulation, irrigated maize scenarios were simulated for assessing the supplementary irrigation requirement during water shortage condition for the period 2012-2015. The simulation results for rainfed maize have shown that the average maize yield of 0.5-2 t ha-1 was observed during deficit monsoon season (<350 mm) whereas 5.3 t ha-1 was noticed during sufficient monsoonal period (>350 mm). Scenario results for irrigated maize simulation during deficit monsoonal period has revealed that 150-200 mm of supplementary irrigation has ensured the 5.8 t ha-1 of irrigated maize yield. Thus, study results clearly portrayed that minimal application of supplementary irrigation during the critical growth period along with the deficit rainfall has increased the crop water productivity from 1.07 to 2.59 kg m-3 for major soil types. Overall, AquaCrop is found to be very effective for the sustainable irrigation assessment considering the model simplicity and minimal inputs requirement.

Keywords: AquaCrop, crop modeling, rainfed maize, water stress

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Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Yuen Shan Ho, Tim Man Ho Li, Andy Choi-Yeung Tse, Cheng-Ta Li, Calvin Pak-Wing Cheng, Roland Beisteiner

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Transcranial pulse stimulation (TPS) is a non-intrusive brain stimulation technology that has been proven effective in older adults with mild neurocognitive disorders and adults with major depressive disorder. Given these robust evidences, TPS might be an adjunct treatment options in neuropsychiatric disorders, for example, autism spectrum disorder (ASD) – which is a common neurodevelopmental disorder in children. This trial aimed to investigate the effects of TPS on right temporoparietal junction, a key node for social cognition for Autism Spectrum Disorder (ASD), and to examine the association between TPS, executive functions and social functions. Design: This trial adopted a two-armed (verum TPS group vs. sham TPS group), double-blinded, randomized, sham-controlled design. Sampling: 32 subjects aged between 12 and 17, diagnosed with ASD were recruited. All subjects were computerized randomized into either verum TPS group or the sham TPS group on a 1:1 ratio. All subjects undertook functional MRI before and after the TPS interventions. Intervention: Six 30-min TPS sessions were administered to subjects in 2 weeks’ time on alternate days assessing neural connectivity changes. Baseline measurements and post-TPS evaluation of the ASD symptoms, executive functions, and social functions were conducted. Participants were followed up at 2-weeks, at 1-month and 3-month, assessing the short-and long-term sustainability of the TPS intervention. Data analysis: Generalized Estimating Equations with repeated measures were used to analyze the group and time difference. Missing data were managed by multiple imputations. The level of significance was set at p < 0.05. To our best knowledge, this is the first study evaluating the efficacy and safety of TPS among adolescents with ASD in Hong Kong and nationwide. Results emerging from this study will develop insight on whether TPS can be used as an adjunct treatment on ASD in neuroscience and clinical psychiatry. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT05408793.

Keywords: adolescents, autism spectrum disorder, neuromodulation, rct, transcranial pulse stimulation

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