Search results for: ISI 2020

Authors: Ming-Dong Wang, Abigail F. Ruby, Michelle E. Ross

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Methylphenidate is a first-line treatment drug for attention deficit hyperactivity disorder (ADHD), a common mental health disorder in children and adolescents. Over the last several decades, the rate of children and adolescents using ADHD medication has been increasing in many countries. A recent study found that the prevalence of ADHD medication use among children aged 3-18 years increased in 13 different world regions between 2001 and 2015, where the absolute increase ranged from 0.02 to 0.26% per year. The goal of this study was to examine the use of methylphenidate in Canadian children and its associated adverse reactions. Methylphenidate use information among young Canadians aged 0-14 years was extracted from IQVIA data on prescriptions dispensed by pharmacies between April 2014 and June 2020. The adverse reaction information associated with methylphenidate use was extracted from the Canada Vigilance database for the same time period. Methylphenidate use trends were analyzed based on sex, age group (0-4 years, 5-9 years, and 10-14 years), and geographical location (province). The common classes of adverse reactions associated with methylphenidate use were sorted, and the relative risks associated with methylphenidate use as compared with two second-line amphetamine medications for ADHD were estimated. This study revealed that among Canadians aged 0-14 years, every 100 people used about 25 prescriptions (or 23,000 mg) of methylphenidate per year during the study period, and the use increased with time. Boys used almost three times more methylphenidate than girls. The amount of drug used was inversely associated with age: Canadians aged 10-14 years used nearly three times as many drugs compared to those aged 5-9 years. Seasonal methylphenidate use patterns were apparent among young Canadians, but the seasonal trends differed among the three age groups. Methylphenidate use varied from region to region, and the highest methylphenidate use was observed in Quebec, where the use of methylphenidate was at least double that of any other province. During the study period, Health Canada received 304 adverse reaction reports associated with the use of methylphenidate for Canadians aged 0-14 years. The number of adverse reaction reports received for boys was 3.5 times higher than that for girls. The three most common adverse reaction classes were psychiatric disorders, nervous system disorders and injury, poisoning procedural complications. The number one commonly reported adverse reaction for boys was aggression (11.2%), while for girls, it was a tremor (9.6%). The safety profile in terms of adverse reaction classes associated with methylphenidate use was similar to that of the selected control products. Methylphenidate is a commonly used pharmaceutical product in young Canadians, particularly in the province of Quebec. Boys used approximately three times more of this product as compared to girls. Future investigation is needed to determine what factors are associated with the observed geographic variations in Canada.

Keywords: adverse reaction risk, methylphenidate, prescription trend, use variation

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Suzanne Strauss, Leandi Steenkamp

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The Finnish symphonic metal band Nightwish is the brainchild of songwriter and lyricist TuomasHolopainen and the band recorded their first demonstration recording in 1996. The band has since produced nine full-length studio albums, the most recent being the 2020 album Human. :||: Nature., and has reached massive international success. The band is well known for songs about fantasy and escapism and employs many sonic, visual and branding tools and techniques to communicate these constructs to the audience. Among these, is the band’s creation of the so-called “Nightwish world and mythology” with a set of recurring characters and narratives which, in turn, creates a psychological anchor and safe space for Nightwish fans around the globe. Nature and the reverence of nature are central themes in Nightwish’s self-created mythology.Swiss psychologist Carl Jung’s theory of the collective unconscious identified a mysterious reservoir of psychological constructs common to all people, being derived from ancestral memory and experience, common to all humankind, and distinct from the individual’s personal unconscious. Furthermore, he defined archetypes as timeless collective patterns and images that springs forth from the collective unconscious. Archetypes can be actualized when they enter consciousness as images in interaction with the outside world. Archetypal patterns or images can manifest in different ways across world cultures, but follow common patterns, also known as archetypal themes and symbols. The Jungian approach to the psyche places great emphasis on nature, positing a direct link betweenthe concept of wholeness and responsible care for nature and the environment.In our proposed paper, we examine, by means of thematic content analysis, how Nightwish makes use of archetypal themes and symbols referring to nature and the environment in selected songs from their ninth full-length album Human. II Nature. Furthermore, we argue that the longing for and reverence of nature in selected Nightwish songs may serve as a type of “social intervention” and social critique on modern capitalist society. The type of social critique that the band offers is generally connoted intertextually and is not equally explicit in their songs. The band uses a unique combination of escapism, fantasy, and nature narratives to inspire a sense of wonder, enchantment, and magic in the listener. In this way, escapism, fantasy, and nature serve as postmodern frames of reference that aim to “re-enchant” the disenchanted and de-spiritualized. In this way, re-enchantment could also refer to spiritual and/or psychological healing and rebirth.

Keywords: archetypes, metal music, nature, Nightwish, social interventions

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Authors: Aisha Maroof

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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.

Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment

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Authors: Giorgia Carratta

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Since the beginning of mass production, plastic items have been crucial in our daily lives. Thanks to their physical and chemical properties, plastic materials have proven almost irreplaceable in a number of economic sectors such as packaging, automotive, building and construction, textile, and many others. At the same time, the disruptive consequences of plastic pollution have been progressively brought to light in all environmental compartments. The overaccumulation of plastics in the environment, and its adverse effects on habitats, wildlife, and (most likely) human health, represents a call for action to decision-makers around the globe. From a regulatory perspective, plastic production is an unprecedented challenge at all levels of governance. At the international level, the design of new legal instruments, the amendment of existing ones, and the coordination among the several relevant policy areas requires considerable effort. Under the pressure of both increasing scientific evidence and a concerned public opinion, countries seem to slowly move towards the discussion of a new international ‘plastic treaty.’ However, whether, how, and with which scopes such instrument would be adopted is still to be seen. Additionally, governments are establishing regional-basedstrategies, prone to consider the specificities of the plastic issue in a certain geographical area. Thanks to the new Circular Economy Action Plan, approved in March 2020 by the European Commission, EU countries are slowly but steadily shifting to a carbon neutral, circular economy in the attempt to reduce the pressure on natural resources and, parallelly, facilitate sustainable economic growth. In this context, the EU Plastic Strategy is promising to change the way plastic is designed, produced, used, and treated after consumption. In fact, only in the EU27 Member States, almost 26 million tons of plastic waste are generated herein every year, whose 24,9% is still destined to landfill. Positive effects of the Strategy also include a more effective protection of our environment, especially the marine one, the reduction of greenhouse gas emissions, a reduced need for imported fossil energy sources, more sustainable production and consumption patterns. As promising as it may sound, the road ahead is still long. The need to implement these measures in domestic legislations makes their outcome difficult to predict at the moment. An analysis of the current international and European Union legal framework on plastic pollution, binding, and voluntary instruments included, could serve to detect ‘blind spots’ in the current governance as well as to facilitate the development of policy interventions along the plastic value chain, where it appears more needed.

Keywords: environmental law, European union, governance, plastic pollution, sustainability

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Authors: Balarabe Z. Ahmad, Anne-Lorène Vernay

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The emergence of electricity in Nigeria was dated back to 1896. The power plants have the potential to generate 12,522 MW of electric power. Whereas current dispatch is about 4,000 MW, access to electrification is about 60%, with consumption at 0.14 MWh/capita. The government embarked on energy reforms to mitigate energy poverty. The reform targeted the provision of electricity access to 75% of the population by 2020 and 90% by 2030. Growth of total electricity demand by a factor of 5 by 2035 had been projected. This means that Nigeria will require almost 530 TWh of electricity which can be delivered through generators with a capacity of 65 GW. Analogously, the geographical location of Nigeria has placed it in an advantageous position as the source of solar energy; the availability of a high sunshine belt is obvious in the country. The implication is that the far North, where energy poverty is high, equally has about twice the solar radiation as against southern Nigeria. Hence, the chance of generating solar electricity is 66% possible at 11850 x 103 GWh per year, which is one hundred times the current electricity consumption rate in the country. Harvesting these huge potentials may be a mirage if the entrepreneurs in the solar panel business are left with the conventional business models that are not uncertainty resilient. Currently, business entities in RE in Nigeria are uncertain of; accessing the national grid, purchasing potentials of cooperating organizations, currency fluctuation and interest rate increases. Uncertainties such as the security of projects and government policy are issues entrepreneurs must navigate to remain sustainable in the solar panel industry in Nigeria. The aim of this paper is to identify how entrepreneurial firms consider uncertainties in developing workable business models for commercializing solar energy projects in Nigeria. In an attempt to develop a novel business model, the paper investigated how entrepreneurial firms assess and navigate uncertainties. The roles of key stakeholders in helping entrepreneurs to manage uncertainties in the Nigeria RE sector were probed in the ongoing study. The study explored empirical uncertainties that are peculiar to RE entrepreneurs in Nigeria. A mixed-mode of research was embraced using qualitative data from face-to-face interviews conducted on the Solar Energy Entrepreneurs and the experts drawn from key stakeholders. Content analysis of the interview was done using Atlas. It is a nine qualitative tool. The result suggested that all stakeholders are required to synergize in developing an uncertainty resilient business model. It was opined that the RE entrepreneurs need modifications in the business recommendations encapsulated in the energy policy in Nigeria to strengthen their capability in delivering solar energy solutions to the yawning Nigerians.

Keywords: uncertainties, entrepreneurial, business model, solar-panel

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Authors: Nzereogu Stella Kosi, Igwe Ogbonnaya, Emeh Chukwuebuka Odinaka

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A comparative analysis of the expansion rate and soil erodibility of some gullies in Nnewi and Nnobi both of Nanka Formation were studied. The study involved an integration of field observations, geotechnical analysis, slope stability analysis, multivariate statistical analysis, gully expansion rate analysis, and determination of the soil erodibility factor (K) from Revised Universal Soil Loss Equation (RUSLE). Fifteen representative gullies were studied extensively, and results reveal that the geotechnical properties of the soil, topography, vegetation cover, rainfall intensity, and the anthropogenic activities in the study area were major factors propagating and influencing the erodibility of the soils. The specific gravity of the soils ranged from 2.45-2.66 and 2.54-2.78 for Nnewi and Nnobi, respectively. Grain size distribution analysis revealed that the soils are composed of gravel (5.77-17.67%), sand (79.90-91.01%), and fines (2.36-4.05%) for Nnewi and gravel (7.01-13.65%), sand (82.47-88.67%), and fines (3.78-5.02%) for Nnobi. The soils are moderately permeable with values ranging from 2.92 x 10-5 - 6.80 x 10-4 m/sec and 2.35 x 10-6 - 3.84 x 10⁻⁴m/sec for Nnewi and Nnobi respectively. All have low cohesion values ranging from 1–5kPa and 2-5kPa and internal friction angle ranging from 29-38° and 30-34° for Nnewi and Nnobi, respectively, which suggests that the soils have low shear strength and are susceptible to shear failure. Furthermore, the compaction test revealed that the soils were loose and easily erodible with values of maximum dry density (MDD) and optimum moisture content (OMC) ranging from 1.82-2.11g/cm³ and 8.20-17.81% for Nnewi and 1.98-2.13g/cm³ and 6.00-17.80% respectively. The plasticity index (PI) of the fines showed that they are nonplastic to low plastic soils and highly liquefiable with values ranging from 0-10% and 0-9% for Nnewi and Nnobi, respectively. Multivariate statistical analyses were used to establish relationship among the determined parameters. Slope stability analysis gave factor of safety (FoS) values in the range of 0.50-0.76 and 0.82-0.95 for saturated condition and 0.73-0.98 and 0.87-1.04 for unsaturated condition for both Nnewi and Nnobi, respectively indicating that the slopes are generally unstable to critically stable. The erosion expansion rate analysis for a fifteen-year period (2005-2020) revealed an average longitudinal expansion rate of 36.05m/yr, 10.76m/yr, and 183m/yr for Nnewi, Nnobi, and Nanka type gullies, respectively. The soil erodibility factor (K) are 8.57x10⁻² and 1.62x10-4 for Nnewi and Nnobi, respectively, indicating that the soils in Nnewi have higher erodibility potentials than those of Nnobi. From the study, both the Nnewi and Nnobi areas are highly prone to erosion. However, based on the relatively lower fine content of the soil, relatively lower topography, steeper slope angle, and sparsely vegetated terrain in Nnewi, soil erodibility and gully intensity are more profound in Nnewi than Nnobi.

Keywords: soil erodibility, gully expansion, nnewi-nnobi, slope stability, factor of safety

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Authors: Mmatladi D. Mnguni, Mustapha Mohammed, George Y. Mahama, Alhassan L. Abdulai, Felix D. Dakora

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Industrial-based nitrogen (N) fertilizers are justifiably credited for the current state of food production across the globe, but their continued use is not sustainable and has an adverse effect on the environment. The search for greener and sustainable technologies has led to an increase in exploiting biological systems such as legumes and organic amendments for plant growth promotion in cropping systems. Although the benefits of legume rotation with cereal crops have been documented, the full benefits of soybean-sorghum rotation systems have not been properly evaluated in Africa. This study explored the benefits of soybean-sorghum rotation through assessing N₂ fixation and water-use efficiency of soybean in rotation with sorghum with and without organic and inorganic amendments. The field trials were conducted from 2017 to 2020. Sorghum was grown on plots previously cultivated to soybean and vice versa. The succeeding sorghum crop received fertilizer amendments [organic fertilizer (5 tons/ha as poultry litter, OF); inorganic fertilizer (80N-60P-60K) IF; organic + inorganic fertilizer (OF+IF); half organic + inorganic fertilizer (HIF+OF); organic + half inorganic fertilizer (OF+HIF); half organic + half inorganic (HOF+HIF) and control] and was arranged in a randomized complete block design. The soybean crop succeeding fertilized sorghum received a blanket application of triple superphosphate at 26 kg P ha⁻¹. Nitrogen fixation and water-use efficiency were respectively assessed at the flowering stage using the ¹⁵N and ¹³C natural abundance techniques. The results showed that the shoot dry matter of soybean plants supplied with HOF+HIF was much higher (43.20 g plant-1), followed by OF+HIF (36.45 g plant⁻¹), and HOF+IF (33.50 g plant⁻¹). Shoot N concentration ranged from 1.60 to 1.66%, and total N content from 339 to 691 mg N plant⁻¹. The δ¹⁵N values of soybean shoots ranged from -1.17‰ to -0.64‰, with plants growing on plots previously treated to HOF+HIF exhibiting much higher δ¹⁵N values, and hence lower percent N derived from N₂ fixation (%Ndfa). Shoot %Ndfa values varied from 70 to 82%. The high %Ndfa values obtained in this study suggest that the previous year’s organic and inorganic fertilizer amendments to sorghum did not inhibit N₂ fixation in the following soybean crop. The amount of N-fixed by soybean ranged from 106 to 197 kg N ha⁻¹. The treatments showed marked variations in carbon (C) content, with HOF+HIF treatment recording the highest C content. Although water-use efficiency varied from -29.32‰ to -27.85‰, shoot water-use efficiency, C concentration, and C:N ratio were not altered by previous fertilizer application to sorghum. This study provides strong evidence that previous HOF+HIF sorghum residues can enhance N nutrition and water-use efficiency in nodulated soybean.

Keywords: ¹³C and ¹⁵N natural abundance, N-fixed, organic and inorganic fertilizer amendments, shoot %Ndfa

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Authors: Gebreselassie Sebhatleab

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According to the Global Peace Index report (GPI, 2023), global peacefulness has deteriorated by more than 0.42%. Old and new conflicts, COVID-19, and political and cultural polarization are the main drivers of conflicts in the world. The 2022 was the deadliest year for armed conflict in the history of the GPI. In Ethiopia, over half a million people died in the Tigray war, which was the largest conflict death event since the 1994 Rwandan genocide. In total, 84 countries recorded an improvement, while 79 countries recorded a deterioration in peacefulness across the globe. The Russia-Ukraine war and its consequences were the main drivers of the deterioration in peacefulness globally. Both Russia and Ukraine are now ranked amongst the ten least peaceful countries, and Ukraine had the largest deterioration of any country in the 2023 GPI. In the same year, the global impact of violence on the economy was 17 percent, which was equivalent to 10.9% of global GDP. Besides, the brutal conflict in Tigray started in November. 2020 claimed more than half a million lives lost and displaced nearly 3 million people, along with widespread human rights violations and sexual violence has left deep damage on the population. The displaced people are still unable to return home because the western, southern and Eastern parts of Tigray are occupied by Eritrean and Amhara forces, despite the Pretoria Agreement. Currently, armed conflicts in Amhara in the Oromya regions are intensified, and human rights violations are being reported in both regions. Meanwhile, protests have been held by war-injured TDF members, IDPs and teachers in the Tigray region. Hence, the general objective of this project is to explore the challenges of peace-building processes in the border woredas of the Eastern Zone of the Tigray Region. Methodologically, the project will employ exploratory qualitative research designs to gather and analyze qualitative data. A purposive sampling technique will be applied to gather pertinent information from the key stakeholders. Open-ended interview questions will be prepared to gather relevant information about the challenges and perceptions of peacebuilding in the study area. Data will be analyzed using qualitative methods such as content analysis, narrative analysis and phenomenological analysis to deeply investigate the challenges of peace-building in the study woredas. Findings of this research project will be employed for program intervention to promote sustainable peace in the study area.

Keywords: peace building, conflcit and violence, political instability, insecurity

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Authors: Sulemana Saibu, Moses Ikpeme

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Background: The severity of the COVID-19 pandemic, brought on by the SARS-CoV-2 coronavirus, has been unprecedented since the 1918 influenza pandemic. SARS-CoV-2 cases of CNS and peripheral nervous system disease, including neurodegenerative disorders and chronic immune-mediated diseases, may be anticipated based on knowledge of past coronaviruses, particularly those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks. Although respiratory symptoms are the most common clinical presentation, neurological symptoms are becoming increasingly recognized, raising concerns about their potential role in causing Parkinson's disease, Multiple sclerosis, and Narcolepsy. This systematic review aims to summarize the current evidence by exploring the association between COVID-19 infection and how it may overlap with etiological mechanisms resulting in Narcolepsy, Parkinson's disease, and Multiple sclerosis. Methods: A systematic search was conducted using electronic databases ((PubMed/MedLine, Embase, PsycINFO, ScieLO, Web of Science, ProQuest (Biotechnology, Virology, and AIDS), Scopus, and CINAHL)) to identify studies published between January 2020 and December 2022 that investigated the association between COVID-19 and Parkinson's disease, multiple sclerosis, and Narcolepsy. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was performed and reported. Study quality was assessed using the Critical Appraisal Skills Programme Checklist and the Joanna Briggs Institute Critical appraisal tools. Results: A total of 21 studies out of 1025 met the inclusion criteria, including 8 studies reporting Parkinson's disease, 11 on multiple sclerosis, and 2 on Narcolepsy. In COVID-19 individuals compared to the general population, Narcolepsy, Parkinson's disease, and multiple sclerosis were shown to have a higher incidence. The findings imply that COVID-19 may worsen the signs or induce multiple sclerosis and Parkinson's disease and may raise the risk of developing Narcolepsy. Further research is required to confirm these connections because the available data is insufficient. Conclusion: According to the existing data, COVID-19 may raise the risk of Narcolepsy and have a causative relationship with Parkinson's disease, multiple sclerosis, and other diseases. More study is required to confirm these correlations and pinpoint probable mechanisms behind these interactions. Clinicians should be aware of how COVID-19 may affect various neurological illnesses and should treat patients who are affected accordingly.

Keywords: COVID-19, parkinson’s disease, multiple sclerosis, narcolepsy, neurological disorders, sars-cov-2, neurodegenerative disorders, chronic immune-mediated diseases

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Authors: Clare S. Sullivan

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The high desert of central Oregon, USA is a challenging growing environment: short growing season (70-100 days); average annual precipitation of 280 mm; drastic swings in diurnal temperatures; possibility of frost any time of year; and sandy soils low in organic matter. Despite strong demand, there is almost no fruit grown in central Oregon due to potential yield loss caused by early and late frosts. Elsewhere in the USA, protected culture (i.e., high tunnels) has been used to extend fruit production seasons and improve yields. In central Oregon, high tunnels are used to grow multiple high-value vegetable crops, and farmers are unlikely to plant a perennial crop in a high tunnel unless proven profitable. In May 2019, two berry trials were established on a farm in Alfalfa, OR, to evaluate raspberry and strawberry yield, season length, and fruit quality in protected (high tunnels) vs. unprotected culture (open field). The main objective was to determine whether high tunnel berry production is a viable enterprise for the region. Each trial was arranged using a split-plot design. The main factor was the production system (high tunnel vs. open field), and the replicated, subplot factor was berry variety. Four day-neutral strawberry varieties and four primocane-bearing raspberry varieties were planted for the study and were managed using organic practices. Berries were harvested once a week early in the season, and twice a week as production increased. Harvested berries were separated into ‘marketable’ and ‘unmarketable’ in order to calculate percent cull. First-year results revealed berry yield and quality differences between varieties and production systems. Strawberry marketable yield and berry fruit size increased significantly in the high tunnel compared to the field; percent yield increase ranged from 7-46% by variety. Evie 2 was the highest yielding strawberry, although berry quality was lower than other berries. Raspberry marketable yield and berry fruit size tended to increase in the high tunnel compared to the field, although variety had a more significant effect. Joan J was the highest yielding raspberry and out-yielded the other varieties by 250% outdoor and 350% indoor. Overall, strawberry and raspberry yields tended to improve in high tunnels as compared to the field, but data from a second year will help determine whether high tunnel investment is worthwhile. It is expected that the production system will have more of an effect on berry yield and season length for second-year plants in 2020.

Keywords: berries, high tunnel, local food, organic

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Authors: Yongrong Liu, Xin Tang

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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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Authors: Grandmother Roberta Oshkawbewisens, Elder Isabelle Meawasige, Lynne Groulx, Chloë Hamilton, Lee Allison Clark, Dana Hickey, Wansu Qiu, Jared Leedham, Nishanthini Mahendran, Cameron Maclaine

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In March of 2020, the world suddenly shifted with the onset of the COVID-19 pandemic; in-person programs and services were unavailable and a scramble to shift to virtual service delivery began. The Native Women’s Association of Canada (NWAC) established virtual programming through the Resiliency Lodge model and connected with Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people across Turtle Island and Inuit Nunangat through programs that provide a safe space to slow down and reflect on their lives, environment, and well-being. To continue to grow the virtual Resiliency Lodge model, NWAC needed to develop an understanding of three questions: how COVID-19 affects Elder-led support services, how Elder-led support services have adapted during the pandemic, and what Wise Practices need to be implemented to continue to develop, refine, and evaluate virtual Elder-led support services specifically for Indigenous women, girls, two-Spirit, transgender, and gender-diverse people. Through funding from the Canadian Institute of Health Research (CIHR), NWAC gained deeper insight into these questions and developed a series of key findings and recommendations that are outlined throughout this report. The goals of this project are to contribute to a more robust participatory analysis that reflects the complexities of Elder-led virtual cultural responses and the impacts of COVID-19 on Elder-led support services; develop culturally and contextually meaningful virtual protocols and wise practices for virtual Indigenous-led support; and develop an Evaluation Strategy to improve the capacity of the Resiliency Lodge model. Significant findings from the project include Resiliency Lodge programs, especially crafting and business sessions, have provided participants with a sense of community and contributed to healing and wellness; Elder-led support services need greater and more stable funding to offer more workshops to more Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people; and Elder- and Indigenous-led programs play a significant role in healing and building a sense of purpose and belonging among Indigenous people. Ultimately, the findings and recommendations outlined in this research project help to guide future Elder-led virtual support services and emphasize the critical need to increase access to Elder-led programming for Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people.

Keywords: indigenous women, traditional healing, virtual programs, covid-19

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Authors: Susan E Orlovich

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Ongoing, effective teacher professional learning is acknowledged as a critical influence on teacher practice. However, it is unclear whether the elements of effective professional learning result in transformed teacher practice in the classroom. This research project is interested in 4C teacher professional learning. The professional learning practices to assist teachers in transforming their practice to integrate the 4C capabilities seldom feature in the academic literature. The 4Cs are a shorthand way of representing the concepts of communication, collaboration, creativity, and critical reflection and refer to the capabilities needed for deeper learning, personal growth, and effective participation in society. The New South Wales curriculum review (2020) acknowledges that identifying, teaching, and assessing the 4C capabilities are areas of challenge for teachers. However, it also recognises that it is essential for teachers to build the confidence and capacity to understand, teach and assess the capabilities necessary for learners to thrive in the 21st century. This qualitative research project explores the professional learning experiences of sixteen teachers in four different primaries (K-6) settings in Sydney, Australia, who are learning to integrate, teach and assess the 4Cs. The project draws on the Theory of Practice Architecture as a framework to analyse and interpret teachers' experiences in each site. The sixteen participants in the study are teachers from four primary settings and include early career, experienced, and teachers in leadership roles (including the principal). In addition, some of the participants are also teachers who are learning within a Community of Practice (CoP) as their school setting is engaged in a 4C professional learning, Community of Practice. Qualitative and arts-informed research methods are utilised to examine the cultural-discursive, social-political, and material-economic practice arrangements of the site, explore how these arrangements may have shaped the professional learning experiences of teachers, and in turn, influence the teaching practices of the 4Cs in the setting. The research is in the data analysis stage (October 2022), with preliminary findings pending. The research objective is to investigate the elements of the professional learning experiences undertaken by teachers to teach the 4Cs in the primary setting. The lens of practice architectures theory is used to identify the influence of the practice architectures on critical praxis in each site and examine how the practice arrangements enable or constrain the teaching of 4C capabilities. This research aims to offer deep insight into the practice arrangements which may enable or constrain teacher professional learning in the 4Cs. Such insight from this study may contribute to a better understanding of the practices that enable teachers to transform their practice to achieve the integration, teaching, and assessment of the 4C capabilities.

Keywords: 4Cs, communication, collaboration, creativity, critical reflection, teacher professional learning

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Nikolaos Katsoulas, Sofia Faliagka, George Kountrias, Eleni Dimitriou, Eleftheria Pechlivani

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The challenges to feed the world in 2050 are becoming more and more apparent. This calls for producing more with fewer inputs (most of them under scarcity), higher resource efficiency, minimum or zero effect on the environment, and higher sustainability. Therefore, increasing the circularity of production systems is highly significant for their sustainability. Protected horticulture offers opportunities for maximum resource efficiency across various levels within and between farms and at the regional level), high-quality production, and contributes significantly to the nutrition security as part of the world food production. In greenhouses, closed soilless cultivation systems give the opportunity to increase the water and nutrient use efficiency and reduce the environmental impact of the cultivation system by the reuse of the drained water and nutrients. However, due to the low quality of the water used in the Mediterranean countries, a completely closed system is not feasible. Partial discharge of the drainage nutrient solution when the levels of electrical conductivity (EC) or of the toxic ions in the system are reached is still a necessity. Thus, in the frame of the circular economy concept, this work presents the utilisation of the drainage solution of soilless cultivation systems for microalgae and biofertilisers production. The system includes a greenhouse equipped with a soilless cultivation system, a drainage solution collection tank, a closed bioreactor for microalgae production, and a biocatalysis tank. The bioreactor tested in the frame of this work includes two closed tube loops of a capacity of 1000 L each where, after the initial inoculation, the microalgae is developed using as a growth medium the drainage solution collected from the greenhouse crops. The bioreactor includes light and temperature control while pH is still manually regulated. As soon as the microalgae culture reaches a certain density level, 20% of the culture is harvested, and the culture system is refiled by a drainage nutrient solution. The microalgae produced goes through a biocatalysis process, which leads to the production of a rich aminoacids (and nitrogen) biofertiliser. The produced biofertiliser is then used for the fertilisation of greenhouse crops. The complete production cycle along with the effects of the biofertiliser produced on crop growth and yield are presented and discussed in this manuscript. Acknowledgment: This work was carried out under the PestNu project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Green Deal grant agreement No. 101037128 — PestNu.

Keywords: soilless, water use efficiency, nutrients use efficiency, biostimulant

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Authors: Marc Bachelet, Abhijit Kumar Chatterjee, José Manuel Avila

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Data quality is a key component of any data-driven organization. Without data quality, organizations cannot effectively make data-driven decisions, which often leads to poor business performance. Therefore, it is important for an organization to ensure that the data they use is of high quality. This is where the concept of data mesh comes in. Data mesh is an organizational and architectural decentralized approach to data management that can help organizations improve the quality of data. The concept of data mesh was first introduced in 2020. Its purpose is to decentralize data ownership, making it easier for domain experts to manage the data. This can help organizations improve data quality by reducing the reliance on centralized data teams and allowing domain experts to take charge of their data. This paper intends to discuss how a set of elements, including data mesh, are tools capable of increasing data quality. One of the key benefits of data mesh is improved metadata management. In a traditional data architecture, metadata management is typically centralized, which can lead to data silos and poor data quality. With data mesh, metadata is managed in a decentralized manner, ensuring accurate and up-to-date metadata, thereby improving data quality. Another benefit of data mesh is the clarification of roles and responsibilities. In a traditional data architecture, data teams are responsible for managing all aspects of data, which can lead to confusion and ambiguity in responsibilities. With data mesh, domain experts are responsible for managing their own data, which can help provide clarity in roles and responsibilities and improve data quality. Additionally, data mesh can also contribute to a new form of organization that is more agile and adaptable. By decentralizing data ownership, organizations can respond more quickly to changes in their business environment, which in turn can help improve overall performance by allowing better insights into business as an effect of better reports and visualization tools. Monitoring and analytics are also important aspects of data quality. With data mesh, monitoring, and analytics are decentralized, allowing domain experts to monitor and analyze their own data. This will help in identifying and addressing data quality problems in quick time, leading to improved data quality. Data culture is another major aspect of data quality. With data mesh, domain experts are encouraged to take ownership of their data, which can help create a data-driven culture within the organization. This can lead to improved data quality and better business outcomes. Finally, the paper explores the contribution of AI in the coming years. AI can help enhance data quality by automating many data-related tasks, like data cleaning and data validation. By integrating AI into data mesh, organizations can further enhance the quality of their data. The concepts mentioned above are illustrated by AEKIDEN experience feedback. AEKIDEN is an international data-driven consultancy that has successfully implemented a data mesh approach. By sharing their experience, AEKIDEN can help other organizations understand the benefits and challenges of implementing data mesh and improving data quality.

Keywords: data culture, data-driven organization, data mesh, data quality for business success

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Authors: Senait Belay Adugna, Mirutse Giday, Tsegahun Manyazewal

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Background: The emergence and resurgence of zoonotic diseases have continued to be a major threat to global health and the economy. Developing countries are particularly vulnerable due to agricultural expansions and the domestication of animals by humans. Scientifically sound clinical trials are important to find better ways to prevent, diagnose, and treat zoonotic diseases, while there is a lack of evidence to inform the clinical trials’ capacity and practice in countries highly affected by the diseases. This study aimed to investigate researchers’ perceptions and experiences in conducting clinical trials on zoonotic diseases in Ethiopia. Methods: This study employed a descriptive, qualitative study design. It included major academic and research institutions in Ethiopia that had active engagements in veterinary and public health research. It included the National Veterinary Institute, the National Animal Health Diagnostic and Investigation Center, the College of Veterinary Medicine at Addis Ababa University, the Ethiopian Public Health Institute, the Armauer Hansen Research Institute, and the College of Health Sciences at Addis Ababa University. In-depth interviews were conducted with 14 senior researcher investigators in the institutions who hold a proven exhibit primarily leading research activities or research units. Data were collected from October 2019 to April 2020. Data analysis was undertaken using open code 4.03 for qualitative data analysis. Results: Five major themes, with 18 sub-themes, emerged from the in-depth interview in connection. These were: challenges in the prevention, control, and treatment of zoonotic diseases; One Health approach to mitigate zoonotic diseases; personal and institutional experiences in conducting clinical trials on zoonotic diseases; barriers in conducting clinical trials towards zoonotic diseases; and strategies that promote conducting clinical trials on zoonotic diseases. Conducting clinical trials on zoonotic diseases in Ethiopia is hampered by a lack of clearly articulated ethics and regulatory frameworks, trial experts, financial resources, and good governance. Conclusions: In Ethiopia, conducting clinical trials on zoonotic diseases deserves due attention. Strengthening institutional and human resources capacity is a precondition to harnessing effective implementation of clinical trials on zoonotic diseases in the country. In Ethiopia, where skilled human resource is scarce, the One Health approach has the potential to form multidisciplinary teams to systematically improve clinical trials capacity and outcomes in the country.

Keywords: Ethiopia, clinical triak, zoonoses, disease

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Authors: Elizabeth Ankiambom Chiatii

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The effective participation of graduates as leaders in entrepreneurial resilience is a key driver to achieving sustainable job creation and curbing unemployment issues in the urban and rural communities of Cameroon. The unemployment problem is a global challenge in the Labour market, especially for youths graduating from universities. Statistics from the Cameroon National Institute of statistics indicate that the unemployment rate in the country increased to 3.9% in 2021 from 3.8% in 2020. One of the main causes of unemployment challenges and job hooping among university graduates is the high expectation for “white-collar jobs syndrome” as opposed to involvement in ‘blue-collar jobs’. In the recent years, the Catholic University of Cameroon has engaged its resources in problem and project based learning (PBL) approaches in order to enable the students at the end of their course work to be competent and resourceful in impacting their communities and the world at large. It is so encouraging to notice that most of our current and female ex-students have engaged as leaders in fostering entrepreneurial resilience through small and medium size ‘blue-collar’ enterprises like seamstresses or tailors, designers, catering services, poultry owners, traditional regalia designers, phone booth operators, farming (gardening) activities, saloon owners, wedding designers, restaurant operators and many other creative jobs where they also act as petty employers. A good number of them sponsor their university studies through these self-income generating activities. Part one of this paper centres on the introduction and background of study. Part two embodies some literature review in which we concentrate on some related conceptual issues. For example, we have some analogy of employment difficulties faced by the university graduates. Secondly, we will examine the details on entrepreneurial resilience within the context of Bamenda- Cameroon. Thirdly, we expound on the leadership role played by these graduates in building resilience as entrepreneurs stemming from their university training. The primary method of data collection is implemented, where questionnaires are distributed to at least 100 of these graduates engaged in building entrepreneurial resilience. The IVProbit regression analysis is used to determine the effect of these graduate participation as leader on entrepreneurial resilience. The results can contribute to the development of entrepreneurial resilience, and recommendations will be made to CATUC Bamenda, some communities and government leaders to enhance their policies to empower these young graduates in fostering these resourceful activities.

Keywords: graduates entrepreneurial resilience, unemployment challenges, white-collar job syndrome, small and medium size blue-collar enterprises

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Authors: Minji Seo

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Fashion stakeholders are becoming increasingly aware of technological innovation in manufacturing. In 2020, the COVID-19 pandemic caused transformations in working patterns, such as working remotely rather thancommuting. To enable smooth remote working, 3D fashion design software is being adoptedas the latest trend in design and production. The majority of fashion designers, however, are still resistantto this change. Previous studies on 3D fashion design software solely highlighted the beneficial and detrimental factors of adopting design innovations. They lacked research on the relationship between resistance factors and the adoption of innovation. These studies also fell short of exploringthe perspectives of users of these innovations. This paper aims to investigate the key drivers and barriers of employing 3D fashion design software as wellas to explore the challenges faced by designers.It also toucheson the governmental support for digital manufacturing in Seoul, South Korea, and London, the United Kingdom. By conceptualising local support, this study aims to provide a new path for industrial clusters to optimise digital apparel manufacturing. The study uses a mixture of quantitative and qualitative approaches. Initially, it reflects a survey of 350 samples, fashion designers, on innovation resistance factors of 3D fashion design software and the effectiveness of local support. In-depth interviews with 30 participants provide a better understanding of designers’ aspects of the benefits and obstacles of employing 3D fashion design software. The key findings of this research are the main barriers to employing 3D fashion design software in fashion production. The cultural characteristics and interviews resultsare used to interpret the survey results. The findings of quantitative data examine the main resistance factors to adopting design innovations. The dominant obstacles are: the cost of software and its complexity; lack of customers’ interest in innovation; lack of qualified personnel, and lack of knowledge. The main difference between Seoul and London is the attitudes towards government support. Compared to the UK’s fashion designers, South Korean designers emphasise that government support is highly relevant to employing 3D fashion design software. The top-down and bottom-up policy implementation approach distinguishes the perception of government support. Compared to top-down policy approaches in South Korea, British fashion designers based on employing bottom-up approaches are reluctant to receive government support. The findings of this research will contribute to generating solutions for local government and the optimisation of use of 3D fashion design software in fashion industrial clusters.

Keywords: digital apparel production, industrial clusters, innovation resistance, 3D fashion design software, manufacturing, innovation, technology, digital manufacturing, innovative fashion design process

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Authors: Ruth Green, Samantha Milton, Rinal Desai

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Background/Aims: Eye pain/swelling/redness is a common presentation to Barnet General Hospital (a district general hospital), pediatric emergency department, and is managed by both the pediatric and emergency teams. The management of each child differs dramatically depending on the healthcare professional who reviews them. There also appears to be confusion in diagnosis between periorbital cellulitis, pre-septal cellulitis, and orbital cellulitis. Pre septal cellulitis refers to an inflammation of the eyelids and soft tissue anterior to the orbital septum. In contrast, orbital cellulitis is a serious, rapidly progressive infection of soft tissues located posterior to the orbital septum. Pre-septal cellulitis is more prevalent and less serious than orbital cellulitis, although it may be part of a continuous spectrum if untreated. Pre-septal cellulitis should there be diagnosed and treated urgently to prevent spread to the septum. For the purpose of the audit, the term periorbital cellulitis has been used as an umbrella term for all spectrums of this infection. The audit aimed to look at, how as a whole, the department is diagnosing and managing orbital and pre-septal cellulitis. Gold Standard: Patients of the same age and diagnosis should be treated with the same medication, advice, and follow-up. Method: Data was collected retrospectively from pediatric patients ( < 18years) who attended the emergency department from June 2019 to February 2020 who had been coded as pre-septal cellulitis, periorbital cellulitis, orbital cellulitis, or eye pain/swelling/redness. Demographics, signs and symptoms, management, and follow-up were recorded for all patients with any of the diagnoses of pre-septal, periorbital, or orbital cellulitis. A Microsoft Excel spreadsheet was used to record the anonymised data. Results: There were vast discrepancies in the diagnosis, management, and follow-up of patients with periorbital cellulitis. Conclusion/Discussion: The audit concluded there is no uniform approach to managing periorbital cellulitis in Barnet General Hospital Paediatric Emergency Department. Healthcare professionals misdiagnosed conjunctivitis as periorbital cellulitis, and adequate steps did not appear to be documented on excluding red flag signs and symptoms of patients presenting. There was no consistency in follow-up, with some patients having timely phone reviews or clinical reviews for mild symptoms. Advice given by the staff was appropriate, and patients did return when symptoms got worse and were treated accordingly. Plan: Given the inconsistency, a gold standard care pathway or local easily accessible clinical guideline can be developed to help with the diagnosis and management of periorbital cellulitis. Along with this, a teaching session can be carried out for the staff of the pediatric team and emergency department to disseminate the teaching. Following the introduction of a guideline and teaching sessions, patients notes can be re-reviewed to check improvement in patient care.

Keywords: periorbital cellulitis, preseptal cellulitis, orbital cellulitis, erythematous eyelid

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Authors: Felicia Orah Rein Moshe

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Soil erosion has become a priority global concern, impairing water quality and degrading ecosystem services. In Mediterranean climates, following a long dry period, the onset of rain occurs when agricultural soils are often bare and most vulnerable to erosion. Early storms transport sediments and sediment-bound pollutants into streams, along with dissolved chemicals. This results in loss of valuable topsoil, water quality degradation, and potentially expensive dredged-material disposal costs. Information on the provenance of fine sediment and priority sources of adsorbed pollutants represents a critical need for developing effective control strategies aimed at source reduction. Modifying sediment traps designed for marine systems, this study tested a cost-effective method to collect suspended sediments on a catchment scale to characterize stream water quality during first-flush storm events in a flashy Eastern Mediterranean coastal perennial stream. This study investigated the Kishon Basin, deploying sediment traps in 23 locations, including 4 in the mainstream and one downstream in each of 19 tributaries, enabling the characterization of sediment as a vehicle for transporting chemicals. Further, it enabled direct comparison of sediment-bound pollutants transported during the first-flush winter storms of 2020 from each of 19 tributaries, allowing subsequent ecotoxicity ranking. Sediment samples were successfully captured in 22 locations. Pesticides, pharmaceuticals, nutrients, and metal concentrations were quantified, identifying a total of 50 pesticides, 15 pharmaceuticals, and 22 metals, with 16 pesticides and 3 pharmaceuticals found in all 23 locations, demonstrating the importance of this transport pathway. Heavy metals were detected in only one tributary, identifying an important watershed pollution source with immediate potential influence on long-term dredging costs. Simultaneous sediment sampling at first flush storms enabled clear identification of priority tributaries and their chemical contributions, advancing a new national watershed monitoring approach, facilitating strategic plan development based on source reduction, and advancing the goal of improving the farm-stream interface, conserving soil resources, and protecting water quality.

Keywords: adsorbed pollution, dredged material, heavy metals, suspended sediment, water quality monitoring

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Authors: Marziye Hadian, Alireza Jabbari

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Background: The World Health Organization has identified COVID-19 as a public health emergency and is urging governments to stop the virus transmission by adopting appropriate policies. In this regard, authorities have taken different approaches to cut the chain or controlling the spread of the disease. Now, the questions we are facing include what these approaches are? What tools should be used to implement each preventive protocol? In addition, what is the impact of each approach? Objective: The aim of this study was to determine the approaches to biological epidemics and related prevention tools with an emphasis on COVID-19 disease. Data sources: Databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, and ProQuest were employed for data extraction. Furthermore, authentic sources such as the WHO website, the published reports of relevant countries, as well as the Worldometer website were evaluated for gray studies. The time-frame of the study was from 1 December 2019 to 30 May 2020. Methods: The present study was a systematic study of publications related to the prevention strategies for the COVID-19 disease. The study was carried out based on the PRISMA guidelines and CASP for articles and AACODS for grey literature. Results: The study findings showed that in order to confront the COVID-19 epidemic, in general, there are three approaches of "mitigation", "active control" and "suppression" and four strategies of "quarantine", "isolation", "social distance" and "lockdown" in both individual and social dimensions to deal with epidemics. Selection and implementation of each approach requires specific strategies and has different effects when it comes to controlling and inhibiting the disease. Key finding: One possible approach to control the disease is to change individual behavior and lifestyle. In addition to prevention strategies, use of masks, observance of personal hygiene principles such as regular hand washing and non-contact of contaminated hands with the face, as well as an observance of public health principles such as sneezing and coughing etiquettes, safe extermination of personal protective equipment, must be strictly observed. Have not been included in the category of prevention tools. However, it has a great impact on controlling the epidemic, especially the new coronavirus epidemic. Conclusion: Although the use of different approaches to control and inhibit biological epidemics depends on numerous variables, however, despite these requirements, global experience suggests that some of these approaches are ineffective. The use of previous experiences in the world, along with the current experiences of countries, can be very helpful in choosing the accurate approach for each country in accordance with the characteristics of that country and lead to the reduction of possible costs at the national and international levels.

Keywords: novel corona virus, COVID-19, approaches, prevention tools, prevention strategies

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Authors: Nulu Nanono

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Background: The Ugandan national health policy and the national population policy all recognize the need to increase access to quality, affordable, acceptable and sustainable contraceptive services for all people but provision and utilization of quality services remains low. Two contraceptive methods are categorized as long-acting temporary methods: intrauterine contraceptive devices (IUCDs) and implants. Copper-containing IUCDs, generally available in Ministry of Health (MoH) family planning programs and is effective for at least 12 years while Implants, depending on the type, last for up to three to seven years. Uganda’s current policy and political environment are favorable towards achieving national access to quality and safe contraceptives for all people as evidenced by increasing government commitments and innovative family planning programs. Despite the increase of modern contraception use from 14% to 26%, long acting reversible contraceptive (LARC) utilization has relatively remained low with less than 5% using IUDs & Implants which in a way explains Uganda’s persistent high fertility rates. Main question/hypothesis: The purpose of the study was to examine relationship between the demographic, socio-economic characteristics of women, health facility factors and long acting reversible contraception utilization. Methodology: LARC utilization was investigated comprising of the two questions namely are you or your partner currently doing something or using any method to delay or avoid getting pregnant? And which method or methods are you using? Data for the study was sourced from the 2016 Uganda Performance Monitoring and Accountability 2020 Survey comprising of 3816 female respondents aged 15 to 49 years. The analysis was done using the Chi-squared tests and the probit regression at bivariate and multivariate levels respectively. The model was further tested for validity and normality of the residuals using the Sharipo wilks test and test for kurtosis and skewness. Results: The results showed the model the age, parity, marital status, region, knowledge of LARCs, availability of LARCs to be significantly associated with long acting contraceptive utilization with p value of less than 0.05. At the multivariate analysis level, women who had higher parities (0.000) tertiary education (0.013), no knowledge about LARCs (0.006) increases their probability of using LARCs. Furthermore while women age 45-49, those who live in the eastern region reduces their probability of using LARCs. Knowledge contribution: The findings of this study join the debate of prior research in this field and add to the body of knowledge related to long acting reversible contraception. An outstanding and queer finding from the study is the non-utilization of LARCs by women who are aware and have knowledge about them, this may be an opportunity for further research to investigate the attribution to this.

Keywords: contraception, long acting, utilization, women (15-49)

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Authors: Minghui Zhang, Sirine Fkaier, Sabri Fernana, Svetlana Kiseleva, Denis Kiselev

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The real-time identification of bacteria and fungi is difficult because they emit much weaker signals than pollen. In 2020, Plair developed Rapid-E+, which extends abilities of Rapid-E to detect smaller bioaerosols such as bacteria and fungal spores with diameters down to 0.3 µm, while keeping the similar or even better capability for measurements of large bioaerosols like pollen. Rapid-E+ enables simultaneous measurements of (1) time-resolved, polarization and angle dependent Mie scattering patterns, (2) fluorescence spectra resolved in 16 channels, and (3) fluorescence lifetime of individual particles. Moreover, (4) it provides 2D Mie scattering images which give the full information on particle morphology. The parameters of every single bioaerosol aspired into the instrument are subsequently analysed by machine learning. Firstly, pure species of microbes, e.g., Bacillus subtilis (a species of bacteria), and Penicillium chrysogenum (a species of fungal spores), were aerosolized in a bioaerosol chamber for Rapid-E+ training. Afterwards, we tested microbes under different concentrations. We used several steps of data analysis to classify and identify microbes. All single particles were analysed by the parameters of light scattering and fluorescence in the following steps. (1) They were treated with a smart filter block to get rid of non-microbes. (2) By classification algorithm, we verified the filtered particles were microbes based on the calibration data. (3) The probability threshold (defined by the user) step provides the probability of being microbes ranging from 0 to 100%. We demonstrate how Rapid-E+ identified simultaneously microbes based on the results of Bacillus subtilis (bacteria) and Penicillium chrysogenum (fungal spores). By using machine learning, Rapid-E+ achieved identification precision of 99% against the background. The further classification suggests the precision of 87% and 89% for Bacillus subtilis and Penicillium chrysogenum, respectively. The developed algorithm was subsequently used to evaluate the performance of microbe classification and quantification in real-time. The bacteria and fungi were aerosolized again in the chamber with different concentrations. Rapid-E+ can classify different types of microbes and then quantify them in real-time. Rapid-E+ enables classifying different types of microbes and quantifying them in real-time. Rapid-E+ can identify pollen down to species with similar or even better performance than the previous version (Rapid-E). Therefore, Rapid-E+ is an all-in-one instrument which classifies and quantifies not only pollen, but also bacteria and fungi. Based on the machine learning platform, the user can further develop proprietary algorithms for specific microbes (e.g., virus aerosols) and other aerosols (e.g., combustion-related particles that contain polycyclic aromatic hydrocarbons).

Keywords: bioaerosols, laser-induced fluorescence, Mie-scattering, microorganisms

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Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

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Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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Authors: Anastasia Beketova, Emmanouil-George C. Tzanakakis, Ioannis G. Tzoutzas, Eleana Kontonasaki

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In restorative dentistry, yttria-stabilized zirconia (YSZ) nanoparticles can be applied as fillers to improve the mechanical properties of various resin-based materials. Using sol-gel based synthesis as simple and cost-effective method, nano-sized YSZ particles with high purity can be produced. The aim of this study was to synthesize YSZ nanoparticles by the Pechini sol-gel method at different temperatures and to investigate their composition, structure, and morphology. YSZ nanopowders were synthesized by the sol-gel method using zirconium oxychloride octahydrate (ZrOCl₂.8H₂O) and yttrium nitrate hexahydrate (Y(NO₃)₃.6H₂O) as precursors with the addition of acid chelating agents to control hydrolysis and gelation reactions. The obtained powders underwent TG_DTA analysis and were sintered at three different temperatures: 800, 1000, and 1200°C for 2 hours. Their composition and morphology were investigated by Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction Analysis (XRD), Scanning Electron Microscopy with associated with Energy Dispersive X-ray analyzer (SEM-EDX), Transmission Electron Microscopy (TEM) methods, and Dynamic Light Scattering (DLS). FTIR and XRD analysis showed the presence of pure tetragonal phase in the composition of nanopowders. By increasing the calcination temperature, the crystallinity of materials increased, reaching 47.2 nm for the YSZ1200 specimens. SEM analysis at high magnifications and DLS analysis showed submicron-sized particles with good dispersion and low agglomeration, which increased in size as the sintering temperature was elevated. From the TEM images of the YSZ1000 specimen, it can be seen that zirconia nanoparticles are uniform in size and shape and attain an average particle size of about 50 nm. The electron diffraction patterns clearly revealed ring patterns of polycrystalline tetragonal zirconia phase. Pure YSZ nanopowders have been successfully synthesized by the sol-gel method at different temperatures. Their size is small, and uniform, allowing their incorporation of dental luting resin cements to improve their mechanical properties and possibly enhance the bond strength of demanding dental ceramics such as zirconia to the tooth structure. This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme 'Human Resources Development, Education and Lifelong Learning 2014- 2020' in the context of the project 'Development of zirconia adhesion cements with stabilized zirconia nanoparticles: physicochemical properties and bond strength under aging conditions' (MIS 5047876).

Keywords: dental cements, nanoparticles, sol-gel, yttria-stabilized zirconia, YSZ

Procedia PDF Downloads 119

Authors: Boriana Karamanova, Svetlana Veleva, Luybomir Soserov, Ana Arenillas, Francesco Lufrano, Antonia Stoyanova

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Supercapacitors have received a lot of research attention and are promising energy storage devices due to their high power and long cycle life. In order to developed an advanced device with significant capacity for storing charge and cheap carbon materials, efforts must focus not only on improving synthesis by controlling the morphology and pore size but also on improving electrode-electrolyte compatibility of the resulting systems. The present study examines the relationship between the surface chemistry of two activated carbon xerogels, the electrolyte type, and the electrochemical properties of supercapacitors. Activated carbon xerogels were prepared by varying the initial pH of the resorcinol-formaldehyde aqueous solution. The materials produced are physicochemical characterized by DTA/TGA, porous characterization, and SEM analysis. The carbon xerogel based electrodes were prepared by spreading over glass plate a slurry containing the carbon gel, graphite, and poly vinylidene difluoride (PVDF) binder. The layer formed was dried consecutively at different temperatures and then detached by water. After, the layer was dried again to improve its mechanical stability. The developed electrode materials and the Aquivion® E87-05S membrane (Solvay Specialty Polymers), socked in Na2SO4 as a polymer electrolyte, were used to assembly the solid-state supercapacitor. Symmetric supercapacitor cells composed by same electrodes and 1 M KOH electrolytes are also assembled and tested for comparison. The supercapacitor performances are verified by different electrochemical methods - cyclic voltammetry, galvanostatic charge/discharge measurements, electrochemical impedance spectroscopy, and long-term durability tests in neutral and alkaline electrolytes. Specific capacitances, energy, and power density, energy efficiencies, and durability were compared into studied supercapacitors. Ex-situ physicochemical analyses on the synthesized materials have also been performed, which provide information about chemical and structural changes in the electrode morphology during charge / discharge durability tests. They are discussed on the basis of electrode-electrolyte interaction. The obtained correlations could be of significance in order to design sustainable solid-state supercapacitors with high power and energy density. Acknowledgement: This research is funded by the Ministry of Education and Science of Bulgaria under the National Program "European Scientific Networks" (Agreement D01-286 / 07.10.2020, D01-78/30.03.2021). Authors gratefully acknowledge.

Keywords: carbon xerogel, electrochemical tests, neutral and alkaline electrolytes, supercapacitors

Procedia PDF Downloads 109

Authors: Richard Grant, Landolf Rhode-Barbarigos, Shouraseni Sen Roy, Lucas Brittan, Change Li, Aiden Rowe

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Ports are critical for the US economy, connecting farmers, manufacturers, retailers, consumers and an array of transport and storage operators. Port facilities vary widely in terms of their productivity, footprint, specializations, and governance. In this context, Port Miami is considered as one of the busiest ports providing both cargo and cruise services in connecting the wider region of the Caribbean and Mesoamerica to the global networks. It is considered as the “Cruise Capital of the World and Global Gateway of the Americas” and “leading container port in Florida.” Furthermore, it has also been ranked as one of the top container ports in the world and the second most efficient port in North America. In this regard, Port Miami has made significant investments in the strategic and capital infrastructure of about US$1 billion, including increasing the channel depth and other onshore infrastructural enhancements. Therefore, this study involves a detailed analysis of Port Miami’s network, using publicly available multiple years of data about marine vessel traffic, cargo, and connectivity and performance indices from 2015-2021. Through the analysis of cargo and cruise vessels to and from Port Miami and its relative performance at the global scale from 2015 to 2021, this study examines the port’s long-term resilience and future growth potential. The main results of the analyses indicate that the top category for both inbound and outbound cargo is manufactured products and textiles. In addition, there are a lot of fresh fruits, vegetables, and produce for inbound and processed food for outbound cargo. Furthermore, the top ten port connections for Port Miami are all located in the Caribbean region, the Gulf of Mexico, and the Southeast USA. About half of the inbound cargo comes from Savannah, Saint Thomas, and Puerto Plata, while outbound cargo is from Puerto Corte, Freeport, and Kingston. Additionally, for cruise vessels, a significantly large number of vessels originate from Nassau, followed by Freeport. The number of passenger's vessels pre-COVID was almost 1,000 per year, which dropped substantially in 2020 and 2021 to around 300 vessels. Finally, the resilience and competitiveness of Port Miami were also assessed in terms of its network connectivity by examining the inbound and outbound maritime vessel traffic. It is noteworthy that the most frequent port connections for Port Miami were Freeport and Savannah, followed by Kingston, Nassau, and New Orleans. However, several of these ports, Puerto Corte, Veracruz, Puerto Plata, and Santo Thomas, have low resilience and are highly vulnerable, which needs to be taken into consideration for the long-term resilience of Port Miami in the future.

Keywords: port, Miami, network, cargo, cruise

Procedia PDF Downloads 55