Search results for: primary health care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14052

Search results for: primary health care

4152 The Spanish Didactic Book 'El Calculo Y La Medida en El Primer Grado De La Escuela Decroly' (1934): A Look at the Mathematical Knowledge

Authors: Juliana Chiarini Balbino Fernandes

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This article aims to investigate the Spanish didactic book, entitled ‘El Calculo y La Medida en El Primer Grado de La Escuela Decroly’, written by Dr. O. Decroly and A. Hamaide, published in Madrid, in the year 1934. In addition to analyzing how mathematical knowledge is present in the proposed Centers of Interest. The textbooks, in addition to pedagogical tools, reflect a certain moment in society and allow the analysis of the theoretical-methodological proposal that can be implemented by the teacher. The study proposed here will be carried out by the lens of Cultural History, supported by Roger Chartier (1991) and by the concepts on textbooks, based on Alain Choppin (2004). The textbook selected for this study exposes a program of ideas associated with the method of Centers of Interest and arithmetic is linked to these interests. In the first courses (six to eight years), most centers can be considered to correspond to occasional calls, as they take advantage of events that arise spontaneously to work with observation, measurement, association and expression exercises. The program of ideas associated with Centers of Interest addresses the biological and social aspects of children, as long as they can express their needs for activities and games, satisfying the natural curiosity. Still, the program of associated ideas offers occasions for problems whose data are taken in observation exercises and concrete expressions (manuals, drawings). In the method applied at the school of L'Ermitage, school created by Decroly in Belgium in 1907, observation, is the basis of each center of interest. It offers the chance to compare and measure. To observe is more than to perceive; it is also to establish relations between the graded aspects of the same object, to seek relations between different intensities; is to verify successions, special and temporary relationships; is to make comparisons, to notice differences and similarities in block or datable (analysis), is to establish a bridge between the world and the thought. To make the observation more precise, it is important to compare, measure, and resort to considered objects as natural units of measure. Measurement and calculation are, therefore, quite naturally subject to observation. Thus, it is possible to make the child enter into the interest in the calculation, linking it to the observation. It was observed that the Centers of Interest, according to Decroly, should respond to the concerns and attend to the motivations of the students and the teaching of arithmetical must obey a logical seriation, considering the interest and the experience of the children. The teaching of arithmetical should not be limited to the schedule, it should cover every quantitative aspect that arises in the other disciplines. The feeling of unity is established in observation, association and expression, which coordinate a whole program of cultural activities, concentrating it around a central idea.

Keywords: didactic book, centers of interest, mathematical knowledge, primary education

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4151 Trends in Conservation and Inheritance of Musical Culture of Ethnic Groups: A Case Study of the Akha Music in Chiang Rai Province, Thailand

Authors: Nutthan Inkhong, Sutthiphong Ruangchante

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Chiang Rai province is located at the northern border of Thailand. Most of the geography there is the northern continental highlands, and the population has many types of inhabitants, including Thai people, immigrants and ethnic groups such as Akha, Lahu, Lisu, Yao, etc. Most of these ethnic groups migrated from neighbouring countries such as Myanmar, Laos, China, etc. and settled in the mountains. Each ethnic group has their unique traditions, culture, and ways of life, including the musical culture that the ancestors of each ethnic group brought with them. In the present, the Akha have the largest population in the region and still live together in numerous villages in many districts. Thus, Akha musical culture still appears in the community traditions and cultural events of Chiang Rai province regularly. This article presents the situations of Akha musical culture in the present and the predictions for the future. The study method involves the analysis of music information and the related social contexts, which were collected from the fieldwork of ethnomusicological methodology by in-depth interviews, observations, audio and visual recordings, and related documents. The results found that the important persons who are related with Akha musical culture include (1) a musical instrument maker (lives in Mae Chan district) who produces various Akha musical instruments, including gourd mouth organs, Akha drums, two-way flutes, three-hole flutes, Jew’s harps (the sound of teenage love), buffalo horns (the sound symbol of hunting) and bird call instruments (the imitation of bird sounds), (2) a folk philosopher (lives in Mae Pha Luang district) who can teach music to the new generation of Akha people as well as lecture and demonstrate music to academics and tourists, and (3) a community leader (lives in Mae Chan district) who conserves Akha performances, singing and music through various activities of the students in an informal school. Because of the changes to the social contexts and ways of life of the Akha people, such as the educational system, religion, social media, etc., including the popularity of both Thai and international popular music among the new generation of Akha people, changes to and the fading away of Akha musical culture in the future may likely occur. Therefore, the conservation and inheritance of Akha music is an issue that should be resolved quickly. This primary study leads to the next step of the ethnomusicological work and plays a part in preventing or reducing the problems impacting Akha musical culture survival by the recording of Akha music in all of its dimensions, such as producing musical instruments, playing musical instruments, analysis of tuning systems, recording Akha music as musical notation using symbols, researching related social contexts, etc. and the transcription of this information to create lessons that can be returned to the Akha community.

Keywords: Akha music, Chiang Rai, ethnic music in Thailand, ethnomusicology

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4150 Analysis in Mexico on Workers Performing Highly Repetitive Movements with Sensory Thermography in the Surface of the Wrist and Elbows

Authors: Sandra K. Enriquez, Claudia Camargo, Jesús E. Olguín, Juan A. López, German Galindo

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Currently companies have increased the number of disorders of cumulative trauma (CTDs), these are increasing significantly due to the Highly Repetitive Movements (HRM) performed in workstations, which causes economic losses to businesses, due to temporary and permanent disabilities of workers. This analysis focuses on the prevention of disorders caused by: repeatability, duration and effort; And focuses on reducing cumulative trauma disorders such as occupational diseases using sensory thermography as a noninvasive method, the above is to evaluate the injuries could have workers to perform repetitive motions. Objectives: The aim is to define rest periods or job rotation before they generate a CTD, this sensory thermography by analyzing changes in temperature patterns on wrists and elbows when the worker is performing HRM over a period of time 2 hours and 30 minutes. Information on non-work variables such as wrist and elbow injuries, weight, gender, age, among others, and work variables such as temperature workspace, repetitiveness and duration also met. Methodology: The analysis to 4 industrial designers, 2 men and 2 women to be specific was conducted in a business in normal health for a period of 12 days, using the following time ranges: the first day for every 90 minutes continuous work were asked to rest 5 minutes, the second day for every 90 minutes of continuous work were asked to rest 10 minutes, the same to work 60 and 30 minutes straight. Each worker was tested with 6 different ranges at least twice. This analysis was performed in a controlled room temperature between 20 and 25 ° C, and a time to stabilize the temperature of the wrists and elbows than 20 minutes at the beginning and end of the analysis. Results: The range time of 90 minutes working continuous and a rest of 5 minutes of activity is where the maximum temperature (Tmax) was registered in the wrists and elbows in the office, we found the Tmax was 35.79 ° C with a difference of 2.79 ° C between the initial and final temperature of the left elbow presented at the individual 4 during the 86 minutes, in of range in 90 minutes continuously working and rested for 5 minutes of your activity. Conclusions: It is possible with this alternative technology is sensory thermography predict ranges of rotation or rest for the prevention of CTD to perform HRM work activities, obtaining with this reduce occupational disease, quotas by health agencies and increasing the quality of life of workers, taking this technology a cost-benefit acceptable in the future.

Keywords: sensory thermography, temperature, cumulative trauma disorder (CTD), highly repetitive movement (HRM)

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4149 Biocompatible Hydrogel Materials Containing Cytostatics for Cancer Treatment

Authors: S. Kudlacik-Kramarczyk, M. Kedzierska, B. Tyliszczak

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Recently, the continuous development of medicine and related sciences has been observed. Particular emphasis is directed on the development of biomaterials, i.e., non-toxic, biocompatible and biodegradable materials that may improve the effectiveness of treatment as well as the comfort of patients. This is particularly important in the case of cancer treatment. Currently, there are many methods of cancer treatment based primarily on chemotherapy and the surgical removal of the tumor, but it is worth noting that these therapies also cause many side effects. Among women, the most common cancer is breast cancer. It may be completely cured, but the consequence of treatment is partial or complete breast mastectomy and radiation therapy, which results in severe skin burns. The skin of the patient after radiation therapy is very burned, and therefore requires intensive care and high frequency of dressing changes. The traditional dressing adheres to the burn wounds and does not absorb adequate amount of exudate from injuries and the patient is forced to change the dressing every 2 hours. Therefore, the main purpose was to develop an innovative combination of dressing material with drug carriers that may be used in anti-cancer therapy. The innovation of this solution is the combination of these two products into one system, i.e., a transdermal system with the possibility of a controlled release of the drug- cytostatic. Besides, the possibility of modifying the hydrogel matrix with aloe vera juice provides this material with new features favorable from the point of view of healing processes of burn wounds resulting from the radiation therapy. In this study, hydrogel materials containing protein spheres with the active substance have been obtained as a result of photopolymerization process. The reaction mixture consisting of the protein (albumin) spheres incorporated with cytostatic, chitosan, adequate crosslinking agent and photoinitiator has been subjected to the UV radiation for 2 minutes. Prepared materials have been subjected to the numerous studies including the analysis of cytotoxicity using murine fibroblasts L929. Analysis was conducted based on the mitochondrial activity test (MTT reduction assay) which involves the determining the number of cells characterized by proper metabolism. Hydrogel materials obtained using different amount of crosslinking agents have been subjected to the cytotoxicity analysis. According to the standards, tested material is defined as cytotoxic when the viability of cells after 24 h incubation with this material is lower than 70%. In the research, hydrogel polymer materials containing protein spheres incorporated with the active substance, i.e. a cytostatic, have been developed. Such a dressing may support the treatment of cancer due to the content of the anti-cancer drug - cytostatic, and may also provide a soothing effect on the healing of the burn wounds resulted from the radiation therapy due to the content of aloe vera juice in the hydrogel matrix. Based on the conducted cytotoxicity studies, it may be concluded that the obtained materials do not adversely affect the tested cell lines, therefore they can be subjected to more advanced analyzes.

Keywords: hydrogel polymers, cytostatics, drug carriers, cytotoxicity

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4148 Comparison of Phytochemicals in Grapes and Wine from Shenton Park Winery

Authors: Amanda Sheard, Garry Lee, Katherine Stockham

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Introduction: Health benefits associated with wine consumption have been well documented; these include anticancer, anti-inflammatory, and cardiovascular protection. The majority of these health benefits have been linked to polyphenols found within wine and grapes. Once consumed polyphenols exhibit free radical quenching capabilities. Environmental factors such as rainfall, temperature, CO2 levels and sunlight exposure have been shown to affect the polyphenol content of grapes. The objective of this work was to evaluate the effect of growing conditions on the antioxidant capacity of grapes obtained from a single plot vineyard in Perth. This was achieved through the analysis of samples using; oxygen radical antioxidant capacity (ORAC), cellular antioxidant activity (CAA) in human red blood cells, ICP-MS and ICP-OES, total polyphenols (PP’s), and total flavonoid’s (FLa). The data obtained was compared to observed climate data. The 14 Selected Vitis Vinefera L. cultivars included Cabernet franc, Cabernet Sauvignon, Carnelian, Chardonnay, Grenache, Melbec, Merlot, Orange muscat, Rousanne, Sauvignon Blanc, Shiraz, Tempernillo, Verdelho, and Voignier. Results: Notable variation’s between cultivars included results ranging from 125 mg/100 g-350 mg/100 g for PP’s, 93 mg/100 g–300 mg/100 g for FLa, 13 mM T.E/kg–33 mM T.E/kg for ORAC and 0.3 mM Q.E/kg–27 mM Q.E/kg CAA were found between red and white grape cultivars. No correlation was found between CAA and the ORAC obtained in this study; except that white cultivars were consistently lower than red. ICP analysis showed that seeds contained the highest concentration of copper followed by skins and flesh of the grape. A positive correlation between copper and ORAC was found. The ORAC, PP’s, and FLa in red grapes were consistently higher than white grape cultivars; these findings were supported by literature values. Significance: The cellular antioxidant activities of white and red wine cultivars were used to compare the bioactivity of these grapes against the chemical ORAC measurement. The common method of antioxidant activity measurement is the chemical value from ORAC analysis; however this may not reflect the activity within the human body. Hence, the measurements were also carried out using the cellular antioxidant activity to perform a comparison. Additionally, the study explored the influence of weather systems such as El Niño and La Niña on the polyphenol content of Australian wine cultivars grown in Perth.

Keywords: oxygen radical antioxidant activity, cellular antioxidant activity, total polyphenols, total flavonoids, wine grapes, climate

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4147 Research Progress on Patient Perception Assessment Tools for Patient Safety

Authors: Yirui Wang

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In the past few decades, patient safety has been the focus of much attention in the global medical and health field. As medical standards continue to improve and develop, the demand for patient safety is also growing. As one of the important dimensions in assessing patient safety, the Patient Perception Patient Safety Assessment Tool provides unique and valuable information from the patient's own perspective and plays an important role in promoting patient safety. This article aims to summarize and analyze the assessment content, assessment methods and applications of currently commonly used patient-perceived patient safety assessment tools at home and abroad, with a view to providing a reference for medical staff to select appropriate patient-perceived patient safety assessment tools.

Keywords: patients, patient safety, perception, assessment tools, review

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4146 Monitoring the Responses to Nociceptive Stimuli During General Anesthesia Based on Electroencephalographic Signals in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA)

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang

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Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.

Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX

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4145 Strategies for Conserving Ecosystem Functions of the Aravalli Range to Combat Land Degradation: Case of Kishangarh and Tijara Tehsil in Rajasthan, India

Authors: Saloni Khandelwal

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The Aravalli hills are one of the oldest and most distinctive mountain chains of peninsular India spanning in around 692 Km. More than 60% of it falls in the state of Rajasthan and influences ecological equilibrium in about 30% of the state. Because of natural and human-induced activities, physical gaps in the Aravallis are increasing, new gaps are coming up, and its physical structure is changing. There are no strict regulations to protect and monitor the Aravallis and no comprehensive research and study has been done for the enhancement of ecosystem functions of these ranges. Through this study, various factors leading to Aravalli’s degradation are identified and its impacts on selected areas are analyzed. A literature study is done to identify factors responsible for the degradation. To understand the severity of the problem at the lowest level, two tehsils from different districts in Rajasthan, which are the most affected due to illegal mining and increasing physical gaps are selected for the study. Case-1 of three-gram panchayats in Kishangarh Tehsil of Ajmer district focuses on the expanding physical gaps in the Aravalli range, and case-2 of three-gram panchayats in Tijara Tehsil of Alwar district focuses on increasing illegal mining in the Aravalli range. For measuring the degradation, physical, biological and social indicators are identified through literature review and for both the cases analysis is done on the basis of these indicators. Primary survey and focus group discussions are done with villagers, mining owners, illegal miners, and various government officials to understand dependency of people on the Aravalli and its importance to them along with the impact of degradation on their livelihood and environment. From the analysis, it has been found that green cover is continuously decreasing in both cases, dense forest areas do not exist now, the groundwater table is depleting at a very fast rate, soil is losing its moisture resulting in low yield and shift in agriculture. Wild animals which were easily seen earlier are now extinct. Cattles of villagers are dependent on the forest area in the Aravalli range for food, but with a decrease in fodder, their cattle numbers are decreasing. There is a decrease in agricultural land and an increase in scrub and salt-affected land. Analysis of various national and state programmes, acts which were passed to conserve biodiversity has been done showing that none of them is helping much to protect the Aravalli. For conserving the Aravalli and its forest areas, regional level and local level initiatives are required and are proposed in this study. This study is an attempt to formulate conservation and management strategies for the Aravalli range. These strategies will help in improving biodiversity which can lead to the revival of its ecosystem functions. It will also help in curbing the pollution at the regional and local level. All this will lead to the sustainable development of the region.

Keywords: Aravalli, ecosystem, LULC, Rajasthan

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4144 The Study of Periodontal Health Status in Menopausal Women with Osteoporosis Referred to Rheumatology Clinics in Yazd and Healthy People

Authors: Mahboobe Daneshvar

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Introduction: Clinical studies on the effect of systemic conditions on periodontal diseases have shown that some systemic deficiencies may provide grounds for the onset of periodontal diseases. One of these systemic problems is osteoporosis, which may be a risk factor for the onset and exacerbation of periodontitis. This study tends to evaluate periodontal indices in osteoporotic menopausal women and compare them with healthy controls. Materials and Methods: In this case-control study, participants included 45-75-year-old menopausal women referred to rheumatology wards of the Khatamolanbia Clinic and Shahid Sadoughi Hospital in Yazd; Their bone density was determined by DEXA-scan and by imaging the femoral-lumbar bone. Thirty patients with osteoporosis and 30 subjects with normal BMD were selected. Then, informed consent was obtained for participation in the study. During the clinical examinations, tooth loss (TL), plaque index (PI), gingival recession, pocket probing depth (PPD), clinical attachment loss (CAL), and tooth mobility (TM) were measured to evaluate the periodontal status. These clinical examinations were performed to determine the periodontal status by catheter, mirror and probe. Results: During the evaluation, there was no significant difference in PPD, PI, TM, gingival recession, and CAL between case and control groups (P-value>0.05); that is, osteoporosis has no effect on the above factors. These periodontal factors are almost the same in both healthy and patient groups. In the case of missing teeth, the following results were obtained: the mean of missing teeth was 22.173% of the total teeth in the case group and 18.583% of the total teeth in the control group. In the study of the missing teeth in the case and control groups, there was a significant relationship between case and control groups (P-value = 0.025). Conclusion: In fact, since periodontal disease is multifactorial and microbial plaque is the main cause, osteoporosis is considered a predisposing factor in exacerbation or persistence of periodontal disease. In patients with osteoporosis, usually pathological fractures, hormonal changes, and aging lead to reduced physical activity and affect oral health, which leads to the manifestation of periodontal disease. But this disease increases tooth loss by changing the shape and structure of bone trabeculae and weakening them. Osteoporosis does not seem to be a deterministic factor in the incidence of periodontal disease, since it affects bone quality rather than bone quantity.

Keywords: plaque index, Osteoporosis, tooth mobility, periodontal packet

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4143 System Devices to Reduce Particulate Matter Concentrations in Railway Metro Systems

Authors: Armando Cartenì

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Within the design of sustainable transportation engineering, the problem of reducing particulate matter (PM) concentrations in railways metro system was not much discussed. It is well known that PM levels in railways metro system are mainly produced by mechanical friction at the rail-wheel-brake interactions and by the PM re-suspension caused by the turbulence generated by the train passage, which causes dangerous problems for passenger health. Starting from these considerations, the aim of this research was twofold: i) to investigate the particulate matter concentrations in a ‘traditional’ railways metro system; ii) to investigate the particulate matter concentrations of a ‘high quality’ metro system equipped with design devices useful for reducing PM concentrations: platform screen doors, rubber-tyred and an advanced ventilation system. Two measurement surveys were performed: one in the ‘traditional’ metro system of Naples (Italy) and onother in the ‘high quality’ rubber-tyred metro system of Turin (Italy). Experimental results regarding the ‘traditional’ metro system of Naples, show that the average PM10 concentrations measured in the underground station platforms are very high and range between 172 and 262 µg/m3 whilst the average PM2,5 concentrations range between 45 and 60 µg/m3, with dangerous problems for passenger health. By contrast the measurements results regarding the ‘high quality’ metro system of Turin show that: i) the average PM10 (PM2.5) concentrations measured in the underground station platform is 22.7 µg/m3 (16.0 µg/m3) with a standard deviation of 9.6 µg/m3 (7.6 µg/m3); ii) the indoor concentrations (both for PM10 and for PM2.5) are statistically lower from those measured in outdoors (with a ratio equal to 0.9-0.8), meaning that the indoor air quality is greater than those in urban ambient; iii) that PM concentrations in underground stations are correlated to the trains passage; iv) the inside trains concentrations (both for PM10 and for PM2.5) are statistically lower from those measured at station platform (with a ratio equal to 0.7-0.8), meaning that inside trains the use of air conditioning system could promote a greater circulation that clean the air. The comparison among the two case studies allow to conclude that the metro system designed with PM reduction devices allow to reduce PM concentration up to 11 times against a ‘traditional’ one. From these results, it is possible to conclude that PM concentrations measured in a ‘high quality’ metro system are significantly lower than the ones measured in a ‘traditional’ railway metro systems. This result allows possessing the bases for the design of useful devices for retrofitting metro systems all around the world.

Keywords: air quality, pollutant emission, quality in public transport, underground railway, external cost reduction, transportation planning

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4142 Evaluation of Sustained Improvement in Trauma Education Approaches for the College of Emergency Nursing Australasia Trauma Nursing Program

Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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4141 Evaluation of Vitamin D Levels in Obese and Morbid Obese Children

Authors: Orkide Donma, Mustafa M. Donma

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Obesity may lead to growing serious health problems throughout the world. Vitamin D appears to play a role in cardiovascular and metabolic health. Vitamin D deficiency may add to derangements in human metabolic systems, particularly those of children. Childhood obesity is associated with an increased risk of chronic and sophisticated diseases. The aim of this study is to investigate associations as well as possible differences related to parameters affected by obesity and their relations with vitamin D status in obese (OB) and morbid obese (MO) children. This study included a total of 78 children. Of them, 41 and 37 were OB and MO, respectively. WHO BMI-for age percentiles were used for the classification of obesity. The values above 99 percentile were defined as MO. Those between 95 and 99 percentiles were included into OB group. Anthropometric measurements were recorded. Basal metabolic rates (BMRs) were measured. Vitamin D status is determined by the measurement of 25-hydroxy cholecalciferol [25- hydroxyvitamin D3, 25(OH)D] using high-performance liquid chromatography. Vitamin D status was evaluated as deficient, insufficient and sufficient. Values < 20.0 ng/ml, values between 20-30 ng/ml and values > 30.0 ng/ml were defined as vitamin D deficient, insufficient and sufficient, respectively. Optimal 25(OH)D level was defined as ≥ 30 ng/ml. SPSSx statistical package program was used for the evaluation of the data. The statistical significance degree was accepted as p < 0.05. Mean ages did not differ between the groups. Significantly increased body mass index (BMI), waist circumference (C) and neck C as well as significantly decreased fasting blood glucose (FBG) and vitamin D values were observed in MO group (p < 0.05). In OB group, 37.5% of the children were vitamin D deficient, and in MO group the corresponding value was 53.6%. No difference between the groups in terms of lipid profile, systolic blood pressure (SBP), diastolic blood pressure (DBP) and insulin values was noted. There was a severe statistical significance between FBG values of the groups (p < 0.001). Important correlations between BMI, waist C, hip C, neck C and both SBP as well as DBP were found in OB group. In MO group, correlations only with SBP were obtained. In a similar manner, in OB group, correlations were detected between SBP-BMR and DBP-BMR. However, in MO children, BMR correlated only with SBP. The associations of vitamin D with anthropometric indices as well as some lipid parameters were defined. In OB group BMI, waist C, hip C and triglycerides (TRG) were negatively correlated with vitamin D concentrations whereas none of them were detected in MO group. Vitamin D deficiency may contribute to the complications associated with childhood obesity. Loss of correlations between obesity indices-DBP, vitamin D-TRG, as well as relatively lower FBG values, observed in MO group point out that the emergence of MetS components starts during obesity state just before the transition to morbid obesity. Aside from its deficiency state, associations of vitamin D with anthropometric measurements, blood pressures and TRG should also be evaluated before the development of morbid obesity.

Keywords: children, morbid obesity, obesity, vitamin D

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4140 Covid-19 Lockdown Experience of Elderly Female as Reflected in Their Artwork

Authors: Liat Shamri-Zeevi, Neta Ram-Vlasov

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Today the world as a whole is attempting to cope with the COVID-19, which has affected all facets of personal and social life from country-wide confinement to maintaining social distance and taking protective measures to maintain hygiene. One of the populations faced with the most severe restrictions is seniors. Various studies have shown that creativity plays a crucial role in dealing with crisis events. Painting - regardless of media - allows for emotional and cognitive processing of these situations, and enables the expression of experiences in a tangible creative way that conveys and endows meaning to the artwork. The current study was conducted in Israel immediately after a 6-week lockdown. It was designed to specifically examine the impact of the COVID-19 pandemic on the quality of life of elderly women as reflected in their artworks. The sample was composed of 21 Israeli women aged 60-90, in good mental health (without diagnosed dementia or Alzheimer's), all of whom were Hebrew-speaking, and retired with an extended family, who indicated that they painted and had engaged in artwork on an ongoing basis throughout the lockdown (from March 12 to May 30, 2020). The participants' artworks were collected, and a semi-structured in-depth interview was conducted that lasted one to two hours. The participants were asked about their feelings during the pandemic and the artworks they produced during this time, and completed a questionnaire on well-being and mental health. The initial analysis of the interviews and artworks revealed themes related to the specific role of each piece of artwork. The first theme included notions that the artwork was an activity and a framework for doing, which supported positive emotions, and provided a sense of vitality during the closure. Most of the participants painted images of nature and growth which were ascribed concrete and symbolic meaning. The second theme was that the artwork enabled the processing of difficult and /or conflicting emotions related to the situation, including anxiety about death and loneliness that were symbolically expressed in the artworks, such as images of the Corona virus and the respiratory machines. The third theme suggested that the time and space prompted by the lockdown gave the participants time for a gathering together of the self, and freed up time for creative activities. Many participants stated that they painted more and more frequently during the Corona lockdown. At the conference, additional themes and findings will be presented.

Keywords: Corona virus, artwork, quality of life of elderly

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4139 An Investigation of Tetraspanin Proteins’ Role in UPEC Infection

Authors: Fawzyah Albaldi

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Urinary tract infections (UTIs) are the most prevalent of infectious diseases and > 80% are caused by uropathogenic E. coli (UPEC). Infection occurs following adhesion to urothelial plaques on bladder epithelial cells, whose major protein constituent are the uroplakins (UPs). Two of the four uroplakins (UPIa and UPIb) are members of the tetraspanin superfamily. The UPEC adhesin FimH is known to interact directly with UPIa. Tetraspanins are a diverse family of transmembrane proteins that generally act as “molecular organizers” by binding different proteins and lipids to form tetraspanin enriched microdomains (TEMs). Previous work by our group has shown that TEMs are involved in the adhesion of many pathogenic bacteria to human cells. Adhesion can be blocked by tetraspanin-derived synthetic peptides, suggesting that tetraspanins may be valuable drug targets. In this study, we investigate the role of tetraspanins in UPEC adherence to bladder epithelial cells. Human bladder cancer cell lines (T24, 5637, RT4), commonly used as in-vitro models to investigate UPEC infection, along with primary human bladder cells, were used in this project. The aim was to establish a model for UPEC adhesion/infection with the objective of evaluating the impact of tetraspanin-derived reagents on this process. Such reagents could reduce the progression of UTI, particularly in patients with indwelling catheters. Tetraspanin expression on the bladder cells was investigated by q-PCR and flow cytometry, with CD9 and CD81 generally highly expressed. Interestingly, despite these cell lines being used by other groups to investigate FimH antagonists, uroplakin proteins (UPIa, UPIb and UPIII) were poorly expressed at the cell surface, although some were present intracellularly. Attempts were made to differentiate the cell lines, to induce cell surface expression of these UPs, but these were largely unsuccessful. Pre-treatment of bladder epithelial cells with anti-CD9 monoclonal antibody significantly decreased UPEC infection, whilst anti-CD81 had no effects. A short (15aa) synthetic peptide corresponding to the large extracellular region (EC2) of CD9 also significantly reduced UPEC adherence. Furthermore, we demonstrated specific binding of that fluorescently tagged peptide to the cells. CD9 is known to associate with a number of heparan sulphate proteoglycans (HSPGs) that have also been implicated in bacterial adhesion. Here, we demonstrated that unfractionated heparin (UFH)and heparin analogs significantly inhibited UPEC adhesion to RT4 cells, as did pre-treatment of the cells with heparinases. Pre-treatment with chondroitin sulphate (CS) and chondroitinase also significantly decreased UPEC adherence to RT4 cells. This study may shed light on a common pathogenicity mechanism involving the organisation of HSPGs by tetraspanins. In summary, although we determined that the bladder cell lines were not suitable to investigate the role of uroplakins in UPEC adhesion, we demonstrated roles for CD9 and cell surface proteoglycans in this interaction. Agents that target these may be useful in treating/preventing UTIs.

Keywords: UTIs, tspan, uroplakins, CD9

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4138 Perceptions of Pregnant Women on the Transitional Use of Traditional Medicine in the Transitional District Western Uganda

Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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4137 Mandate of Heaven and Serving the People in Chinese Political Rhetoric: An Evolving Discourse System across Three Thousand Years

Authors: Weixiao Wei, Chris Shei

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This paper describes Mandate of Heaven as a source of justification for the ruling regime from ancient China approximately three thousand years ago. Initially, the kings of Shang dynasty simply nominated themselves as the sons of Heaven sent to Earth to rule the common people. As the last generation of the kings became corrupted and ruled withbrutal force and crueltywhich directly caused their destruction, the successive kings of Zhou dynasty realised the importance of virtue and the provision of goods to the people. Legitimacy of the ruling regimes became rested not entirely on random allocation of the throne by an unknown supernatural force but on a foundation comprising morality and the ability to provide goods. The latter composite was picked up by the current ruling regime, the Chinese Communist Party, and became the cornerstone of its political legitimacy, also known as ‘performance legitimacy’ where economic development accounts for the satisfaction of the people in place of election and other democratic means of providing legal-rational legitimacy. Under this circumstance, it becomes important as well for the ruling party to use political rhetoric to convince people of the good performance of the government in the economy, morality, and foreign policy. Thus, we see a lot of propaganda materials in both government policy statements and international press conference announcements. The former consists mainly of important speeches made by prominent figures in Party conferences which are not only made publicly available on the government websites but also become obligatory reading materials for university entrance examinations. The later consists of announcements about foreign policies and strategies and actions taken by the government regarding foreign affairsmade in international conferences and offered in Chinese-English bilingual versions on official websites. This documentation strategy creates an impressive image of the Chinese Communist Party that is domestically competent and international strong, taking care of the people it governs in terms of economic needs and defending the country against any foreign interference and global adversities. This political discourse system comprising reading materials fully extractable from government websites also becomes excellent repertoire for teaching and researching in contemporary Chinese language, discourse and rhetoric, Chinese culture and tradition, Chinese political ideology, and Chinese-English translation. This paper aims to provide a detailed and comprehensive description of the current Chinese political discourse system, arguing about its lineage from the rhetorical convention of Mandate of Heaven in ancient China and its current concentration on serving the people in place of election, human rights, and freedom of speech. The paper will also provide guidelines as to how this discourse system and the manifestation of official documents created under this system can become excellent research and teaching materials in applied linguistics.

Keywords: mandate of heaven, Chinese communist party, performance legitimacy, serving the people, political discourse

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4136 The Cadence of Proximity: Indigenous Resilience as Caring for Country-in-the-City

Authors: Jo Anne Rey

Abstract:

Caring for Country (Ngurrain Dharug language) is core to Aboriginal identity, Law/Lore, practice, and resilience within the continent called ‘Australia’. It is the basis of thousands of years of sustainability. However, when Ngurra is a city known as Sydney, due to 235 years of colonial impact, caring for the Country is limited, being controlled by the State and private ownership of the land title. Recent research indicates that localised Indigenous activism is most successful when community members are geographically proximate to the presences and places of connection, caring, and belonging. This article frames these findings through the cadence that proximity provides. This presentation is centred on the proximate agency that is being exercised by Dharug community through three significant sites within the Sydney basin. Those sites include, firstly, Shaw’s Creek Aboriginal Place, at the foot of the Blue Mountains in far western Sydney. Second inclusion is the site of Blacktown Native Institution, that was the part of the authoritarian colonial governance of British Governor Lachlan Macquarie (after who Macquarie University is named), which saw the beginnings of the removal of children from their families and culture to ‘civilize’ them. The third site is that of the so-called Brown’s Waterhole in the State government administered Lane Cove National Park. Each of these sites is being activated through Dharug and, more broadly, Aboriginalways of knowing, doing, and being. These ways involvethe land, water, wind, and star-based ecologies interwoven with traditional transgenerational storying of the presences (Ancestral and spiritual) creating them. Activations include, but are not limited to, the return of cultural fire for reviving plants, soils, animals, and birds. These fire practices have traditionally been at the basis of sustainable, regenerative biodiversity. These practices involve the literacy of reading Ngurra and the seasonal interactions across the ecologies. Together, they both care for the Country and support humanity, and have done so across thousands of years. However, when the cost of real-estate and rental accommodation prevents community members from being able to live on Dharug Ngurra when bureaucratic governance restricts and/or excludes traditional custodial relationships, and when private treaty land title destroys the presences and places while disconnecting people from their Ancestral practices, it becomes clear that caring for Country is only possible when the community can afford to live nearby. Recognising the cadence of proximityas the agency that underpinscaring for Country-in-the-city, sustainable change opportunities don’t have to only focus on regional and remote areas. Urban-based Aboriginal relationality offers an alternative to the unsustainable practices that underpin human-centric disconnection. Weaving Indigenous cadence offers opportunities for sustainable futures even when facing the extremes of climate changing catastrophes.

Keywords: australian aboriginal, biocultural knowledges, climate change, dharug ngurra, sustainability, resilience

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4135 Categorical Metadata Encoding Schemes for Arteriovenous Fistula Blood Flow Sound Classification: Scaling Numerical Representations Leads to Improved Performance

Authors: George Zhou, Yunchan Chen, Candace Chien

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Kidney replacement therapy is the current standard of care for end-stage renal diseases. In-center or home hemodialysis remains an integral component of the therapeutic regimen. Arteriovenous fistulas (AVF) make up the vascular circuit through which blood is filtered and returned. Naturally, AVF patency determines whether adequate clearance and filtration can be achieved and directly influences clinical outcomes. Our aim was to build a deep learning model for automated AVF stenosis screening based on the sound of blood flow through the AVF. A total of 311 patients with AVF were enrolled in this study. Blood flow sounds were collected using a digital stethoscope. For each patient, blood flow sounds were collected at 6 different locations along the patient’s AVF. The 6 locations are artery, anastomosis, distal vein, middle vein, proximal vein, and venous arch. A total of 1866 sounds were collected. The blood flow sounds are labeled as “patent” (normal) or “stenotic” (abnormal). The labels are validated from concurrent ultrasound. Our dataset included 1527 “patent” and 339 “stenotic” sounds. We show that blood flow sounds vary significantly along the AVF. For example, the blood flow sound is loudest at the anastomosis site and softest at the cephalic arch. Contextualizing the sound with location metadata significantly improves classification performance. How to encode and incorporate categorical metadata is an active area of research1. Herein, we study ordinal (i.e., integer) encoding schemes. The numerical representation is concatenated to the flattened feature vector. We train a vision transformer (ViT) on spectrogram image representations of the sound and demonstrate that using scalar multiples of our integer encodings improves classification performance. Models are evaluated using a 10-fold cross-validation procedure. The baseline performance of our ViT without any location metadata achieves an AuROC and AuPRC of 0.68 ± 0.05 and 0.28 ± 0.09, respectively. Using the following encodings of Artery:0; Arch: 1; Proximal: 2; Middle: 3; Distal 4: Anastomosis: 5, the ViT achieves an AuROC and AuPRC of 0.69 ± 0.06 and 0.30 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 10; Proximal: 20; Middle: 30; Distal 40: Anastomosis: 50, the ViT achieves an AuROC and AuPRC of 0.74 ± 0.06 and 0.38 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 100; Proximal: 200; Middle: 300; Distal 400: Anastomosis: 500, the ViT achieves an AuROC and AuPRC of 0.78 ± 0.06 and 0.43 ± 0.11. respectively. Interestingly, we see that using increasing scalar multiples of our integer encoding scheme (i.e., encoding “venous arch” as 1,10,100) results in progressively improved performance. In theory, the integer values do not matter since we are optimizing the same loss function; the model can learn to increase or decrease the weights associated with location encodings and converge on the same solution. However, in the setting of limited data and computation resources, increasing the importance at initialization either leads to faster convergence or helps the model escape a local minimum.

Keywords: arteriovenous fistula, blood flow sounds, metadata encoding, deep learning

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4134 The Diverse Experiences of Men Living with Disabilities Participating in Violence Prevention Interventions in Africa and Asia: Men as Victims; Men as Perpetrators

Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

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4133 Physical Fitness Activities for Elementary School Pupils of Matacon Elementary School

Authors: Ariel B. Domagsang

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This study dealt with the physical fitness activities for elementary school pupils of Matacon Elementary School, Polangui South District, Albay Division are presented in this chapter. Specifically, it looked into the pre-post test performance based on the Physical Fitness Test which were subjected to statistical significant test of difference including health- and skill-related improvement. Finally, it came up with physical fitness activities to improve the physical fitness performance of the pupils. The descriptive method through survey using questionnaire-checklist, unstructured interview and document(ary) analysis were utilized in this research. There were 171 grades five and six pupil participants in this undertaking.

Keywords: Matakon, fitness acitivities, elementary schools, physical fitness of pupils

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4132 Organic Tuber Production Fosters Food Security and Soil Health: A Decade of Evidence from India

Authors: G. Suja, J. Sreekumar, A. N. Jyothi, V. S. Santhosh Mithra

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Worldwide concerns regarding food safety, environmental degradation and threats to human health have generated interest in alternative systems like organic farming. Tropical tuber crops, cassava, sweet potato, yams, and aroids are food-cum-nutritional security-cum climate resilient crops. These form stable or subsidiary food for about 500 million global population. Cassava, yams (white yam, greater yam, and lesser yam) and edible aroids (elephant foot yam, taro, and tannia) are high energy tuberous vegetables with good taste and nutritive value. Seven on-station field experiments at ICAR-Central Tuber Crops Research Institute, Thiruvananthapuram, India and seventeen on-farm trials in three districts of Kerala, were conducted over a decade (2004-2015) to compare the varietal response, yield, quality and soil properties under organic vs conventional system in these crops and to develop a learning system based on the data generated. The industrial, as well as domestic varieties of cassava, the elite and local varieties of elephant foot yam and taro and the three species of Dioscorea (yams), were on a par under both systems. Organic management promoted yield by 8%, 20%, 9%, 11% and 7% over conventional practice in cassava, elephant foot yam, white yam, greater yam and lesser yam respectively. Elephant foot yam was the most responsive to organic management followed by yams and cassava. In taro, slight yield reduction (5%) was noticed under organic farming with almost similar tuber quality. The tuber quality was improved with higher dry matter, starch, crude protein, K, Ca and Mg contents. The anti-nutritional factors, oxalate content in elephant foot yam and cyanogenic glucoside content in cassava were lowered by 21 and 12.4% respectively. Organic plots had significantly higher water holding capacity, pH, available K, Fe, Mn and Cu, higher soil organic matter, available N, P, exchangeable Ca and Mg, dehydrogenase enzyme activity and microbial count. Organic farming scored significantly higher soil quality index (1.93) than conventional practice (1.46). The soil quality index was driven by water holding capacity, pH and available Zn followed by soil organic matter. Organic management enhanced net profit by 20-40% over chemical farming. A case in point is the cost-benefit analysis in elephant foot yam which indicated that the net profit was 28% higher and additional income of Rs. 47,716 ha-1 was obtained due to organic farming. Cost-effective technologies were field validated. The on-station technologies developed were validated and popularized through on-farm trials in 10 sites (5 ha) under National Horticulture Mission funded programme in elephant foot yam and seven sites in yams and taro. The technologies are included in the Package of Practices Recommendations for crops of Kerala Agricultural University. A learning system developed using artificial neural networks (ANN) predicted the performance of elephant foot yam organic system. Use of organically produced seed materials, seed treatment in cow-dung, neem cake, bio-inoculant slurry, farmyard manure incubated with bio-inoculants, green manuring, use of neem cake, bio-fertilizers and ash formed the strategies for organic production. Organic farming is an eco-friendly management strategy that enables 10-20% higher yield, quality tubers and maintenance of soil health in tuber crops.

Keywords: eco-agriculture, quality, root crops, healthy soil, yield

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4131 Isolated Hydatidosis of Spleen: A Rare Entity

Authors: Anshul Raja

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Cystic lesions of the spleen are rare and splenic hydatid cysts account for only 0.5% to 8% of all hydatidosis. Authors hereby report a case where a 50-year-old female presented to our hospital with the complains of heaviness and pain over left upper abdomen over the past 8-10 years. On radiological examination, ultrasonography revealed findings consistent with isolated splenic hydatid cyst and was later on confirmed on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). No other organ or system involvement was seen. The patient underwent splenectomy and hydatid cyst was confirmed on histopathology. Owing to its rarity, it offers a diagnostic challenge to physicians but can reliably be diagnosed with great confidence employing various imaging modalities like CT and MRI.

Keywords: gastrointestinal radiology, abdominal imaging, hydatid cyst, medical and health sciences

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4130 Impact of Traffic Restrictions due to Covid19, on Emissions from Freight Transport in Mexico City

Authors: Oscar Nieto-Garzón, Angélica Lozano

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In urban areas, on-road freight transportation creates several social and environmental externalities. Then, it is crucial that freight transport considers not only economic aspects, like retailer distribution cost reduction and service improvement, but also environmental effects such as global CO2 and local emissions (e.g. Particulate Matter, NOX, CO) and noise. Inadequate infrastructure development, high rate of urbanization, the increase of motorization, and the lack of transportation planning are characteristics that urban areas from developing countries share. The Metropolitan Area of Mexico City (MAMC), the Metropolitan Area of São Paulo (MASP), and Bogota are three of the largest urban areas in Latin America where air pollution is often a problem associated with emissions from mobile sources. The effect of the lockdown due to COVID-19 was analyzedfor these urban areas, comparing the same period (January to August) of years 2016 – 2019 with 2020. A strong reduction in the concentration of primary criteria pollutants emitted by road traffic were observed at the beginning of 2020 and after the lockdown measures.Daily mean concentration of NOx decreased 40% in the MAMC, 34% in the MASP, and 62% in Bogota. Daily mean ozone levels increased after the lockdown measures in the three urban areas, 25% in MAMC, 30% in the MASP and 60% in Bogota. These changes in emission patterns from mobile sources drastically changed the ambient atmospheric concentrations of CO and NOX. The CO/NOX ratioat the morning hours is often used as an indicator of mobile sources emissions. In 2020, traffic from cars and light vehicles was significantly reduced due to the first lockdown, but buses and trucks had not restrictions. In theory, it implies a decrease in CO and NOX from cars or light vehicles, maintaining the levels of NOX by trucks(or lower levels due to the congestion reduction). At rush hours, traffic was reduced between 50% and 75%, so trucks could get higher speeds, which would reduce their emissions. By means an emission model, it was found that an increase in the average speed (75%) would reduce the emissions (CO, NOX, and PM) from diesel trucks by up to 30%. It was expected that the value of CO/NOXratio could change due to thelockdownrestrictions. However, although there was asignificant reduction of traffic, CO/NOX kept its trend, decreasing to 8-9 in 2020. Hence, traffic restrictions had no impact on the CO/NOX ratio, although they did reduce vehicle emissions of CO and NOX. Therefore, these emissions may not adequately represent the change in the vehicle emission patterns, or this ratio may not be a good indicator of emissions generated by vehicles. From the comparison of the theoretical data and those observed during the lockdown, results that the real NOX reduction was lower than the theoretical reduction. The reasons could be that there are other sources of NOX emissions, so there would be an over-representation of NOX emissions generated by diesel vehicles, or there is an underestimation of CO emissions. Further analysis needs to consider this ratioto evaluate the emission inventories and then to extend these results forthe determination of emission control policies to non-mobile sources.

Keywords: COVID-19, emissions, freight transport, latin American metropolis

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4129 Poultry in Motion: Text Mining Social Media Data for Avian Influenza Surveillance in the UK

Authors: Samuel Munaf, Kevin Swingler, Franz Brülisauer, Anthony O’Hare, George Gunn, Aaron Reeves

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Background: Avian influenza, more commonly known as Bird flu, is a viral zoonotic respiratory disease stemming from various species of poultry, including pets and migratory birds. Researchers have purported that the accessibility of health information online, in addition to the low-cost data collection methods the internet provides, has revolutionized the methods in which epidemiological and disease surveillance data is utilized. This paper examines the feasibility of using internet data sources, such as Twitter and livestock forums, for the early detection of the avian flu outbreak, through the use of text mining algorithms and social network analysis. Methods: Social media mining was conducted on Twitter between the period of 01/01/2021 to 31/12/2021 via the Twitter API in Python. The results were filtered firstly by hashtags (#avianflu, #birdflu), word occurrences (avian flu, bird flu, H5N1), and then refined further by location to include only those results from within the UK. Analysis was conducted on this text in a time-series manner to determine keyword frequencies and topic modeling to uncover insights in the text prior to a confirmed outbreak. Further analysis was performed by examining clinical signs (e.g., swollen head, blue comb, dullness) within the time series prior to the confirmed avian flu outbreak by the Animal and Plant Health Agency (APHA). Results: The increased search results in Google and avian flu-related tweets showed a correlation in time with the confirmed cases. Topic modeling uncovered clusters of word occurrences relating to livestock biosecurity, disposal of dead birds, and prevention measures. Conclusions: Text mining social media data can prove to be useful in relation to analysing discussed topics for epidemiological surveillance purposes, especially given the lack of applied research in the veterinary domain. The small sample size of tweets for certain weekly time periods makes it difficult to provide statistically plausible results, in addition to a great amount of textual noise in the data.

Keywords: veterinary epidemiology, disease surveillance, infodemiology, infoveillance, avian influenza, social media

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4128 Prosodic Transfer in Foreign Language Learning: A Phonetic Crosscheck of Intonation and F₀ Range between Italian and German Native and Non-Native Speakers

Authors: Violetta Cataldo, Renata Savy, Simona Sbranna

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Background: Foreign Language Learning (FLL) is characterised by prosodic transfer phenomena regarding pitch accents placement, intonation patterns, and pitch range excursion from the learners’ mother tongue to their Foreign Language (FL) which suggests that the gradual development of general linguistic competence in FL does not imply an equally correspondent improvement of the prosodic competence. Topic: The present study aims to monitor the development of prosodic competence of learners of Italian and German throughout the FLL process. The primary object of this study is to investigate the intonational features and the f₀ range excursion of Italian and German from a cross-linguistic perspective; analyses of native speakers’ productions point out the differences between this pair of languages and provide models for the Target Language (TL). A following crosscheck compares the L2 productions in Italian and German by non-native speakers to the Target Language models, in order to verify the occurrence of prosodic interference phenomena, i.e., type, degree, and modalities. Methodology: The subjects of the research are university students belonging to two groups: Italian native speakers learning German as FL and German native speakers learning Italian as FL. Both of them have been divided into three subgroups according to the FL proficiency level (beginners, intermediate, advanced). The dataset consists of wh-questions placed in situational contexts uttered in both speakers’ L1 and FL. Using a phonetic approach, analyses have considered three domains of intonational contours (Initial Profile, Nuclear Accent, and Terminal Contour) and two dimensions of the f₀ range parameter (span and level), which provide a basis for comparison between L1 and L2 productions. Findings: Results highlight a strong presence of prosodic transfer phenomena affecting L2 productions in the majority of both Italian and German learners, irrespective of their FL proficiency level; the transfer concerns all the three domains of the contour taken into account, although with different modalities and characteristics. Currently, L2 productions of German learners show a pitch span compression on the domain of the Terminal Contour compared to their L1 towards the TL; furthermore, German learners tend to use lower pitch range values in deviation from their L1 when improving their general linguistic competence in Italian FL proficiency level. Results regarding pitch range span and level in L2 productions by Italian learners are still in progress. At present, they show a similar tendency to expand the pitch span and to raise the pitch level, which also reveals a deviation from the L1 possibly in the direction of German TL. Conclusion: Intonational features seem to be 'resistant' parameters to which learners appear not to be particularly sensitive. By contrast, they show a certain sensitiveness to FL pitch range dimensions. Making clear which the most resistant and the most sensitive parameters are when learning FL prosody could lay groundwork for the development of prosodic trainings thanks to which learners could finally acquire a clear and natural pronunciation and intonation.

Keywords: foreign language learning, German, Italian, L2 prosody, pitch range, transfer

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4127 Liquid Waste Management in Cluster Development

Authors: Abheyjit Singh, Kulwant Singh

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There is a gradual depletion of the water table in the earth's crust, and it is required to converse and reduce the scarcity of water. This is only done by rainwater harvesting, recycling of water and by judicially consumption/utilization of water and adopting unique treatment measures. Domestic waste is generated in residential areas, commercial settings, and institutions. Waste, in general, is unwanted, undesirable, and nevertheless an inevitable and inherent product of social, economic, and cultural life. In a cluster, a need-based system is formed where the project is designed for systematic analysis, collection of sewage from the cluster, treating it and then recycling it for multifarious work. The liquid waste may consist of Sanitary sewage/ Domestic waste, Industrial waste, Storm waste, or Mixed Waste. The sewage contains both suspended and dissolved particles, and the total amount of organic material is related to the strength of the sewage. The untreated domestic sanitary sewage has a BOD (Biochemical Oxygen Demand) of 200 mg/l. TSS (Total Suspended Solids) about 240 mg/l. Industrial Waste may have BOD and TSS values much higher than those of sanitary sewage. Another type of impurities of wastewater is plant nutrients, especially when there are compounds of nitrogen N phosphorus P in the sewage; raw sanitary contains approx. 35 mg/l Nitrogen and 10 mg/l of Phosphorus. Finally, the pathogen in the waste is expected to be proportional to the concentration of facial coliform bacteria. The coliform concentration in raw sanitary sewage is roughly 1 billion per liter. The system of sewage disposal technique has been universally applied to all conditions, which are the nature of soil formation, Availability of land, Quantity of Sewage to be disposed of, The degree of treatment and the relative cost of disposal technique. The adopted Thappar Model (India) has the following designed parameters consisting of a Screen Chamber, a Digestion Tank, a Skimming Tank, a Stabilization Tank, an Oxidation Pond and a Water Storage Pond. The screening Chamber is used to remove plastic and other solids, The Digestion Tank is designed as an anaerobic tank having a retention period of 8 hours, The Skimming Tank has an outlet that is kept 1 meter below the surface anaerobic condition at the bottom and also help in organic solid remover, Stabilization Tank is designed as primary settling tank, Oxidation Pond is a facultative pond having a depth of 1.5 meter, Storage Pond is designed as per the requirement. The cost of the Thappar model is Rs. 185 Lakh per 3,000 to 4,000 population, and the Area required is 1.5 Acre. The complete structure will linning as per the requirement. The annual maintenance will be Rs. 5 lakh per year. The project is useful for water conservation, silage water for irrigation, decrease of BOD and there will be no longer damage to community assets and economic loss to the farmer community by inundation. There will be a healthy and clean environment in the community.

Keywords: collection, treatment, utilization, economic

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4126 Multiple Insecticide Resistance in Culex quinquefasciatus Say, from Siliguri, West Bengal, India

Authors: Minu Bharati, Priyanka Rai, Satarupa Dutta, Dhiraj Saha

Abstract:

Culex quinquefasciatus Say, is a mosquito of immense public health concern due to its role in transmission of filariasis, which is an endemic disease in 20 states and union territories of India, putting about 600 million people at the risk of infection. The main strategies to control filaria in India include anti-larval measures in urban areas, Indoor Residual Spray (IRS) in rural areas and mass diethylcarbamazine citrate (DEC) administration. Larval destruction measures and IRS are done with the use of insecticides. In this study, Susceptibility/ Resistance to insecticides were assessed in Culex quinquefasciatus mosquitoes collected from eight densely populated areas of Siliguri subdivision, which has a high rate of filarial infection. To unveil the insecticide susceptibility status of Culex quinquefasciatus, bioassays were performed on field-caught mosquitoes against two major groups of insecticides, i.e. Synthetic Pyrethroids (SPs): 0.05% deltamethrin and 0.05% lambda-cyhalothrin and Organophosphates (OPs): 5% malathion and temephos using World Health Organisation (WHO) discriminating doses. The knockdown rates and knockdown times (KDT50) were also noted against deltamethrin, lambda-cyhalothrin and malathion. Also, activities of major detoxifying enzymes, i.e. α-carboxylesterases, β-carboxylesterases and cytochrome P450 (CYP450) monooxygenases were determined to find the involvement of biochemical mechanisms in resistance phenomenon (if any). The results obtained showed that, majority of the mosquito populations were moderately to severely resistant against both the SPs and one OP, i.e. temephos. Whereas, most of the populations showed 100% susceptibility to malathion. The knockdown rates and KDT50 in response to above-mentioned insecticides showed significant variation among different populations. Variability in activities of carboxylesterases and CYP450 monooxygenases were also observed with hints of their involvement in contribution towards insecticide resistance in some of the tested populations. It may be concluded that, Culex quinquefasciatus has started developing resistance against deltamethrin, lambda-cyhalothrin and temephos in Siliguri subdivision. Malathion seems to hold the greatest potentiality for control of these mosquitoes in this area as revealed through this study. Adoption of Integrated mosquito management (IMM) strategy should be the prime objective of the concerned authorities to delimit the insecticide resistance phenomenon and filariasis infections.

Keywords: Culex quinquefasciatus, detoxifying enzymes, insecticide resistance, knockdown rate

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4125 Designing Program for Developing Self-Esteem of Gifted Children

Authors: Mohammad Jamalallail

Abstract:

Self-esteem implies a person’s overall self-worth, self-respect, and self-value. It helps a person to maintain good mental health, personality, and achievement. Gifted students face some emotional problems, sometimes, which cause decreases in their self-esteem. Such emotional problems include loneliness, anxiety, and depression as examples. For this reason, designing a counseling program is necessary for gifted students who need a high level of self-esteem. The available counseling programs focused on developmental aspect only to the best of the writer’s knowledge. While the proposed program focuses on both clinical and developmental counseling by applying psychoanalytic play therapy. The proposed program consists of; Theoretical background such as; Behavior, and RET. It also consists of counseling procedures and therapeutic interventions.

Keywords: self-esteem, gifted, program, design

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4124 Characteristics of the Mortars Obtained by Radioactive Recycled Sand

Authors: Claudiu Mazilu, Ion Robu, Radu Deju

Abstract:

At the end of 2011 worldwide there were 124 power reactors shut down, from which: 16 fully decommissioned, 50 power reactors in a decommissioning process, 49 reactors in “safe enclosure mode”, 3 reactors “entombed”, for other 6 reactors it was not yet have specified the decommissioning strategy. The concrete radioactive waste that will be generated from dismantled structures of VVR-S nuclear research reactor from Magurele (e.g.: biological shield of the reactor core and hot cells) represents an estimated amount of about 70 tons. Until now the solid low activity radioactive waste (LLW) was pre-placed in containers and cementation with mortar made from cement and natural fine aggregates, providing a fill ratio of the container of approximately 50 vol. % for concrete. In this paper is presented an innovative technology in which radioactive concrete is crushed and the mortar made from recycled radioactive sand, cement, water and superplasticizer agent is poured in container with radioactive rubble (that is pre-placed in container) for cimentation. Is achieved a radioactive waste package in which the degree of filling of radioactive waste increases substantially. The tests were carried out on non-radioactive material because the radioactive concrete was not available in a good time. Waste concrete with maximum size of 350 mm were crushed in the first stage with a Liebhher type jaw crusher, adjusted to nominal size of 50 mm. Crushed concrete less than 50 mm was sieved in order to obtain useful sort for preplacement, 10 to 50 mm. The rest of the screening > 50 mm obtained from primary crushing of concrete was crushed in the second stage, with different working principles crushers at size < 2.5 mm, in order to produce recycled fine aggregate (sand) for the filler mortar and which fulfills the technical specifications proposed: –jaw crusher, Retsch type, model BB 100; –hammer crusher, Buffalo Shuttle model WA-12-H; presented a series of characteristics of recycled concrete aggregates by predefined class (the granulosity, the granule shape, the absorption of water, behavior to the Los Angeles test, the content of attached mortar etc.), most in comparison with characteristics of natural aggregates. Various mortar recipes were used in order to identify those that meet the proposed specification (flow-rate: 16-50s, no bleeding, min. 30N/mm2 compressive strength of the mortar after 28 days, the proportion of recycled sand used in mortar: min. 900kg/m3) and allow obtaining of the highest fill ratio for mortar. In order to optimize the mortars following compositional factors were varied: aggregate nature, water/cement (W/C) ratio, sand/cement (S/C) ratio, nature and proportion of additive. To confirm the results obtained on a small scale, it made an attempt to fill the mortar in a container that simulates the final storage drums. Was measured the mortar fill ratio (98.9%) compared with the results of laboratory tests and targets set out in the proposed specification. Although fill ratio obtained on the mock-up is lower by 0.8 vol. % compared to that obtained in the laboratory tests (99.7%), the result meets the specification criteria.

Keywords: characteristics, radioactive recycled concrete aggregate, mortars, fill ratio

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4123 Enhancing Precision in Abdominal External Beam Radiation Therapy: Exhale Breath Hold Technique for Respiratory Motion Management

Authors: Stephanie P. Nigro

Abstract:

The Exhale Breath Hold (EBH) technique presents a promising approach to enhance the precision and efficacy of External Beam Radiation Therapy (EBRT) for abdominal tumours, which include liver, pancreas, kidney, and adrenal glands. These tumours are challenging to treat due to their proximity to organs at risk (OARs) and the significant motion induced by respiration and physiological variations, such as stomach filling. Respiratory motion can cause up to 40mm of displacement in abdominal organs, complicating accurate targeting. While current practices like limiting fasting help reduce motion related to digestive processes, they do not address respiratory motion. 4DCT scans are used to assess this motion, but they require extensive workflow time and expose patients to higher doses of radiation. The EBH technique, which involves holding the breath in an exhale with no air in the lungs, stabilizes internal organ motion, thereby reducing respiratory-induced motion. The primary benefit of EBH is the reduction in treatment volume sizes, specifically the Internal Target Volume (ITV) and Planning Target Volume (PTV), as demonstrated by smaller ITVs when gated in EBH. This reduction also improves the quality of 3D Cone Beam CT (CBCT) images by minimizing respiratory artifacts, facilitating soft tissue matching akin to stereotactic treatments. Patients suitable for EBH must meet criteria including the ability to hold their breath for at least 15 seconds and maintain a consistent breathing pattern. For those who do not qualify, the traditional 4DCT protocol will be used. The implementation involves an EBH planning scan and additional short EBH scans to ensure reproducibility and assist in contouring and volume expansions, with a Free Breathing (FB) scan used for setup purposes. Treatment planning on EBH scans leads to smaller PTVs, though intrafractional and interfractional breath hold variations must be accounted for in margins. The treatment decision process includes performing CBCT in EBH intervals, with careful matching and adjustment based on soft tissue and fiducial markers. Initial studies at two sites will evaluate the necessity of multiple CBCTs, assessing shifts and the benefits of initial versus mid-treatment CBCT. Considerations for successful implementation include thorough patient coaching, staff training, and verification of breath holds, despite potential disadvantages such as longer treatment times and patient exhaustion. Overall, the EBH technique offers significant improvements in the accuracy and quality of abdominal EBRT, paving the way for more effective and safer treatments for patients.

Keywords: abdominal cancers, exhale breath hold, radiation therapy, respiratory motion

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