Search results for: common injuries
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6000

Search results for: common injuries

5010 Clinicomycological Pattern of Superficial Fungal Infections among Primary School Children in Communities in Enugu, Nigeria

Authors: Nkeiruka Elsie Ezomike, Chinwe L. Onyekonwu, Anthony N. Ikefuna, Bede C. Ibe

Abstract:

Superficial fungal infections (SFIs) are one of the common cutaneous infections that affect children worldwide. They may lead to school absenteeism or school drop-out and hence setback in the education of the child. Community-based studies in any locality are good reflections of the health conditions within that area. There is a dearth of information in the literature about SFI among primary school children in Enugu. This study aimed to determine the clinicomycological pattern of SFIs among primary school children in rural and urban communities in Enugu. This was a comparative descriptive cross-sectional study among primary school children in Awgu (rural) and Enugu North (urban) Local Government Areas (LGAs). Subjects' selection was made over 6 months using a multi-stage sampling method. Information such as age, sex, parental education, and occupation were collected using questionnaires. Socioeconomic classes of the children were determined using the classification proposed by Oyedeji et al. The samples were collected from subjects with SFIs. Potassium hydroxide tests were done on the samples. The samples that tested positive were cultured for SFI by inoculating onto Sabouraud's dextrose chloramphenicol actidione agar. The characteristics of the isolates were identified according to their morphological features using Mycology Online, Atlas 2000, and Mycology Review 2003. Equal numbers of children were recruited from the two LGAs. A total of 1662 pupils were studied. The mean ages of the study subjects were 9.03 ± 2.10years in rural and 10.46 ± 2.33years in urban communities. The male to female ratio was 1.6:1 in rural and 1:1.1 in urban communities. The personal hygiene of the children was significantly related to the presence of SFIs. The overall prevalence of SFIs among the study participants was 45%. In the rural, the prevalence was 29.6%, and in the urban prevalence was 60.4%. The types of SFIs were tinea capitis (the commonest), tinea corporis, pityriasis Versicolor, tinea unguium, and tinea manuum with prevalence rates lower in rural than urban communities. The clinical patterns were gray patch and black dot type of non-inflammatory tinea capitis, kerion, tinea corporis with trunk and limb distributions, and pityriasis Versicolor with face, trunk and limb distributions. Gray patch was the most frequent pattern of SFI seen in rural and urban communities. Black dot type was more frequent in rural than urban communities. SFIs were frequent among children aged 5 to 8years in rural and 9 to 12 years in urban communities. SFIs were commoner in males in the rural, whereas female dominance was observed in the urban. SFIs were more in children from low social class and those with poor hygiene. Trichophyton tonsurans and Trichophyton soudanese were the common mycological isolates in rural and urban communities, respectively. In conclusion, SFIs were less prevalent in rural than in urban communities. Trichophyton species were the most common fungal isolates in the communities. Health education of mothers and their children on SFI and good personal hygiene will reduce the incidence of SFIs.

Keywords: clinicomycological pattern, communities, primary school children, superficial fungal infections

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5009 Molecular Detection of Acute Virus Infection in Children Hospitalized with Diarrhea in North India during 2014-2016

Authors: Ali Ilter Akdag, Pratima Ray

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Background:This acute gastroenteritis viruses such as rotavirus, astrovirus, and adenovirus are mainly responsible for diarrhea in children below < 5 years old. Molecular detection of these viruses is crucially important to the understand development of the effective cure. This study aimed to determine the prevalence of common these viruses in children < 5 years old presented with diarrhea from Lala Lajpat Rai Memorial Medical College (LLRM) centre (Meerut) North India, India Methods: Total 312 fecal samples were collected from diarrheal children duration 3 years: in year 2014 (n = 118), 2015 (n = 128) and 2016 (n = 66) ,< 5 years of age who presented with acute diarrhea at the Lala Lajpat Rai Memorial Medical College (LLRM) centre(Meerut) North India, India. All samples were the first detection by EIA/RT-PCR for rotaviruses, adenovirus and astrovirus. Results: In 312 samples from children with acute diarrhea in sample viral agent was found, rotavirus A was the most frequent virus identified (57 cases; 18.2%), followed by Astrovirus in 28 cases (8.9%), adenovirus in 21 cases (6.7%). Mixed infections were found in 14 cases, all of which presented with acute diarrhea (14/312; 4.48%). Conclusions: These viruses are a major cause of diarrhea in children <5 years old in North India. Rotavirus A is the most common etiological agent, follow by astrovirus. This surveillance is important to vaccine development of the entire population. There is variation detection of virus year wise due to differences in the season of sampling, method of sampling, hygiene condition, socioeconomic level of the entire people, enrolment criteria, and virus detection methods. It was found Astrovirus higher then Rotavirus in 2015, but overall three years study Rotavirus A is mainly responsible for causing severe diarrhea in children <5 years old in North India. It emphasizes the required for cost-effective diagnostic assays for Rotaviruses which would help to determine the disease burden.

Keywords: adenovirus, Astrovirus, hospitalized children, Rotavirus

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5008 Ethical 'Spaces': A Critical Analysis of the Medical, Ethical and Legal Complexities in the Treatment and Care of Unidentified and Critically Incapacitated Victims Following a Disaster

Authors: D. Osborn, L. Easthope

Abstract:

The increasing threat of ‘marauding terror,' utilising improvised explosive devices and firearms, has focused the attention of policy makers and emergency responders once again on the treatment of the critically injured patient in a highly volatile scenario. Whilst there have been significant improvements made in the response and lessons learned from recent disasters in the international disaster community there still remain areas of uncertainty and a lack of clarity in the care of the critically injured. This innovative, longitudinal study has at its heart the aim of using ethnographic methods to ‘slow down’ the journey such patients will take and make visible the ethical complexities that 2017 technologies, expectations and over a decade of improved combat medicine techniques have brought. The primary researcher, previously employed in the hospital emergency management environment, has closely followed responders as they managed casualties with life-threatening injuries. Ethnographic observation of Exercise Unified Response in March 2016, exposed the ethical and legal 'vacuums' within a mass casualty and fatality setting, specifically the extrication, treatment and care of critically injured patients from crushed and overturned train carriages. This article highlights a gap in the debate, evaluation, planning and response to an incident of this nature specifically the incapacitated, unidentified patients and the ethics of submitting them to the invasive ‘Disaster Victim Identification’ process. Using a qualitative ethnographic analysis, triangulating observation, interviews and documentation, this analysis explores the gaps and highlights the next stages in the researcher’s pathway as she continues to explore with emergency practitioners some of this century’s most difficult questions in relation to the medico-legal and ethical challenges faced by emergency services in the wake of new and emerging threats and medical treatment expectations.

Keywords: ethics, disaster, Disaster Victim Identification (DVI), legality, unidentified

Procedia PDF Downloads 189
5007 Geospatial Analysis of Hydrological Response to Forest Fires in Small Mediterranean Catchments

Authors: Bojana Horvat, Barbara Karleusa, Goran Volf, Nevenka Ozanic, Ivica Kisic

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Forest fire is a major threat in many regions in Croatia, especially in coastal areas. Although they are often caused by natural processes, the most common cause is the human factor, intentional or unintentional. Forest fires drastically transform landscapes and influence natural processes. The main goal of the presented research is to analyse and quantify the impact of the forest fire on hydrological processes and propose the model that best describes changes in hydrological patterns in the analysed catchments. Keeping in mind the spatial component of the processes, geospatial analysis is performed to gain better insight into the spatial variability of the hydrological response to disastrous events. In that respect, two catchments that experienced severe forest fire were delineated, and various hydrological and meteorological data were collected both attribute and spatial. The major drawback is certainly the lack of hydrological data, common in small torrential karstic streams; hence modelling results should be validated with the data collected in the catchment that has similar characteristics and established hydrological monitoring. The event chosen for the modelling is the forest fire that occurred in July 2019 and burned nearly 10% of the analysed area. Surface (land use/land cover) conditions before and after the event were derived from the two Sentinel-2 images. The mapping of the burnt area is based on a comparison of the Normalized Burn Index (NBR) computed from both images. To estimate and compare hydrological behaviour before and after the event, curve number (CN) values are assigned to the land use/land cover classes derived from the satellite images. Hydrological modelling resulted in surface runoff generation and hence prediction of hydrological responses in the catchments to a forest fire event. The research was supported by the Croatian Science Foundation through the project 'Influence of Open Fires on Water and Soil Quality' (IP-2018-01-1645).

Keywords: Croatia, forest fire, geospatial analysis, hydrological response

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5006 Major Causes of Delay in Construction Projects

Authors: Y. Gholipour, E. Rezazadeh

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Delay is one of the most serious and common problems of construction project that can affect project delivery unfavorably. This research presents the most important causes of delay in large dam projects based on a survey on some executed dam construction in Iran. In this survey a randomly selected samples of owners, consultants and contractors have been involved. The outcome of this survey revealed that scheduled payments, site management, shop drawing review process, unforeseen ground conditions and contractor experience as the most important factors affecting on delay in dam construction projects.

Keywords: delay, dam construction, project management, Iran

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5005 Computer Self-Efficacy, Study Behaviour and Use of Electronic Information Resources in Selected Polytechnics in Ogun State, Nigeria

Authors: Fredrick Olatunji Ajegbomogun, Bello Modinat Morenikeji, Okorie Nancy Chituru

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Electronic information resources are highly relevant to students' academic and research needs but are grossly underutilized, despite the institutional commitment to making them available. The under-utilisation of these resources could be attributed to a low level of study behaviour coupled with a low level of computer self-efficacy. This study assessed computer self-efficacy, study behaviour, and the use of electronic information resources by students in selected polytechnics in Ogun State. A simple random sampling technique using Krejcie and Morgan's (1970) Table was used to select 370 respondents for the study. A structured questionnaire was used to collect data on respondents. Data were analysed using frequency counts, percentages, mean, standard deviation, Pearson Product Moment Correlation (PPMC) and multiple regression analysis. Results reveal that the internet (= 1.94), YouTube (= 1.74), and search engines (= 1.72) were the common information resources available to the students, while the Internet (= 4.22) is the most utilized resource. Major reasons for using electronic information resources were to source materials and information (= 3.30), for research (= 3.25), and to augment class notes (= 2.90). The majority (91.0%) of the respondents have a high level of computer self-efficacy in the use of electronic information resources through selecting from screen menus (= 3.12), using data files ( = 3.10), and efficient use of computers (= 3.06). Good preparation for tests (= 3.27), examinations (= 3.26), and organization of tutorials (= 3.11) are the common study behaviours of the respondents. Overall, 93.8% have good study behaviour. Inadequate computer facilities to access information (= 3.23), and poor internet access (= 2.87) were the major challenges confronting students’ use of electronic information resources. According to the PPMC results, study behavior (r = 0.280) and computer self-efficacy (r = 0.304) have significant (p 0.05) relationships with the use of electronic information resources. Regression results reveal that self-efficacy (=0.214) and study behavior (=0.122) positively (p 0.05) influenced students' use of electronic information resources. The study concluded that students' use of electronic information resources depends on the purpose, their computer self-efficacy, and their study behaviour. Therefore, the study recommended that the management should encourage the students to improve their study habits and computer skills, as this will enhance their continuous and more effective utilization of electronic information resources.

Keywords: computer self-efficacy, study behaviour, electronic information resources, polytechnics, Nigeria

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5004 Predictors of Recent Work-Related Injury in a Rapidly Developing Country: Results from a Worker Survey in Qatar

Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

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5003 Quantitative Ranking Evaluation of Wine Quality

Authors: A. Brunel, A. Kernevez, F. Leclere, J. Trenteseaux

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Today, wine quality is only evaluated by wine experts with their own different personal tastes, even if they may agree on some common features. So producers do not have any unbiased way to independently assess the quality of their products. A tool is here proposed to evaluate wine quality by an objective ranking based upon the variables entering wine elaboration, and analysed through principal component analysis (PCA) method. Actual climatic data are compared by measuring the relative distance between each considered wine, out of which the general ranking is performed.

Keywords: wine, grape, weather conditions, rating, climate, principal component analysis, metric analysis

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5002 The Model of Open Cooperativism: The Case of Open Food Network

Authors: Vangelis Papadimitropoulos

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This paper is part of the research program “Techno-Social Innovation in the Collaborative Economy”, funded by the Hellenic Foundation for Research and Innovation (H.F.R.I.) for the years 2022-2024. The paper showcases the Open Food Network (OFN) as an open-sourced digital platform supporting short food supply chains in local agricultural production and consumption. The paper outlines the research hypothesis, the theoretical framework, and the methodology of research as well as the findings and conclusions. Research hypothesis: The model of open cooperativism as a vehicle for systemic change in the agricultural sector. Theoretical framework: The research reviews the OFN as an illustrative case study of the three-zoned model of open cooperativism. The OFN is considered a paradigmatic case of the model of open cooperativism inasmuch as it produces commons, it consists of multiple stakeholders including ethical market entities, and it is variously supported by local authorities across the globe, the latter prefiguring the mini role of a partner state. Methodology: Research employs Ernesto Laclau and Chantal Mouffe’s discourse analysis -elements, floating signifiers, nodal points, discourses, logics of equivalence and difference- to analyse the breadth of empirical data gathered through literature review, digital ethnography, a survey, and in-depth interviews with core OFN members. Discourse analysis classifies OFN floating signifiers, nodal points, and discourses into four themes: value proposition, governance, economic policy, and legal policy. Findings: OFN floating signifiers align around the following nodal points and discourses: “digital commons”, “short food supply chains”, “sustainability”, “local”, “the elimination of intermediaries” and “systemic change”. The current research identifies a lack of common ground of what the discourse of “systemic change” signifies on the premises of the OFN’s value proposition. The lack of a common mission may be detrimental to the formation of a common strategy that would be perhaps deemed necessary to bring about systemic change in agriculture. Conclusions: Drawing on Laclau and Mouffe’s discourse theory of hegemony, research introduces a chain of equivalence by aligning discourses such as “agro-ecology”, “commons-based peer production”, “partner state” and “ethical market entities” under the model of open cooperativism, juxtaposed against the current hegemony of neoliberalism, which articulates discourses such as “market fundamentalism”, “privatization”, “green growth” and “the capitalist state” to promote corporatism and entrepreneurship. Research makes the case that for OFN to further agroecology and challenge the current hegemony of industrial agriculture, it is vital that it opens up its supply chains into equivalent sectors of the economy, civil society, and politics to form a chain of equivalence linking together ethical market entities, the commons and a partner state around the model of open cooperativism.

Keywords: sustainability, the digital commons, open cooperativism, innovation

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5001 Artificial Intelligence and Liability within Healthcare: A South African Analysis

Authors: M. Naidoo

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AI in healthcare can have a massive positive effect in low-resource states like South Africa, where patients outnumber personnel greatly. However, the complexity and ‘black box’ aspects of these technologies pose challenges for the liability regimes of states. This is currently being discussed at the international level. This research finds that within the South African medical negligence context, the current common law fault-based inquiry proves to be wholly inadequate for patient redress. As a solution to this, this research paper culminates in legal reform recommendations designed to solve these issues.

Keywords: artificial intelligence, law, liability, policy

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5000 Evaluation of Redundancy Architectures Based on System on Chip Internal Interfaces for Future Unmanned Aerial Vehicles Flight Control Computer

Authors: Sebastian Hiergeist

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It is a common view that Unmanned Aerial Vehicles (UAV) tend to migrate into the civil airspace. This trend is challenging UAV manufacturer in plenty ways, as there come up a lot of new requirements and functional aspects. On the higher application levels, this might be collision detection and avoidance and similar features, whereas all these functions only act as input for the flight control components of the aircraft. The flight control computer (FCC) is the central component when it comes up to ensure a continuous safe flight and landing. As these systems are flight critical, they have to be built up redundantly to be able to provide a Fail-Operational behavior. Recent architectural approaches of FCCs used in UAV systems are often based on very simple microprocessors in combination with proprietary Application-Specific Integrated Circuit (ASIC) or Field Programmable Gate Array (FPGA) extensions implementing the whole redundancy functionality. In the future, such simple microprocessors may not be available anymore as they are more and more replaced by higher sophisticated System on Chip (SoC). As the avionic industry cannot provide enough market power to significantly influence the development of new semiconductor products, the use of solutions from foreign markets is almost inevitable. Products stemming from the industrial market developed according to IEC 61508, or automotive SoCs, according to ISO 26262, can be seen as candidates as they have been developed for similar environments. Current available SoC from the industrial or automotive sector provides quite a broad selection of interfaces like, i.e., Ethernet, SPI or FlexRay, that might come into account for the implementation of a redundancy network. In this context, possible network architectures shall be investigated which could be established by using the interfaces stated above. Of importance here is the avoidance of any single point of failures, as well as a proper segregation in distinct fault containment regions. The performed analysis is supported by the use of guidelines, published by the aviation authorities (FAA and EASA), on the reliability of data networks. The main focus clearly lies on the reachable level of safety, but also other aspects like performance and determinism play an important role and are considered in the research. Due to the further increase in design complexity of recent and future SoCs, also the risk of design errors, which might lead to common mode faults, increases. Thus in the context of this work also the aspect of dissimilarity will be considered to limit the effect of design errors. To achieve this, the work is limited to broadly available interfaces available in products from the most common silicon manufacturer. The resulting work shall support the design of future UAV FCCs by giving a guideline on building up a redundancy network between SoCs, solely using on board interfaces. Therefore the author will provide a detailed usability analysis on available interfaces provided by recent SoC solutions, suggestions on possible redundancy architectures based on these interfaces and an assessment of the most relevant characteristics of the suggested network architectures, like e.g. safety or performance.

Keywords: redundancy, System-on-Chip, UAV, flight control computer (FCC)

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4999 The Importance of including All Data in a Linear Model for the Analysis of RNAseq Data

Authors: Roxane A. Legaie, Kjiana E. Schwab, Caroline E. Gargett

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Studies looking at the changes in gene expression from RNAseq data often make use of linear models. It is also common practice to focus on a subset of data for a comparison of interest, leaving aside the samples not involved in this particular comparison. This work shows the importance of including all observations in the modeling process to better estimate variance parameters, even when the samples included are not directly used in the comparison under test. The human endometrium is a dynamic tissue, which undergoes cycles of growth and regression with each menstrual cycle. The mesenchymal stem cells (MSCs) present in the endometrium are likely responsible for this remarkable regenerative capacity. However recent studies suggest that MSCs also plays a role in the pathogenesis of endometriosis, one of the most common medical conditions affecting the lower abdomen in women in which the endometrial tissue grows outside the womb. In this study we compared gene expression profiles between MSCs and non-stem cell counterparts (‘non-MSC’) obtained from women with (‘E’) or without (‘noE’) endometriosis from RNAseq. Raw read counts were used for differential expression analysis using a linear model with the limma-voom R package, including either all samples in the study or only the samples belonging to the subset of interest (e.g. for the comparison ‘E vs noE in MSC cells’, including only MSC samples from E and noE patients but not the non-MSC ones). Using the full dataset we identified about 100 differentially expressed (DE) genes between E and noE samples in MSC samples (adj.p-val < 0.05 and |logFC|>1) while only 9 DE genes were identified when using only the subset of data (MSC samples only). Important genes known to be involved in endometriosis such as KLF9 and RND3 were missed in the latter case. When looking at the MSC vs non-MSC cells comparison, the linear model including all samples identified 260 genes for noE samples (including the stem cell marker SUSD2) while the subset analysis did not identify any DE genes. When looking at E samples, 12 genes were identified with the first approach and only 1 with the subset approach. Although the stem cell marker RGS5 was found in both cases, the subset test missed important genes involved in stem cell differentiation such as NOTCH3 and other potentially related genes to be used for further investigation and pathway analysis.

Keywords: differential expression, endometriosis, linear model, RNAseq

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4998 Thermoelectric Generators as Alternative Source for Electric Power

Authors: L. C. Ding, Bradley G. Orr, K. Rahauoi, S. Truza, A. Date, A. Akbarzadeh

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The research on thermoelectric has been a blooming field of research for the latest decade, owing to large amount of heat source available to be harvested, being eco-friendly and static in operation. This paper provides the performance of thermoelectric generator (TEG) with bulk material of bismuth telluride, Bi2Te3. Later, the performance of the TEGs is evaluated by considering attaching the TEGs on a plastic (polyethylene sheet) in contrast to the common method of attaching the TEGs on the metal surface.

Keywords: electric power, heat transfer, renewable energy, thermoelectric generator

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4997 A Sustainable and Low-Cost Filter to Treat Pesticides in Water

Authors: T. Abbas, J. McEvoy, E. Khan

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Pesticide contamination in water supply is a common environmental problem in rural agricultural communities. Advanced water treatment processes such as membrane filtration and adsorption on activated carbon only remove pesticides from water without degrading them into less toxic/easily degradable compounds leaving behind contaminated brine and activated carbon that need to be managed. Rural communities which normally cannot afford expensive water treatment technologies need an economical and sustainable filter which not only treats pesticides from water but also degrades them into benign products. In this study, iron turning waste experimented as potential point-of-use filtration media for the removal/degradation of a mixture of six chlorinated pesticides (lindane, heptachlor, endosulfan, dieldrin, endrin, and DDT) in water. As a common and traditional medium for water filtration, sand was also tested along with iron turning waste. Iron turning waste was characterized using scanning electron microscopy and energy dispersive X-Ray analyzer. Four glass columns with different filter media layer configurations were set up: (1) only sand, (2) only iron turning, (3) sand and iron turning (two separate layers), and (4) sand, iron turning and sand (three separate layers). The initial pesticide concentration and flow rate were 2 μg/L and 10 mL/min. Results indicate that sand filtration was effective only for the removal of DDT (100%) and endosulfan (94-96%). Iron turning filtration column effectively removed endosulfan, endrin, and dieldrin (85-95%) whereas the lindane and DDT removal were 79-85% and 39-56%, respectively. The removal efficiencies for heptachlor, endosulfan, endrin, dieldrin, and DDT were 90-100% when sand and iron turning waste (two separate layers) were used. However, better removal efficiencies (93-100%) for five out of six pesticides were achieved, when sand, iron turning and sand (three separate layers) were used as filtration media. Moreover, the effects of water pH, amounts of media, and minerals present in water such as magnesium, sodium, calcium, and nitrate on the removal of pesticides were examined. Results demonstrate that iron turning waste efficiently removed all the pesticides under studied parameters. Also, it completely de-chlorinated all the pesticides studied and based on the detection of by-products, the degradation mechanisms for all six pesticides were proposed.

Keywords: pesticide contamination, rural communities, iron turning waste, filtration

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4996 Purple Spots on Historical Parchments: Confirming the Microbial Succession at the Basis of Biodeterioration

Authors: N. Perini, M. C. Thaller, F. Mercuri, S. Orlanducci, A. Rubechini, L. Migliore

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The preservation of cultural heritage is one of the major challenges of today’s society, because of the fundamental right of future generations to inherit it as the continuity with their historical and cultural identity. Parchments, consisting of a semi-solid matrix of collagen produced from animal skin (i.e., sheep or goats), are a significant part of the cultural heritage, being used as writing material for many centuries. Due to their animal origin, parchments easily undergo biodeterioration. The most common biological damage is characterized by isolated or coalescent purple spots that often leads to the detachment of the superficial layer and the loss of the written historical content of the document. Although many parchments with the same biodegradative features were analyzed, no common causative agent has been found so far. Very recently, a study was performed on a purple-damaged parchment roll dated back 1244 A.D, the A.A. Arm. I-XVIII 3328, belonging to the oldest collection of the Vatican Secret Archive (Fondo 'Archivum Arcis'), by comparing uncolored undamaged and purple damaged areas of the same document. As a whole, the study gave interesting results to hypothesize a model of biodeterioration, consisting of a microbial succession acting in two main phases: the first one, common to all the damaged parchments, is characterized by halophilic and halotolerant bacteria fostered by the salty environment within the parchment maybe induced by bringing of the hides; the second one, changing with the individual history of each parchment, determines the identity of its colonizers. The design of this model was pivotal to this study, performed by different labs of the Tor Vergata University (Rome, Italy), in collaboration with the Vatican Secret Archive. Three documents, belonging to a collection of dramatically damaged parchments archived as 'Faldone Patrizi A 19' (dated back XVII century A.D.), were analyzed through a multidisciplinary approach, including three updated technologies: (i) Next Generation Sequencing (NGS, Illumina) to describe the microbial communities colonizing the damaged and undamaged areas, (ii) RAMAN spectroscopy to analyze the purple pigments, (iii) Light Transmitted Analysis (LTA) to evaluate the kind and entity of the damage to native collagen. The metagenomic analysis obtained from NGS revealed DNA sequences belonging to Halobacterium salinarum mainly in the undamaged areas. RAMAN spectroscopy detected pigments within the purple spots, mainly bacteriorhodopsine/rhodopsin-like pigments, a purple transmembrane protein containing retinal and present in Halobacteria. The LTA technique revealed extremely damaged collagen structures in both damaged and undamaged areas of the parchments. In the light of these data, the study represents a first confirmation of the microbial succession model described above. The demonstration of this model is pivotal to start any possible new restoration strategy to bring back historical parchments to their original beauty, but also to open opportunities for intervention on a huge amount of documents.

Keywords: biodeterioration, parchments, purple spots, ecological succession

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4995 The Characteristics of Static Plantar Loading in the First-Division College Sprint Athletes

Authors: Tong-Hsien Chow

Abstract:

Background: Plantar pressure measurement is an effective method for assessing plantar loading and can be applied to evaluating movement performance of the foot. The purpose of this study is to explore the sprint athletes’ plantar loading characteristics and pain profiles in static standing. Methods: Experiments were undertaken on 80 first-division college sprint athletes and 85 healthy non-sprinters. ‘JC Mat’, the optical plantar pressure measurement was applied to examining the differences between both groups in the arch index (AI), three regional and six distinct sub-regional plantar pressure distributions (PPD), and footprint characteristics. Pain assessment and self-reported health status in sprint athletes were examined for evaluating their common pain areas. Results: Findings from the control group, the males’ AI fell into the normal range. Yet, the females’ AI was classified as the high-arch type. AI values of the sprint group were found to be significantly lower than the control group. PPD were higher at the medial metatarsal bone of both feet and the lateral heel of the right foot in the sprint group, the males in particular, whereas lower at the medial and lateral longitudinal arches of both feet. Footprint characteristics tended to support the results of the AI and PPD, and this reflected the corresponding pressure profiles. For the sprint athletes, the lateral knee joint and biceps femoris were the most common musculoskeletal pains. Conclusions: The sprint athletes’ AI were generally classified as high arches, and that their PPD were categorized between the features of runners and high-arched runners. These findings also correspond to the profiles of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles appeared to correspond to the symptoms of high-arched runners and PFPS. The findings reflected upon the possible link between high arches and PFPS. The correlation between high-arched runners and PFPS development is worth further studies.

Keywords: sprint athletes, arch index, plantar pressure distributions, high arches, patellofemoral pain syndrome

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4994 The Use of Religious Symbols in the Workplace: Remarks on the Latest Case Law

Authors: Susana Sousa Machado

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The debate on the use of religious symbols has been highlighted in modern societies, especially in the field of labour relationships. As litigiousness appears to be growing, the matter requires a careful study from a legal perspective. In this context, a description and critical analysis of the most recent case law is conducted regarding the use of symbols by the employee in the workplace, delivered both by the European Court of Human Rights and by the Court of Justice of the European Union. From this comparative analysis we highlight the most relevant aspects in order to seek a common core regarding the juridical-argumentative approach of case law.

Keywords: religion, religious symbols, workplace, discrimination

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4993 The Effect of Cross-Curriculum of L1 and L2 on Elementary School Students’ Linguistic Proficiency: To Sympathize with Others

Authors: Reiko Yamamoto

Abstract:

This paper reports on a project to integrate Japanese (as a first language) and English (as a second language) education. This study focuses on the mutual effects of the two languages on the linguistic proficiency of elementary school students. The research team consisted of elementary school teachers and researchers at a university. The participants of the experiment were students between 3rd and 6th grades at an elementary school. The research process consisted of seven steps: 1) specifying linguistic proficiency; 2) developing the cross-curriculum of L1 and L2; 3) forming can-do statements; 4) creating a self-evaluation questionnaire; 5) executing the self-evaluation questionnaire at the beginning of the school year; 6) instructing L1 and L2 based on the curriculum; and 7) executing the self-evaluation questionnaire at the beginning of the next school year. In Step 1, the members of the research team brainstormed ways to specify elementary school students’ linguistic proficiency that can be observed in various scenes. It was revealed that the teachers evaluate their students’ linguistic proficiency on the basis of the students’ utterances, but also informed by their non-verbal communication abilities. This led to the idea that competency for understanding others’ minds through the use of physical movement or bodily senses in communication in L1 – to sympathize with others – can be transferred to that same competency in communication in L2. Based on the specification of linguistic proficiency that L1 and L2 have in common, a cross-curriculum of L1 and L2 was developed in Step 2. In Step 3, can-do statements based on the curriculum were also formed, building off of the action-oriented approach from the Common European Framework of Reference for Languages (CEFR) used in Europe. A self-evaluation questionnaire consisting of the main can-do statements was given to the students between 3rd grade and 6th grade at the beginning of the school year (Step 4 and Step 5), and all teachers gave L1 and L2 instruction based on the curriculum to the students for one year (Step 6). The same questionnaire was given to the students at the beginning of the next school year (Step 7). The results of statistical analysis proved the enhancement of the students’ linguistic proficiency. This verified the validity of developing the cross-curriculum of L1 and L2 and adapting it in elementary school. It was concluded that elementary school students do not distinguish between L1 and L2, and that they just try to understand others’ minds through physical movement or senses in any language.

Keywords: cross curriculum of L1 and L2, elementary school education, language proficiency, sympathy with others

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4992 The Urgenda and Juliana Cases: Redefining the Notion of Environmental Democracy

Authors: Valentina Dotto

Abstract:

Climate change cases used to take the form of statutory disputes rather than constitutional or common law disputes. This changed in 2015, with the Urgenda Climate case in the Netherlands (Urgenda Foundation v. The State of the Netherlands, C/09/456689/HAZA 13-1396) and, the Juliana case in the U.S. (United States v. U.S. District Court for District of Oregon, 17-71692, 9th Cir.). The two cases represent a new type of climate litigation, the claims brought against the federal government were in fact grounded in constitutional rights. The complaints used the Doctrine of Public Trust as a cornerstone for the lawsuits asserting that government's actions against climate change failed to protect essential public trust resources; thus, violating a generation's constitutional rights to life, liberty, and property. The Public Trust Doctrine –a quintessentially American legal concept-, reserved to the States by virtue of the 9th and 10th amendment of the federal Constitution, gives them considerable jurisdiction over natural resources and has been refined by a number of Supreme Court rulings. The Juliana case exemplifies the Doctrine’s evolutionary nature because it attempts to apply it to the federal government, and establish a right to a climate system capable of sustaining human life as a fundamental right protected by a substantive due process. Furthermore, the flexibility of the Doctrine makes it permissible to be applied to a variety of different legal systems as in the Urgenda case. At the very heart of the lawsuits stands the question of who owns the Earth resources and, to what extent the general public can claim the services that the Earth provides as common property. By employing the widest possible definition of the Doctrine of Public Trust these lawsuits tried to redefine environmental resources as a collective right of all people. By doing case analysis, the paper explores how these cases can contribute to widening the public access to information and broadening the public voice in decision making as well as providing a precedent to equal access in seeking justice and redress from environmental failures.

Keywords: climate change, doctrine of public trust, environmental democracy, Juliana case, Urgenda climate case

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4991 Non-Invasive Characterization of the Mechanical Properties of Arterial Walls

Authors: Bruno RamaëL, GwenaëL Page, Catherine Knopf-Lenoir, Olivier Baledent, Anne-Virginie Salsac

Abstract:

No routine technique currently exists for clinicians to measure the mechanical properties of vascular walls non-invasively. Most of the data available in the literature come from traction or dilatation tests conducted ex vivo on native blood vessels. The objective of the study is to develop a non-invasive characterization technique based on Magnetic Resonance Imaging (MRI) measurements of the deformation of vascular walls under pulsating blood flow conditions. The goal is to determine the mechanical properties of the vessels by inverse analysis, coupling imaging measurements and numerical simulations of the fluid-structure interactions. The hyperelastic properties are identified using Solidworks and Ansys workbench (ANSYS Inc.) solving an optimization technique. The vessel of interest targeted in the study is the common carotid artery. In vivo MRI measurements of the vessel anatomy and inlet velocity profiles was acquired along the facial vascular network on a cohort of 30 healthy volunteers: - The time-evolution of the blood vessel contours and, thus, of the cross-section surface area was measured by 3D imaging angiography sequences of phase-contrast MRI. - The blood flow velocity was measured using a 2D CINE MRI phase contrast (PC-MRI) method. Reference arterial pressure waveforms were simultaneously measured in the brachial artery using a sphygmomanometer. The three-dimensional (3D) geometry of the arterial network was reconstructed by first creating an STL file from the raw MRI data using the open source imaging software ITK-SNAP. The resulting geometry was then transformed with Solidworks into volumes that are compatible with Ansys softwares. Tetrahedral meshes of the wall and fluid domains were built using the ANSYS Meshing software, with a near-wall mesh refinement method in the case of the fluid domain to improve the accuracy of the fluid flow calculations. Ansys Structural was used for the numerical simulation of the vessel deformation and Ansys CFX for the simulation of the blood flow. The fluid structure interaction simulations showed that the systolic and diastolic blood pressures of the common carotid artery could be taken as reference pressures to identify the mechanical properties of the different arteries of the network. The coefficients of the hyperelastic law were identified using Ansys Design model for the common carotid. Under large deformations, a stiffness of 800 kPa is measured, which is of the same order of magnitude as the Young modulus of collagen fibers. Areas of maximum deformations were highlighted near bifurcations. This study is a first step towards patient-specific characterization of the mechanical properties of the facial vessels. The method is currently applied on patients suffering from facial vascular malformations and on patients scheduled for facial reconstruction. Information on the blood flow velocity as well as on the vessel anatomy and deformability will be key to improve surgical planning in the case of such vascular pathologies.

Keywords: identification, mechanical properties, arterial walls, MRI measurements, numerical simulations

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4990 Assessment, Diagnosis and Treatment, Simulation for the Nurse Practitioner Student

Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

Abstract:

Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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4989 Clinical Trial of VEUPLEXᵀᴹ TBI Assay to Help Diagnose Traumatic Brain Injury by Quantifying Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 in the Serum of Patients Suspected of Mild TBI by Fluorescence Immunoassay

Authors: Moon Jung Kim, Guil Rhim

Abstract:

The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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4988 The Comparison Study of Human Microbiome in Chronic Rhinosinusitis between Adults and Children

Authors: Il Ho Park, Joong Seob Lee, Sung Hun Kang, Jae-Min Shin, Il Seok Park, Seok Min Hong, Seok Jin Hong

Abstract:

Introduction: The human microbiota is the aggregate of microorganisms, and the bacterial microbiome of the human digestive tract contributes to both health and disease. In health, bacteria are key components in the development of mucosal barrier function and in innate and adaptive immune responses, and they also work to suppress the establishment of pathogens. In human upper airway, the sinonasal microbiota might play an important role in chronic rhinosinusitis (CRS). The purpose of this study is to investigate the human upper airway microbiome in CRS patients and to compare the sinonasal microbiome of adults with children. Materials and methods: A total of 19 samples from 19 patients (Group1; 9 CRS in children, aged 5 to 14 years versus Group 2; 10 CRS in adults aged 21 to 59 years) were examined. Swabs were collected from the middle meatus and/or anterior ethmoid region under general anesthesia during endoscopic sinus surgery or tonsillectomy. After DNA extraction from swab samples, we analysed bacterial microbiome consortia using 16s rRNA gene sequencing approach (the Illumina MiSeq platform). Results: In this study, relatively abundance of the six bacterial phyla and tremendous genus and species found in substantial amounts in the individual sinus swab samples, include Corynebacterium, Hemophilus, Moraxella, and Streptococcus species. Anaerobes like Fusobacterium and Bacteroides were abundantly present in the children group, Bacteroides and Propionibacterium were present in adults group. In genus, Haemophilus was the most common CRS microbiome in children and Corynebacterium was the most common CRS microbiome in adults. Conclusions: Our results show the diversity of human upper airway microbiome, and the findings will suggest that CRS is a polymicrobial infection. The Corynebacterium and Hemophilus may live as commensals on mucosal surfaces of sinus in the upper respiratory tract. The further study will be needed for analysis of microbiome-human interactions in upper airway and CRS.

Keywords: microbiome, upper airway, chronic rhinosinusitis, adult and children

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4987 Analysis of the Black Sea Gas Hydrates

Authors: Sukru Merey, Caglar Sinayuc

Abstract:

Gas hydrate deposits which are found in deep ocean sediments and in permafrost regions are supposed to be a fossil fuel reserve for the future. The Black Sea is also considered rich in terms of gas hydrates. It abundantly contains gas hydrates as methane (CH4~80 to 99.9%) source. In this study, by using the literature, seismic and other data of the Black Sea such as salinity, porosity of the sediments, common gas type, temperature distribution and pressure gradient, the optimum gas production method for the Black Sea gas hydrates was selected as mainly depressurization method. Numerical simulations were run to analyze gas production from gas hydrate deposited in turbidites in the Black Sea by depressurization.

Keywords: CH4 hydrate, Black Sea hydrates, gas hydrate experiments, HydrateResSim

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4986 Rural Landscape Design-Method Researching Based on the Population Diversification

Authors: Zhou Ziyi, Chen Qiuxiao, Wu Shuang

Abstract:

Population diversification is very common in villages located in the developed coastal areas of China. Based on the analyses of the characteristics of the traditional rural society and its landscape, also in consideration of the diversified landscape demand due to the population diversification of the village, with the dual ideas of heritage and innovation, the ideas and methods of rural landscape design were explored by taking Duxuao Village in Zhejiang Province of China as an example.

Keywords: rural landscape, population diversification, landscape design, architecture

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4985 Trashing Customary International Law Comprehensive Evaluation

Authors: Hamid Vahidkia

Abstract:

Central to the World Court’s mission is the assurance of universal custom “as prove of a common hone acknowledged as law.” Understudies of the Court’s law have long been mindful that the Court has been superior at applying standard law than characterizing it. However until Nicaragua v. Joined together States, small hurt was done. For within the strongly challenged cases earlier to Nicaragua, the Court overseen to inspire commonalities in factious structure that floated its decisions toward the standard standards certain in state hone. The Court’s need of hypothetical unequivocality basically implied that a career opportunity emerged for a few eyewitnesses like me to endeavor to supply the lost hypothesis of custom.

Keywords: law, international law, jurisdication, customary

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4984 In vitro Method to Evaluate the Effect of Steam-Flaking on the Quality of Common Cereal Grains

Authors: Wanbao Chen, Qianqian Yao, Zhenming Zhou

Abstract:

Whole grains with intact pericarp are largely resistant to digestion by ruminants because entire kernels are not conducive to bacterial attachment. But processing methods makes the starch more accessible to microbes, and increases the rate and extent of starch degradation in the rumen. To estimate the feasibility of applying a steam-flaking as the processing technique of grains for ruminants, cereal grains (maize, wheat, barley and sorghum) were processed by steam-flaking (steam temperature 105°C, heating time, 45 min). And chemical analysis, in vitro gas production, volatile fatty acid concentrations, and energetic values were adopted to evaluate the effects of steam-flaking. In vitro cultivation was conducted for 48h with the rumen fluid collected from steers fed a total mixed ration consisted of 40% hay and 60% concentrates. The results showed that steam-flaking processing had a significant effect on the contents of neutral detergent fiber and acid detergent fiber (P < 0.01). The concentration of starch gelatinization degree in all grains was also great improved in steam-flaking grains, as steam-flaking processing disintegrates the crystal structure of cereal starch, which may subsequently facilitate absorption of moisture and swelling. Theoretical maximum gas production after steam-flaking processing showed no great difference. However, compared with intact grains, total gas production at 48 h and the rate of gas production were significantly (P < 0.01) increased in all types of grain. Furthermore, there was no effect of steam-flaking processing on total volatile fatty acid, but a decrease in the ratio between acetate and propionate was observed in the current in vitro fermentation. The present study also found that steam-flaking processing increased (P < 0.05) organic matter digestibility and energy concentration of the grains. The collective findings of the present study suggest that steam-flaking processing of grains could improve their rumen fermentation and energy utilization by ruminants. In conclusion, the utilization of steam-flaking would be practical to improve the quality of common cereal grains.

Keywords: cereal grains, gas production, in vitro rumen fermentation, steam-flaking processing

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4983 Assessment of Implementation of the Health and Safety Contents of the Nigerian Factories Act by Small and Medium Scale Industries in Anambra State, Nigeria

Authors: Vivian Uchechi Okpala

Abstract:

Background: Millions of workers die every year as a result of occupational hazards, accidents and injuries, which are as a result of non- compliance to the laws or legislations guiding the health, safety and welfare of workers in the industries. This and many more lead to the assessment of implementation of the health and safety contents of the Nigerian Factories Act (NFA) by small and medium scale industries in Anambra State. Objectives: The study is aimed at achieving the following specific objectives; to assess the extent of implementation of Part-II Health and Part -III Safety (General Provisions), implementation of Part II Health and Part -III Safety (General Provisions Nigerian Factories Acts based on the age of the industries, locations of the industries and level of education of the workers of the small and medium scale industries Methods: the research design that was used for this study was descriptive survey research design, Area of this study was Anambra state, The population for this study comprised 180 chairmen/presidents of union workers of manufacturing industries in Anambra State, The instrument used for this study was structured questionnaire titled ‘assessment of implementation of NFA health and safety contents by small and medium scale industries, results: From the analysis, the following findings were made: Results: The medium scale industries implemented the Part-II Health and Part III Safety (General provisions) better than the small scale industries in Anambra state, the age of the industries, location of the industries and the level of education of the workers in the industries significantly influenced the implementation of the Part III Safety (General Provisions) of NFA, the location of the industries significantly influenced the implementation of the Part II-Health (General Provisions) of NFA. Conclusion: there was generally a certain level of implementation of the factories Act, there is need for more improvement, strict inspection by the regulatory agencies. Implications of the study were highlighted and several suggestions for further studies were made. Based on the findings, several recommendations were made including that the Ministry of Labour and Productivity and the Ministry of Health should strengthen planned information, strict policies to sanction the offenders. Keywords: Occupational Health and Safety, Nigerian Factories Act

Keywords: occupational health and safety, Nigerian factories act, workers, welfare

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4982 Promoting Health and Academic Achievement: Mental Health Promoting Online Education

Authors: Natalie Frandsen

Abstract:

Pursuing post-secondary education is a milestone for many Canadian youths. This transition involves many changes and opportunities for growth. However, this may also be a period where challenges arise. Perhaps not surprisingly, mental health challenges for post-secondary students are common. This poses difficulties for students and instructors. Common mental-health-related symptoms (e.g., low motivation, fatigue, inability to concentrate) can affect academic performance, and instructors may need to provide accommodations for these students without the necessary expertise. ‘Distance education’ has been growing and gaining momentum in Canada for three decades. As a consequence of the COVID-19 pandemic, post-secondary institutions have been required to deliver courses using ‘remote’ methods (i.e., various online delivery modalities). The learning challenges and subsequent academic performance issues experienced by students with mental-health-related disabilities studying online are not well understood. However, we can postulate potential factors drawing from learning theories, the relationship between mental-health-related symptoms and academic performance, and learning design. Identifying barriers and opportunities to academic performance is an essential step in ensuring that students with mental-health-related disabilities are able to achieve their academic goals. Completing post-secondary education provides graduates with more employment opportunities. It is imperative that our post-secondary institutions take a holistic view of learning by providing learning and mental health support while reducing structural barriers. Health-promoting universities and colleges infuse health into their daily operations and academic mandates. Acknowledged in this Charter is the notion that all sectors must take an active role in favour of health, social justice, and equity for all. Drawing from mental health promotion and Universal Design for Learning (UDL) frameworks, relevant adult learning concepts, and critical digital pedagogy, considerations for mental-health-promoting, online learning community development will be summarized. The education sector has the opportunity to create and foster equitable and mental health-promoting learning environments. This is of particular importance during a global pandemic when the mental health of students is being disproportionately impacted.

Keywords: academic performance, community, mental health promotion, online learning

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4981 Alteration of Placental Development and Vascular Dysfunction in Gestational Diabetes Mellitus Has Impact on Maternal and Infant Health

Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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