Search results for: employment factors

Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Qianxi Lv, Junying Liang

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Among the various modes of interpreting, simultaneous interpreting (SI) is regarded as a ‘complex’ and ‘extreme condition’ of cognitive tasks while consecutive interpreters (CI) do not have to share processing capacity between tasks. Given that SI exerts great cognitive demand, it makes sense to posit that the output of SI may be more compromised than that of CI in the linguistic features. The bulk of the research has stressed the varying cognitive demand and processes involved in different modes of interpreting; however, related empirical research is sparse. In keeping with our interest in investigating the quantitative linguistic factors discriminating between SI and CI, the current study seeks to examine the potential lexical simplification, syntactic complexity and sequential organization mechanism with a self-made inter-model corpus of transcribed simultaneous and consecutive interpretation, translated speech and original speech texts with a total running word of 321960. The lexical features are extracted in terms of the lexical density, list head coverage, hapax legomena, and type-token ratio, as well as core vocabulary percentage. Dependency distance, an index for syntactic complexity and reflective of processing demand is employed. Frequency motif is a non-grammatically-bound sequential unit and is also used to visualize the local function distribution of interpreting the output. While SI is generally regarded as multitasking with high cognitive load, our findings evidently show that CI may impose heavier or taxing cognitive resource differently and hence yields more lexically and syntactically simplified output. In addition, the sequential features manifest that SI and CI organize the sequences from the source text in different ways into the output, to minimize the cognitive load respectively. We reasoned the results in the framework that cognitive demand is exerted both on maintaining and coordinating component of Working Memory. On the one hand, the information maintained in CI is inherently larger in volume compared to SI. On the other hand, time constraints directly influence the sentence reformulation process. The temporal pressure from the input in SI makes the interpreters only keep a small chunk of information in the focus of attention. Thus, SI interpreters usually produce the output by largely retaining the source structure so as to relieve the information from the working memory immediately after formulated in the target language. Conversely, CI interpreters receive at least a few sentences before reformulation, when they are more self-paced. CI interpreters may thus tend to retain and generate the information in a way to lessen the demand. In other words, interpreters cope with the high demand in the reformulation phase of CI by generating output with densely distributed function words, more content words of higher frequency values and fewer variations, simpler structures and more frequently used language sequences. We consequently propose a revised effort model based on the result for a better illustration of cognitive demand during both interpreting types.

Keywords: cognitive demand, corpus-based, dependency distance, frequency motif, interpreting types, lexical simplification, sequential units distribution, syntactic complexity

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Authors: Zylfi Shehu, Shpetim Madani, Bashkim Delia

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Context: The study focuses on the interest and engagement of high school students in Tirana, Albania, in physical activity, sports, and foreign languages. It acknowledges the numerous physiological benefits of physical activity, such as cardiovascular health and improved mood. It also recognizes the importance of physical activity in childhood and adolescence for proper skeletal development and long-term health. Research Aim: The main purpose of the study is to investigate and analyze the preferences and interests of male and female high school students in Tirana regarding their functional development, physical activity, sports participation, and choice of foreign languages. The aim is to provide insights for the students and teachers to guide future objectives and improve the quality of physical education. Methodology: The study employed a survey-based approach, targeting both male and female students in public high schools in Tirana. A total of 410 students aged 15 to 19 years old, participated in the study. The data collected from the survey were processed using Excel and presented through tables and graphs. Findings: The results revealed that team sports were more favored by the students, with football being the preferred choice among males, while basketball and volleyball were more popular among females. Additionally, English was found to be the most preferred foreign language, selected by a higher percentage of females (38.57%) compared to males (16.90%). German followed as the second preferred language. Theoretical Importance: This study contributes to the understanding of students' interests in physical activity, sports, and foreign languages in Tirana's high schools. The findings highlight the need to focus on specific sports and languages to cater to students' preferences and guide future educational objectives. It also emphasizes the importance of physical education in promoting students' overall well-being and highlights potential areas for policy and program improvement. Data Collection and Analysis Procedures: The study collected data through surveys administered to high school students in Tirana. The survey responses were processed and analyzed using Excel, and the findings were presented through tables and graphs. The data analysis allowed for the identification of preferences and trends among male and female students, providing valuable insights for future decision-making. Question Addressed: The study aimed to address the question of high school students' interest in physical activity, sports, and foreign languages. It sought to understand the preferences and choices made by students in Tirana and investigate factors such as gender, family income, and accessibility to extracurricular sports activities. Conclusion: The study revealed that high school students in Tirana show a preference for team sports, with football being the most favored among males and basketball and volleyball among females. English was found to be the most preferred foreign language. The findings provide important insights for educators and policymakers to enhance physical education programs and consider students' preferences and interests to foster a more effective learning environment. The study also emphasizes the importance of physical activity and sports in promoting students' physical and mental well-being.

Keywords: female, male, foreign languages, sports, physical education, high school students

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Authors: Milica Carević, Katarina Banjanac, Marija ĆOrović, Ana Milivojević, Nevena Prlainović, Aleksandar Marinković, Dejan Bezbradica

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Nowadays, considering the growing awareness of functional food beneficial effects on human health, due attention is dedicated to the research in the field of obtaining new prominent products exhibiting improved physiological and physicochemical characteristics. Therefore, different approaches to valuable bioactive compounds synthesis have been proposed. β-Galactosidase, for example, although mainly utilized as hydrolytic enzyme, proved to be a promising tool for these purposes. Namely, under the particular conditions, such as high lactose concentration, elevated temperatures and low water activities, reaction of galactose moiety transfer to free hydroxyl group of the alternative acceptor (e.g. different sugars, alcohols or aromatic compounds) can generate a wide range of potentially interesting products. Up to now, galacto-oligosaccharides and lactulose have attracted the most attention due to their inherent prebiotic properties. The goal of this study was to obtain a novel product sorbitol galactoside, using the similar reaction mechanism, namely transgalactosylation reaction catalyzed by β-galactosidase from Aspergillus oryzae. By using sugar alcohol (sorbitol) as alternative acceptor, a diverse mixture of potential prebiotics is produced, enabling its more favorable functional features. Nevertheless, an introduction of alternative acceptor into the reaction mixture contributed to the complexity of reaction scheme, since several potential reaction pathways were introduced. Therefore, the thorough optimization using response surface method (RSM), in order to get an insight into different parameter (lactose concentration, sorbitol to lactose molar ratio, enzyme concentration, NaCl concentration and reaction time) influences, as well as their mutual interactions on product yield and productivity, was performed. In view of product yield maximization, the obtained model predicted optimal lactose concentration 500 mM, the molar ratio of sobitol to lactose 9, enzyme concentration 0.76 mg/ml, concentration of NaCl 0.8M, and the reaction time 7h. From the aspect of productivity, the optimum substrate molar ratio was found to be 1, while the values for other factors coincide. In order to additionally, improve enzyme efficiency and enable its reuse and potential continual application, immobilization of β-galactosidase onto tailored silica nanoparticles was performed. These non-porous fumed silica nanoparticles (FNS)were chosen on the basis of their biocompatibility and non-toxicity, as well as their advantageous mechanical and hydrodinamical properties. However, in order to achieve better compatibility between enzymes and the carrier, modifications of the silica surface using amino functional organosilane (3-aminopropyltrimethoxysilane, APTMS) were made. Obtained support with amino functional groups (AFNS) enabled high enzyme loadings and, more importantly, extremely high expressed activities, approximately 230 mg proteins/g and 2100 IU/g, respectively. Moreover, this immobilized preparation showed high affinity towards sorbitol galactoside synthesis. Therefore, the findings of this study could provided a valuable contribution to the efficient production of physiologically active galactosides in immobilized enzyme reactors.

Keywords: β-galactosidase, immobilization, silica nanoparticles, transgalactosylation

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Authors: Chang-Hui Shen, Michelle Esposito, Andrew J. Shen, Michael Adejokun, Diana Laterman

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The packaging of DNA into nucleosomes is critical to genomic compaction, yet it can leave gene promoters inaccessible to activator proteins or transcription machinery and thus prevents transcriptional initiation. Both chromatin remodelers and histone acetylases (HATs) are the two main transcription co-activators that can reconfigure chromatin structure for transcriptional activation. Ino80p is the core component of the INO80 remodeling complex. Recently, it was shown that Ino80p dissociates from the yeast INO1 promoter after induction. However, when certain HATs were deleted or mutated, Ino80p accumulated at the promoters during gene activation. This suggests a link between HATs’ presence and Ino80p’s dissociation. However, it has yet to be demonstrated that Ino80p can be acetylated. To determine if Ino80p can be acetylated, wild-type Saccharomyces cerevisiae cells carrying Ino80p engineered with a double FLAG tag (MATa INO80-FLAG his3∆200 leu2∆0 met15∆0 trp1∆63 ura3∆0) were grown to mid log phase, as were non-tagged wild type (WT) (MATa his3∆200 leu2∆0 met15∆0 trp1∆63 ura3∆0) and ino80∆ (MATa ino80∆::TRP1 his3∆200 leu2∆0 met15∆0 trp1∆63 ura3∆0) cells as controls. Cells were harvested, and the cell lysates were subjected to immunoprecipitation (IP) with α-FLAG resin to isolate Ino80p. These eluted IP samples were subjected to SDS-PAGE and Western blot analysis. Subsequently, the blots were probed with the α-FLAG and α-acetyl lysine antibodies, respectively. For the blot probed with α-FLAG, one prominent band was shown in the INO80-FLAG cells, but no band was detected in the IP samples from the WT and ino80∆ cells. For the blot probed with the α-acetyl lysine antibody, we detected acetylated Ino80p in the INO80-FLAG strain while no bands were observed in the control strains. As such, our results showed that Ino80p can be acetylated. This acetylation can explain the co-activator’s recruitment patterns observed in current gene activation models. In yeast INO1, it has been shown that Ino80p is recruited to the promoter during repression, and then dissociates from the promoter once de-repression begins. Histone acetylases, on the other hand, have the opposite pattern of recruitment, as they have an increased presence at the promoter as INO1 de-repression commences. This Ino80p recruitment pattern significantly changes when HAT mutant strains are studied. It was observed that instead of dissociating, Ino80p accumulates at the promoter in the absence of functional HATs, such as Gcn5p or Esa1p, under de-repressing processes. As such, Ino80p acetylation may be required for its proper dissociation from the promoters. The remodelers’ dissociation mechanism may also have a wide range of implications with respect to transcriptional initiation, elongation, or even repression as it allows for increased spatial access to the promoter for the various transcription factors and regulators that need to bind in that region. Our findings here suggest a previously uncharacterized interaction between Ino80p and other co-activators recruited to promoters. As such, further analysis of Ino80p acetylation not only will provide insight into the role of epigenetic modifications in transcriptional activation, but also gives insight into the interactions occurring between co-activators at gene promoters during gene regulation.

Keywords: acetylation, chromatin remodeler, epigenetic modification, Ino80p

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Authors: Nicholas Aerne, John P. Parmigiani

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There is an increasing desire for renewable and sustainable energy sources to replace fossil fuels. This desire is the result of several factors. First, is the role of fossil fuels in climate change. Scientific data clearly shows that global warming is occurring. It has also been concluded that it is highly likely human activity; specifically, the combustion of fossil fuels, is a major cause of this warming. Second, despite the current surplus of petroleum, fossil fuels are a finite resource and will eventually become scarce and alternatives, such as clean or renewable energy will be needed. Third, operations to obtain fossil fuels such as fracking, off-shore oil drilling, and strip mining are expensive and harmful to the environment. Given these environmental impacts, there is a need to replace fossil fuels with renewable energy sources as a primary energy source. Various sources of renewable energy exist. Many familiar sources obtain renewable energy from the sun and natural environments of the earth. Common examples include solar, hydropower, geothermal heat, ocean waves and tides, and wind energy. Often obtaining significant energy from these sources requires physically-large, sophisticated, and expensive equipment (e.g., wind turbines, dams, solar panels, etc.). Other sources of renewable energy are from the man-made environment. An example is municipal water distribution systems. The movement of water through the pipelines of these systems typically requires the reduction of hydraulic pressure through the use of pressure reducing valves. These valves are needed to reduce upstream supply-line pressures to levels suitable downstream users. The energy associated with this reduction of pressure is significant but is currently not harvested and is simply lost. While the integrity of municipal water supplies is of paramount importance, one can certainly envision means by which this lost energy source could be safely accessed. This paper provides a technical description and analysis of one such means by the technology company InPipe Energy to generate hydroelectricity by harvesting energy from municipal water distribution pressure reducing valve stations. Specifically, InPipe Energy proposes to install hydropower turbines in parallel with existing pressure reducing valves in municipal water distribution systems. InPipe Energy in partnership with Oregon State University has evaluated this approach and built a prototype system at the O. H. Hinsdale Wave Research Lab. The Oregon State University evaluation showed that the prototype system rapidly and safely initiates, maintains, and ceases power production as directed. The outgoing water pressure remained constant at the specified set point throughout all testing. The system replicates the functionality of the pressure reducing valve and ensures accurate control of down-stream pressure. At a typical water-distribution-system pressure drop of 60 psi the prototype, operating at an efficiency 64%, produced approximately 5 kW of electricity. Based on the results of this study, this proposed method appears to offer a viable means of producing significant amounts of clean renewable energy from existing pressure reducing valves.

Keywords: pressure reducing valve, renewable energy, sustainable energy, water supply

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Authors: Tarek Abdoun, Waleed Elsekelly

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Introduction: Liquefaction of soils during earthquakes can have significant consequences on the stability of structures and infrastructure. This study focuses on comparing two liquefaction case histories in California, namely the response of the Wildlife site in the Imperial Valley to the 2010 El-Mayor Cucapah earthquake (Mw = 7.2, amax = 0.15g) and the response of the Treasure Island Fire Station (F.S.) site in the San Francisco Bay area to the 1989 Loma Prieta Earthquake (Mw = 6.9, amax = 0.16g). Both case histories involve liquefiable layers of silty sand with non-plastic fines, similar shear wave velocities, low CPT cone penetration resistances, and groundwater tables at similar depths. The liquefaction charts based on shear wave velocity field predict liquefaction at both sites. However, a significant difference arises in their pore pressure responses during the earthquakes. The Wildlife site did not experience liquefaction, as evidenced by piezometer data, while the Treasure Island F.S. site did liquefy during the shaking. Objective: The primary objective of this study is to investigate and understand the reason for the contrasting pore pressure responses observed at the Wildlife site and the Treasure Island F.S. site despite their similar geological characteristics and predicted liquefaction potential. By conducting a detailed analysis of similarities and differences between the two case histories, the objective is to identify the factors that contributed to the higher liquefaction resistance exhibited by the Wildlife site. Methodology: To achieve this objective, the geological and seismic data available for both sites were gathered and analyzed. Then their soil profiles, seismic characteristics, and liquefaction potential as predicted by shear wave velocity-based liquefaction charts were analyzed. Furthermore, the seismic histories of both regions were examined. The number of previous earthquakes capable of generating significant excess pore pressures for each critical layer was assessed. This analysis involved estimating the total seismic activity that the Wildlife and Treasure Island F.S. critical layers experienced over time. In addition to historical data, centrifuge and large-scale experiments were conducted to explore the impact of prior seismic activity on liquefaction resistance. These findings served as supporting evidence for the investigation. Conclusions: The higher liquefaction resistance observed at the Wildlife site and other sites in the Imperial Valley can be attributed to preshaking by previous earthquakes. The Wildlife critical layer was subjected to a substantially greater number of seismic events capable of generating significant excess pore pressures over time compared to the Treasure Island F.S. layer. This crucial disparity arises from the difference in seismic activity between the two regions in the past century. In conclusion, this research sheds light on the complex interplay between geological characteristics, seismic history, and liquefaction behavior. It emphasizes the significant impact of past seismic activity on liquefaction resistance and can provide valuable insights for evaluating the stability of sandy sites in other seismic regions.

Keywords: liquefaction, case histories, centrifuge, preshaking

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Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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Authors: Miroslava Cuperlovic-Culf, Lipu Wang, Ketty Boyle, Nadine Makley, Ian Burton, Anissa Belkaid, Mohamed Touaibia, Marc E. Surrette

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Metabolic changes are one of the major factors in the development of a variety of diseases in various species. Metabolism of agricultural plants is altered the following infection with pathogens sometimes contributing to resistance. At the same time, pathogens use metabolites for infection and progression. In humans, metabolism is a hallmark of cancer development for example. Quantified metabolomics data combined with other omics or clinical data and analyzed using various unsupervised and supervised methods can lead to better diagnosis and prognosis. It can also provide information about resistance as well as contribute knowledge of compounds significant for disease progression or prevention. In this work, different methods for metabolomics quantification and analysis from Nuclear Magnetic Resonance (NMR) measurements that are used for investigation of disease development in wheat and human cells will be presented. One-dimensional 1H NMR spectra are used extensively for metabolic profiling due to their high reliability, wide range of applicability, speed, trivial sample preparation and low cost. This presentation will describe a new method for metabolite quantification from NMR data that combines alignment of spectra of standards to sample spectra followed by multivariate linear regression optimization of spectra of assigned metabolites to samples’ spectra. Several different alignment methods were tested and multivariate linear regression result has been compared with other quantification methods. Quantified metabolomics data can be analyzed in the variety of ways and we will present different clustering methods used for phenotype determination, network analysis providing knowledge about the relationships between metabolites through metabolic network as well as biomarker selection providing novel markers. These analysis methods have been utilized for the investigation of fusarium head blight resistance in wheat cultivars as well as analysis of the effect of estrogen receptor and carbonic anhydrase activation and inhibition on breast cancer cell metabolism. Metabolic changes in spikelet’s of wheat cultivars FL62R1, Stettler, MuchMore and Sumai3 following fusarium graminearum infection were explored. Extensive 1D 1H and 2D NMR measurements provided information for detailed metabolite assignment and quantification leading to possible metabolic markers discriminating resistance level in wheat subtypes. Quantification data is compared to results obtained using other published methods. Fusarium infection induced metabolic changes in different wheat varieties are discussed in the context of metabolic network and resistance. Quantitative metabolomics has been used for the investigation of the effect of targeted enzyme inhibition in cancer. In this work, the effect of 17 β -estradiol and ferulic acid on metabolism of ER+ breast cancer cells has been compared to their effect on ER- control cells. The effect of the inhibitors of carbonic anhydrase on the observed metabolic changes resulting from ER activation has also been determined. Metabolic profiles were studied using 1D and 2D metabolomic NMR experiments, combined with the identification and quantification of metabolites, and the annotation of the results is provided in the context of biochemical pathways.

Keywords: metabolic biomarkers, metabolic network, metabolomics, multivariate linear regression, NMR quantification, quantified metabolomics, spectral alignment

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Authors: Trenten Theis, Trevor Daubert, Kennedy Kluthe, Austin Nuxoll

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Staphylococcus aureus is a gram-positive bacterium responsible for an estimated 23,000 deaths in the United States and 25,000 deaths in the European Union annually. Recurring S. aureus bacteremia is associated with biofilm-mediated infections and can occur in 5 - 20% of cases, even with the use of antibiotics. Despite these infections being caused by drug-susceptible pathogens, they are surprisingly difficult to eradicate. One potential explanation for this is the presence of persister cells—a dormant type of cell that shows a high tolerance to antibiotic treatment. Recent studies have shown a connection between low intracellular ATP and persister cell formation. Specifically, this decrease in ATP, and therefore increase in persister cell formation, is due to an interrupted tricarboxylic acid (TCA) cycle. However, S. aureus persister cells’ role in pathogenesis remains unclear. Initial studies have shown that a fumC (TCA cycle gene) knockout survives challenge from aspects of the innate immune system better than wild-type S. aureus. Specifically, challenges from two antimicrobial peptides--LL-37 and hBD-3—show a log increase in survival of the fumC::N∑ strain compared to wild type S. aureus after 18 hours. Furthermore, preliminary studies show that the fumC knockout has a log more survival within a macrophage. These data lead us to hypothesize that the fumC knockout is better suited to other aspects of the innate immune system compared to wild-type S. aureus. To further investigate the mechanism for increased survival of fumC::N∑ within a macrophage, we tested bacterial growth in the presence of reactive oxygen species (ROS), reactive nitrogen species (RNS), and a low pH. Preliminary results suggest that the fumC knockout has increased growth compared to wild-type S. aureus in the presence of all three antimicrobial factors; however, no difference was observed in any single factor alone. To investigate survival within a host, a nine-day biofilm-associated catheter infection was performed on 6–8-week-old male and female C57Bl/6 mice. Although both sexes struggled to clear the infection, female mice were trending toward more frequently clearing the HG003 wild-type infection compared to the fumC::N∑ infection. One possible reason for the inability to reduce the bacterial burden is that biofilms are largely composed of persister cells. To test this hypothesis further, flow cytometry in conjunction with a persister cell marker was used to measure persister cells within a biofilm. Cap5A (a known persister cell marker) expression was found to be increased in a maturing biofilm, with the lowest levels of expression seen in immature biofilms and the highest expression exhibited by the 48-hour biofilm. Additionally, bacterial cells in a biofilm state closely resemble persister cells and exhibit reduced membrane potential compared to cells in planktonic culture, further suggesting biofilms are largely made up of persister cells. These data may provide an explanation as to why infections caused by antibiotic-susceptible strains remain difficult to treat.

Keywords: antibiotic tolerance, Staphylococcus aureus, host-pathogen interactions, microbial pathogenesis

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Authors: Julia Baker

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Development plays a major role in stopping biodiversity loss. But the ‘silo species’ protection of legislation (where certain species are protected while many are not) means that development can be ‘legally compliant’ and result in biodiversity loss. ‘Net Gain’ (NG) policies can help overcome this by making it an absolute requirement that development causes no overall loss of biodiversity and brings a benefit. However, offsetting biodiversity losses in one location with gains elsewhere is controversial because people suspect ‘offsetting’ to be an easy way for developers to buy their way out of conservation requirements. Yet the good practice principles (GPP) of offsetting provide several advantages over existing legislation for protecting biodiversity from development. This presentation describes the learning from implementing NG approaches based on GPP. It regards major upgrades of the UK’s transport networks, which involved removing vegetation in order to construct and safely operate new infrastructure. While low-lying habitats were retained, trees and other habitats disrupting the running or safety of transport networks could not. Consequently, achieving NG within the transport corridor was not possible and offsetting was required. The first ‘lessons learnt’ were on obtaining a commitment from business leaders to go beyond legislative requirements and deliver NG, and on the institutional change necessary to embed GPP within daily operations. These issues can only be addressed when the challenges that biodiversity poses for business are overcome. These challenges included: biodiversity cannot be measured easily unlike other sustainability factors like carbon and water that have metrics for target-setting and measuring progress; and, the mindset that biodiversity costs money and does not generate cash in return, which is the opposite of carbon or waste for example, where people can see how ‘sustainability’ actions save money. The challenges were overcome by presenting the GPP of NG as a cost-efficient solution to specific, critical risks facing the business that also boost industry recognition, and by using government-issued NG metrics to develop business-specific toolkits charting their NG progress whilst ensuring that NG decision-making was based on rich ecological data. An institutional change was best achieved by supporting, mentoring and training sustainability/environmental managers for these ‘frontline’ staff to embed GPP within the business. The second learning was from implementing the GPP where business partnered with local governments, wildlife groups and land owners to support their priorities for nature conservation, and where these partners had a say in decisions about where and how best to achieve NG. From this inclusive approach, offsetting contributed towards conservation priorities when all collaborated to manage trade-offs between: -Delivering ecologically equivalent offsets or compensating for losses of one type of biodiversity by providing another. -Achieving NG locally to the development whilst contributing towards national conservation priorities through landscape-level planning. -Not just protecting the extent and condition of existing biodiversity but ‘doing more’. -The multi-sector collaborations identified practical, workable solutions to ‘in perpetuity’. But key was strengthening linkages between biodiversity measures implemented for development and conservation work undertaken by local organizations so that developers support NG initiatives that really count.

Keywords: biodiversity offsetting, development, nature conservation planning, net gain

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Authors: Benjamin Kaufmann, Michael Hofstätter, Nadine Raidl, Peter Supancic

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ZnO varistors are the leading overvoltage protection elements in today’s electronic industry. Their highly non-linear current-voltage characteristics, very fast response times, good reliability and attractive cost of production are unique in this field. There are challenges and questions unsolved. Especially, the urge to create even smaller, versatile and reliable parts, that fit industry’s demands, brings manufacturers to the limits of their abilities. Although, the varistor effect of sintered ZnO is known since the 1960’s, and a lot of work was done on this field to explain the sudden exponential increase of conductivity, the strict dependency on sinter parameters, as well as the influence of the complex microstructure, is not sufficiently understood. For further enhancement and down-scaling of varistors, a better understanding of the microscopic processes is needed. This work attempts a microscopic approach to investigate ZnO varistor performance. In order to cope with the polycrystalline varistor ceramic and in order to account for all possible current paths through the material, a preferably realistic model of the microstructure was set up in the form of three-dimensional networks where every grain has a constant electric potential, and voltage drop occurs only at the grain boundaries. The electro-thermal workload, depending on different grain size distributions, was investigated as well as the influence of the metal-semiconductor contact between the electrodes and the ZnO grains. A number of experimental methods are used, firstly, to feed the simulations with realistic parameters and, secondly, to verify the obtained results. These methods are: a micro 4-point probes method system (M4PPS) to investigate the current-voltage characteristics between single ZnO grains and between ZnO grains and the metal electrode inside the varistor, micro lock-in infrared thermography (MLIRT) to detect current paths, electron back scattering diffraction and piezoresponse force microscopy to determine grain orientations, atom probe to determine atomic substituents, Kelvin probe force microscopy for investigating grain surface potentials. The simulations showed that, within a critical voltage range, the current flow is localized along paths which represent only a tiny part of the available volume. This effect could be observed via MLIRT. Furthermore, the simulations exhibit that the electric power density, which is inversely proportional to the number of active current paths, since this number determines the electrical active volume, is dependent on the grain size distribution. M4PPS measurements showed that the electrode-grain contacts behave like Schottky diodes and are crucial for asymmetric current path development. Furthermore, evaluation of actual data suggests that current flow is influenced by grain orientations. The present results deepen the knowledge of influencing microscopic factors on ZnO varistor performance and can give some recommendations on fabrication for obtaining more reliable ZnO varistors.

Keywords: metal-semiconductor contact, Schottky diode, varistor, zinc oxide

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Authors: Rakesh Tiwary, D. M. Diwakar, Sandhya Mahapatro

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Agro-forestry offers huge opportunities for diversification of agriculture in middle Gangetic Basin of India, particularly in the state of Bihar as the region is identified with traditional & stagnant agriculture, low productivity, high population pressure, rural poverty and lack of agro- industrial development. The region is endowed with favourable agro-climatic, soil & drainage conditions; interestingly, there has been an age old tradition of agro-forestry in the state. However, due to demographic pressures, declining land holdings and other socio- economic factors, agro forestry practices have declined in recent decades. The government of Bihar has initiated a special program for expansion of agro-forestry based on modern practices with an aim to raise income level of farmers, make available raw material for wood based industries and increase green cover in the state. The Agro-forestry Schemes – Poplar & Other Species are the key components of the program being implemented by Department of Environment & Forest, Govt. of Bihar. The paper is based on fieldwork based evaluation study on experiences of implementation of the agro-forestry schemes. Understanding adoption patterns, identification of key motives for practising agro-forestry, experiences of farmers well analysing the barriers in expansion constituted the major themes of the research study. This paper is based on primary as well as secondary data. The primary data consists of beneficiary household survey, Focus Group Discussions among beneficiary communities, dialogue and multi stakeholder meetings and field visit to the sites. The secondary data information was collected and analysed from official records, policy documents and reports. Primary data was collected from about 500 beneficiary households of Muzaffarpur & Saharsa- two populous, large and agriculture dominated districts of middle Gangetic basin of North Bihar. Survey also covers 100 households of non-beneficiaries. Probability Proportionate to Size method was used to determine the number of samples to be covered in different blocks of two districts. Qualitative tools were also implemented to have better insights about key research questions. Present paper discusses socio-economic background of farmers practising agro-forestry; the adoption patterns of agro- forestry (choice of plants, methods of plantation and others); and motivation behind adoption of agro-forestry and the comparative benefits of agro-forestry (vis-a-vis traditional agriculture). Experience of beneficiary farmers with agro-forestry based on government programs & promotional campaigns (in terms of awareness, ease of access, knowhow and others) have been covered in the paper. Different aspects of survival of plants have been closely examined. Non beneficiaries but potential adopters were also interviewed to understand barriers of adoption of agro- forestry. Paper provides policy recommendations and interventions required for effective expansion of the agro- forestry and realisation of its future prospects for agricultural diversification in the region.

Keywords: agro-forestry adoption patterns, farmers’ motivations & experiences, Indian middle Gangetic plains, strategies for expansion

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Authors: Piotr Romaniuk, Krzysztof Kaczmarek, Adam Szromek

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Background: A number of approaches to assess the performance of health system have been proposed so far. Nonetheless, they lack a consensus regarding the key components of assessment procedure and criteria of evaluation. The WHO and OECD have developed methods of assessing health system to counteract the underlying issues, but they are not free of controversies and did not manage to produce a commonly accepted consensus. The aim of the study: On the basis of WHO and OECD approaches we decided to develop own methodology to assess the performance of health systems in Central and Eastern European countries. We have applied the method to compare the effects of health systems reforms in 20 countries of the region, in order to evaluate the dynamic of changes in terms of health system outcomes.Methods: Data was collected from a 25-year time period after the fall of communism, subsetted into different post-reform stages. Datasets collected from individual countries underwent one-, two- or multi-dimensional statistical analyses, and the Synthetic Measure of health system Outcomes (SMO) was calculated, on the basis of the method of zeroed unitarization. A map of dynamics of changes over time across the region was constructed. Results: When making a comparative analysis of the tested group in terms of the average SMO value throughout the analyzed period, we noticed some differences, although the gaps between individual countries were small. The countries with the highest SMO were the Czech Republic, Estonia, Poland, Hungary and Slovenia, while the lowest was in Ukraine, Russia, Moldova, Georgia, Albania, and Armenia. Countries differ in terms of the range of SMO value changes throughout the analyzed period. The dynamics of change is high in the case of Estonia and Latvia, moderate in the case of Poland, Hungary, Czech Republic, Croatia, Russia and Moldova, and small when it comes to Belarus, Ukraine, Macedonia, Lithuania, and Georgia. This information reveals fluctuation dynamics of the measured value in time, yet it does not necessarily mean that in such a dynamic range an improvement appears in a given country. In reality, some of the countries moved from on the scale with different effects. Albania decreased the level of health system outcomes while Armenia and Georgia made progress, but lost distance to leaders in the region. On the other hand, Latvia and Estonia showed the most dynamic progress in improving the outcomes. Conclusions: Countries that have decided to implement comprehensive health reform have achieved a positive result in terms of further improvements in health system efficiency levels. Besides, a higher level of efficiency during the initial transition period generally positively determined the subsequent value of the efficiency index value, but not the dynamics of change. The paths of health system outcomes improvement are highly diverse between different countries. The instrument we propose constitutes a useful tool to evaluate the effectiveness of reform processes in post-communist countries, but more studies are needed to identify factors that may determine results obtained by individual countries, as well as to eliminate the limitations of methodology we applied.

Keywords: health system outcomes, health reforms, health system assessment, health system evaluation

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Authors: Qudsiya Baig

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Empathy yields an unparalleled therapeutic value within patient physician interactions. Medical research is inundated with evidence to support that a physician’s ability to empathise with patients leads to a greater willingness to report symptoms, an improvement in diagnostic accuracy and safety, and a better adherence and satisfaction with treatment plans. Furthermore, the Institute of Medicine states that empathy leads to a more patient-centred care, which is one of the six main goals of a 21st century health system. However, there is a paradox between the theoretical significance of empathy and its presence, or lack thereof, in clinical practice. Recent studies have reported that empathy declines amongst students and physicians over time. The three most impactful contributors to this decline are: (1) disagreements over the definitions of empathy making it difficult to implement it into practice (2) poor consideration or regulation of empathy leading to burnout and thus, abandonment altogether, and (3) the lack of diversity in the curriculum and the influence of medical culture, which prioritises science over patient experience, limiting some physicians from using ‘too much’ empathy in the fear of losing clinical objectivity. These issues were investigated by conducting a fully inductive thematic narrative analysis of patient narratives in the UK to evaluate the behaviours and attitudes that patients associate with empathy. The principal enquiries underpinning this study included uncovering the factors that affected experience of empathy within provider-patient interactions and to analyse their effects on patient care. This research contributes uniquely to this discourse by examining the phenomenon of empathy directly from patients’ experiences, which were systematically extracted from a repository of online patient narratives of care titled ‘CareOpinion UK’. Narrative analysis was specifically chosen as the methodology to examine narratives from a phenomenological lens to focus on the particularity and context of each story. By enquiring beyond the superficial who-whatwhere, the study of narratives prescribed meaning to illness by highlighting the everyday reality of patients who face the exigent life circumstances created by suffering, disability, and the threat of life. The following six themes were found to be the most impactful in influencing the experience of empathy: dismissive behaviours, judgmental attitudes, undermining patients’ pain or concerns, holistic care and failures and successes of communication or language. For each theme there were overarching themes relating to either a failure to understand the patient’s perspective or a success in taking a person-centred approach. An in-depth analysis revealed that a lack of empathy was greatly associated with an emotive-cognitive imbalance, which disengaged physicians with their patients’ emotions. This study hereby concludes that competent providers require a combination of knowledge, skills, and more importantly empathic attitudes to help create a context for effective care. The crucial elements of that context involve (a) identifying empathy clues within interactions to engage with patients’ situations, (b) attributing a perspective to the patient through perspective-taking and (c) adapting behaviour and communication according to patient’s individual needs. Empathy underpins that context, as does an appreciation of narrative, and the two are interrelated.

Keywords: empathy, narratives, person-centred, perspective, perspective-taking

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Authors: Ado Ismail Sabo

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Statement of the Problem: The global trend in tertiary education institutions today is changing and moving towards engagement, promotion and marketing. The reason is to upscale reputation and impact positioning. More prominently, existing rivalry today seeks to draw-in the best and brightest students. A university or college is no longer just an institution of higher learning, but one adapting additional business nomenclature. Therefore, huge financial resources are invested by educational institutions to polish their image and improve their global and national ranking. In Nigeria, which boasts of a vast population of over 180 million people, some of whose patronage can bolster its education sector; standard of education continues to decline. Today, some Nigerian tertiary education institutions are shadows of their pasts, in terms of academic excellence. Quality has been relinquished because of the unquenchable quest by government officials, some civil servants, school heads and educators to amass wealth. It is very difficult to gain student satisfaction and their loyalty. Some of the student’s loyalties factor towards public higher educational institutions might be confusing. It is difficult to understand the extent to which students are satisfy on many needs. Some students might feel satisfy with the academic lecturers only, whereas others may want everything, and others will never satisfy. Due to these problems, this research aims to uncover the crucial factors influencing student loyalty and to examine if students’ satisfaction might impact mediate the relationship between service quality, organisational image and students’ loyalty towards public higher education institutions in Kano State, Nigeria. The significance of the current study is underscored by the paucity of similar research in the subject area and public tertiary education in a developing country like Nigeria as shown in existing literature. Methodology: The current study was undertaken by quantitative research methodology. Sample of 600 valid responses were obtained within the study population comprising six selected public higher education institutions in Kano State, Nigeria. These include: North West University Kano, Bayero University Kano, School of Management Studies Kano, School of Technology Kano, Sa’adatu Rimi College Kano and Federal College of Education (FCE) Kano. Four main hypotheses were formulated and tested using structural equation modeling techniques with Analysis of Moment Structure (AMOS Version 22.0). Results: Analysis of the data provided support for the main issue of this study, and the following findings are established: “Student Satisfaction mediates the relationship between Service Quality and Student Loyalty”, “Student Satisfaction mediates the relationship between Organizational Image and Student Loyalty” respectively. The findings of this study contributed to the theoretical implication which proposed a structural model that examined the relationships among overall Organizational image, service quality, student satisfaction and student loyalty. Conclusion: In addition, the findings offered a better insight to the managerial (higher institution of learning service providers) by focusing on portraying the image of service quality with student satisfaction in improving the quality of student loyalty.

Keywords: student loyalty, service quality, student satisfaction, organizational image

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Authors: Prajna Paramita Naik, Sujit Kumar Bhutia

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Background: Regardless of the development multimodal treatment strategies, oral squamous cell carcinoma (OSCC) is often associated with a high rate of recurrence, metastasis and chemo- and radio- resistance. The present study inspected the relevance of CD44, ABCB1 and ADAM17 expression as a putative stem cell compartment in oral squamous cell carcinoma (OSCC) and deciphered the role of autophagy in regulating the expression of aforementioned proteins, stemness and chemoresistance. Methods: A retrospective analysis of CD44, ABCB1 and ADAM17 expression with respect to the various clinicopathological factors of sixty OSCC patients were determined via immunohistochemistry. The correlation among CD44, ABCB1 and ADAM17 expression was established. Sphere formation assay, flow cytometry and fluorescence microscopy were conducted to elucidate the stemness and chemoresistance nature of established cisplatin-resistant oral cancer cells (FaDu). The pattern of expression of CD44, ABCB1 and ADAM17 in parental (FaDu-P) and resistant FaDu cells (FaDu-CDDP-R) were investigated through fluorescence microscopy. Western blot analysis of autophagy marker proteins was performed to compare the status of autophagy in parental and resistant FaDu cell. To investigate the role of autophagy in chemoresistance and stemness, sphere formation assay, immunofluorescence and Western blot analysis was performed post transfection with siATG14 and the level of expression of autophagic proteins, mitochondrial protein and stemness-associated proteins were analyzed. The statistical analysis was performed by GraphPad Prism 4.0 software. p-value was defined as follows: not significant (n.s.): p > 0.05;*: p ≤ 0.05; **: p ≤ 0.01; ***: p ≤ 0.001; ****: p ≤ 0.0001 were considered statistically significant. Results: In OSCC, high CD44, ABCB1 and ADAM17 expression were significantly correlated with higher tumor grades and poor differentiation. However, the expression of these proteins was not related to the age and sex of OSCC patients. Moreover, the expression of CD44, ABCB1 and ADAM17 were positively correlated with each other. In vitro and OSCC tissue double labeling experiment data showed that CD44+ cells were highly associated with ABCB1 and ADAM17 expression. Further, FaDu-CDDP-R cells showed higher sphere forming capacity along with increased fraction of the CD44+ population and β-catenin expression FaDu-CDDP-R cells also showed accelerated expression of CD44, ABCB1 and ADAM17. A comparatively higher autophagic flux was observed in FaDu-CDDP-R against FaDu-P cells. The expression of mitochondrial proteins was noticeably reduced in resistant cells as compared to parental cells indicating the occurrence of autophagy-mediated mitochondrial degradation in oral cancer. Moreover, inhibition of autophagy was coupled with the decreased formation of orospheres suggesting autophagy-mediated stemness in oral cancer. Blockade of autophagy was also found to induce the restoration of mitochondrial proteins in FaDu-CDDP-R cells indicating the involvement of mitophagy in chemoresistance. Furthermore, a reduced expression of CD44, ABCB1 and ADAM17 was also observed in ATG14 deficient cells FaDu-P and FaDu-CDDP-R cells. Conclusion: The CD44+ ⁄ABCB1+ ⁄ADAM17+ expression in OSCC might be associated with chemoresistance and a putative CSC compartment. Further, the present study highlights the contribution of mitophagy in chemoresistance and confirms the potential involvement of autophagic regulation in acquisition of stem-like characteristics in OSCC.

Keywords: ABCB1, ADAM17, autophagy, CD44, chemoresistance, mitophagy, OSCC, stemness

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Authors: Inna Kornienko, Svetlana Guryeva, Anatoly Shekhter, Elena Petersen

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Transplantation is an effective treatment option for patients suffering from different end-stage diseases. However, it is plagued by a constant shortage of donor organs and the subsequent need of a lifelong immunosuppressive therapy for the patient. Currently some researchers look towards using of pig organs to replace human organs for transplantation since the matrix derived from porcine organs is a convenient substitute for the human matrix. As an initial step to create a new ex vivo tissue engineered model, optimized protocols have been created to obtain organ-specific acellular matrices and evaluated their potential as tissue engineered scaffolds for culture of normal cells and tumor cell lines. These protocols include decellularization by perfusion in a bioreactor system and immersion-agitation on an orbital shaker with use of various detergents (SDS, Triton X-100) and freezing. Complete decellularization – in terms of residual DNA amount – is an important predictor of probability of immune rejection of materials of natural origin. However, the signs of cellular material may still remain within the matrix even after harsh decellularization protocols. In this regard, the matrices obtained from tissues of low-immunogenic pigs with α3Galactosyl-tranferase gene knock out (GalT-KO) may be a promising alternative to native animal sources. The research included a study of induced effect of frozen and fresh fragments of GalT-KO skin on healing of full-thickness plane wounds in 80 rats. Commercially available wound dressings (Ksenoderm, Hyamatrix and Alloderm) as well as allogenic skin were used as a positive control and untreated wounds were analyzed as a negative control. The results were evaluated on the 4th day after grafting, which corresponds to the time of start of normal wound epithelization. It has been shown that a non-specific immune response in models treated with GalT-Ko pig skin was milder than in all the control groups. Research has been performed to measure technical skin characteristics: stiffness and elasticity properties, corneometry, tevametry, and cutometry. These metrics enabled the evaluation of hydratation level, corneous layer husking level, as well as skin elasticity and micro- and macro-landscape. These preliminary data may contribute to development of personalized transplantable organs from GalT-Ko pigs with significantly limited potential of immune rejection. By applying growth factors to a decellularized skin sample it is possible to achieve various regenerative effects based on the particular situation. In this particular research BMP2 and Heparin-binding EGF-like growth factor have been used. Ideally, a bioengineered organ must be biocompatible, non-immunogenic and support cell growth. Porcine organs are attractive for xenotransplantation if severe immunologic concerns can be bypassed. The results indicate that genetically modified pig tissues with knock-outed α3Galactosyl-tranferase gene may be used for production of low-immunogenic matrix suitable for transplantation.

Keywords: decellularization, low-immunogenic, matrix, scaffolds, transplants

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Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: Deepak Loura

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The most contemporary method of producing horticulture crops both qualitatively and quantitatively is protected cultivation, or greenhouse cultivation, which has gained widespread acceptance in recent decades. Protected farming, commonly referred to as controlled environment agriculture (CEA), is extremely productive, land- and water-wise, as well as environmentally friendly. The technology entails growing horticulture crops in a controlled environment where variables such as temperature, humidity, light, soil, water, fertilizer, etc. are adjusted to achieve optimal output and enable a consistent supply of them even during the off-season. Over the past ten years, protected cultivation of high-value crops and cut flowers has demonstrated remarkable potential. More and more agricultural and horticultural crop production systems are moving to protected environments as a result of the growing demand for high-quality products by global markets. By covering the crop, it is possible to control the macro- and microenvironments, enhancing plant performance and allowing for longer production times, earlier harvests, and higher yields of higher quality. These shielding features alter the environment of the plant while also offering protection from wind, rain, and insects. Protected farming opens up hitherto unexplored opportunities in agriculture as the liberalised economy and improved agricultural technologies advance. Typically, the revenues from fruit, vegetable, and flower crops are 4 to 8 times higher than those from other crops. If any of these high-value crops are cultivated in protected environments like greenhouses, net houses, tunnels, etc., this profit can be multiplied. Vegetable and cut flower post-harvest losses are extremely high (20–0%), however sheltered growing techniques and year-round cropping can greatly minimize post-harvest losses and enhance yield by 5–10 times. Seasonality and weather have a big impact on the production of vegetables and flowers. The variety of their products results in significant price and quality changes for vegetables. For the application of current technology in crop production, achieving a balance between year-round availability of vegetables and flowers with minimal environmental impact and remaining competitive is a significant problem. The future of agriculture will be protected since population growth is reducing the amount of land that may be held. Protected agriculture is a particularly profitable endeavor for tiny landholdings. Small greenhouses, net houses, nurseries, and low tunnel greenhouses can all be built by farmers to increase their income. Protected agriculture is also aided by the rise in biotic and abiotic stress factors. As a result of the greater productivity levels, these technologies are not only opening up opportunities for producers with larger landholdings, but also for those with smaller holdings. Protected cultivation can be thought of as a kind of precise, forward-thinking, parallel agriculture that covers almost all aspects of farming and is rather subject to additional inspection for technical applicability to circumstances, farmer economics, and market economics.

Keywords: protected cultivation, horticulture, greenhouse, vegetable, controlled environment agriculture

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Authors: Manta Nowbuth, Marie Anais Kimberley Therese

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The vulnerability of coastal areas to storm surges stands as a critical global concern. The increasing frequency and intensity of extreme weather events have increased the risks faced by communities living along the coastlines Worldwide. Small Island developing states (SIDS) stands out as being exceptionally vulnerable, coastal regions, ecosystems of human habitation and natural forces, bear witness to the frontlines of climate-induced challenges, and the intensification of storm surges underscores the urgent need for a comprehensive understanding of coastal vulnerability. With limited landmass, low-lying terrains, and resilience on coastal resources, SIDS face an amplified vulnerability to the consequences of storm surges, the delicate balance between human activities and environmental dynamics in these island nations increases the urgency of tailored strategies for assessing and mitigating coastal vulnerability. This research uses an approach to evaluate the vulnerability of coastal communities in Mauritius. The Satellite imagery analysis makes use of sentinel satellite imageries, modified normalised difference water index, classification techniques and the DSAS add on to quantify the extent of shoreline erosion or accumulation, providing a spatial perspective on coastal vulnerability. The coastal Vulnerability Index (CVI) is applied by Gonitz et al Formula, this index considers factors such as coastal slope, sea level rise, mean significant wave height, and tidal range. Weighted assessments identify regions with varying levels of vulnerability, ranging from low to high. The study was carried out in a Village Located in the south of Mauritius, namely Rivière des Galets, with a population of about 500 people over an area of 60,000m². The Village of Rivière des Galets being located in the south, and the southern coast of Mauritius being exposed to the open Indian ocean, is vulnerable to swells, The swells generated by the South east trade winds can lead to large waves and rough sea conditions along the Southern Coastline which has an impact on the coastal activities, including fishing, tourism and coastal Infrastructures, hence, On the one hand, the results highlighted that from a stretch of 123km of coastline the linear rate regression for the 5 –year span varies from-24.1m/yr. to 8.2m/yr., the maximum rate of change in terms of eroded land is -24m/yr. and the maximum rate of accretion is 8.2m/yr. On the other hand, the coastal vulnerability index varies from 9.1 to 45.6 and it was categorised into low, moderate, high and very high risks zones. It has been observed that region which lacks protective barriers and are made of sandy beaches are categorised as high risks zone and hence it is imperative to high risk regions for immediate attention and intervention, as they will most likely be exposed to coastal hazards and impacts from climate change, which demands proactive measures for enhanced resilience and sustainable adaptation strategies.

Keywords: climate change, coastal vulnerability, disaster management, remote sensing, satellite imagery, storm surge

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Authors: Rajkumar Ghosh

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Water scarcity is a pressing issue in urban areas, even in smart cities where efficient resource management is a priority. This scarcity is mainly caused by factors such as lifestyle changes, excessive groundwater extraction, over-usage of water, rapid urbanization, and uncontrolled population growth. In the specific case of Gomti Nagar, Lucknow, Uttar Pradesh, India, the depletion of groundwater resources is particularly severe, leading to a water imbalance and posing a significant challenge for the region's sustainable development. The aim of this study is to address the water shortage in the Gomti Nagar region by focusing on the implementation of artificial groundwater recharge methods. Specifically, the research aims to investigate the effectiveness of rainwater collection through rooftop rainwater harvesting systems (RTRWHs) as a sustainable approach to reduce aquifer depletion and bridge the gap between groundwater recharge and extraction. The research methodology for this study involves the utilization of RTRWHs as the main method for collecting rainwater. This approach is considered effective in managing and conserving water resources in a sustainable manner. The focus is on implementing RTRWHs in residential and commercial buildings to maximize the collection of rainwater and its subsequent utilization for various purposes in the Gomti Nagar region. The study reveals that the installation of RTRWHs in the Gomti Nagar region has a positive impact on addressing the water scarcity issue. Currently, RTRWHs cover only a small percentage (0.04%) of the total rainfall collected in the region. However, when RTRWHs are installed in all buildings, their influence on increasing water availability and reducing aquifer depletion will be significantly greater. The study also highlights the significant water imbalance of 24519 ML/yr in the region, emphasizing the urgent need for sustainable water management practices. This research contributes to the theoretical understanding of sustainable water management systems in smart cities. By highlighting the effectiveness of RTRWHs in reducing aquifer depletion, it emphasizes the importance of implementing such systems in urban areas. The findings of this study can serve as a basis for policymakers, urban planners, and developers to prioritize and incentivize the installation of RTRWHs as a potential solution to the water shortage crisis. The data for this study were collected through various sources such as government reports, surveys, and existing groundwater abstraction patterns. The collected data were then analysed to assess the current water situation, groundwater depletion rate, and the potential impact of implementing RTRWHs. Statistical analysis and modelling techniques were employed to quantify the water imbalance and evaluate the effectiveness of RTRWHs. The findings of this study demonstrate that the implementation of RTRWHs can effectively mitigate the water scarcity crisis in Gomti Nagar. By reducing aquifer depletion and bridging the gap between groundwater recharge and extraction, RTRWHs offer a sustainable solution to the region's water scarcity challenges. The study highlights the need for widespread adoption of RTRWHs in all buildings and emphasizes the importance of integrating such systems into the urban planning and development process. By doing so, smart cities like Gomti Nagar can achieve efficient water management, ensuring a better future with improved water availability for its residents.

Keywords: rooftop rainwater harvesting, rainwater, water management, aquifer

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Authors: Naghmeh M. Bandari, Javad Dargahi, Muthukumaran Packirisamy

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Robot-assisted minimally invasive surgery (RMIS) has been widely performed around the world during the last two decades. RMIS demonstrates significant advantages over conventional surgery, e.g., improving the accuracy and dexterity of a surgeon, providing 3D vision, motion scaling, hand-eye coordination, decreasing tremor, and reducing x-ray exposure for surgeons. Despite benefits, surgeons cannot touch the surgical site and perceive tactile information. This happens due to the remote control of robots. The literature survey identified the lack of force feedback as the riskiest limitation in the existing technology. Without the perception of tool-tissue contact force, the surgeon might apply an excessive force causing tissue laceration or insufficient force causing tissue slippage. The primary use of force sensors has been to measure the tool-tissue interaction force in real-time in-situ. Design of a tactile sensor is subjected to a set of design requirements, e.g., biocompatibility, electrical-passivity, MRI-compatibility, miniaturization, ability to measure static and dynamic force. In this study, a planar optical fiber-based sensor was proposed to mount at the surgical grasper. It was developed based on the light intensity modulation principle. The deflectable part of the sensor was a beam modeled as a cantilever Euler-Bernoulli beam on rigid substrates. A semi-cylindrical indenter was attached to the bottom surface the beam at the mid-span. An optical fiber was secured at both ends on the same rigid substrates. The indenter was in contact with the fiber. External force on the sensor caused deflection in the beam and optical fiber simultaneously. The micro-bending of the optical fiber would consequently result in light power loss. The sensor was simulated and studied using finite element methods. A laser light beam with 800nm wavelength and 5mW power was used as the input to the optical fiber. The output power was measured using a photodetector. The voltage from photodetector was calibrated to the external force for a chirp input (0.1-5Hz). The range, resolution, and hysteresis of the sensor were studied under monotonic and harmonic external forces of 0-2.0N with 0 and 5Hz, respectively. The results confirmed the validity of proposed sensing principle. Also, the sensor demonstrated an acceptable linearity (R2 > 0.9). A minimum external force was observed below which no power loss was detectable. It is postulated that this phenomenon is attributed to the critical angle of the optical fiber to observe total internal reflection. The experimental results were of negligible hysteresis (R2 > 0.9) and in fair agreement with the simulations. In conclusion, the suggested planar sensor is assessed to be a cost-effective solution, feasible, and easy to use the sensor for being miniaturized and integrated at the tip of robotic graspers. Geometrical and optical factors affecting the minimum sensible force and the working range of the sensor should be studied and optimized. This design is intrinsically scalable and meets all the design requirements. Therefore, it has a significant potential of industrialization and mass production.

Keywords: force sensor, minimally invasive surgery, optical sensor, robotic surgery, tactile sensor

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Authors: Zi Y. Kang, Tracy D. Cassidy, Tom Cassidy

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3D apparel CAD is one of the remarkable products in advanced technology which enables intuitive design, visualisation and evaluation of garments through stereoscopic drape simulation. The progressive improvements of 3D apparel CAD have led to the creation of more realistic clothing simulation which is used not only in design development but also in presentation, promotion and communication for fashion as well as other industries such as film, game and social network services. As a result, 3D clothing technology is becoming more ubiquitous in human culture and lives today. This study considers that such phenomenon implies that the technology has reached maturity and it is time to inspect the status of current technology and to explore its potential uses in ways to create cultural values to further move forward. For this reason, this study aims to generate virtual costumes as culturally significant objects using 3D apparel CAD and to assess its capability, applicability and attitudes of the audience towards clothing simulation through comparison with physical counterparts. Since the access to costume collection is often limited due to the conservative issues, the technology may make valuable contribution by democratization of culture and knowledge for museums and its audience. This study is expected to provide foundation knowledge for development of clothing technology and for expanding its boundary of practical uses. To prevent any potential damage, two replicas of the costumes in the 1860s and 1920s at the Museum of London were chosen as samples. Their structural, visual and physical characteristics were measured and collected using patterns, scanned images of fabrics and objective fabric measurements with scale, KES-F (Kawabata Evaluation System of Fabrics) and Titan. Commercial software, DC Suite 5.0 was utilised to create virtual costumes applying collected data and the following outcomes were produced for the evaluation: Images of virtual costumes and video clips showing static and dynamic simulation. Focus groups were arranged with fashion design students and the public for evaluation which exposed the outcomes together with physical samples, fabrics swatches and photographs. The similarities, application and acceptance of virtual costumes were estimated through discussion and a questionnaire. The findings show that the technology has the capability to produce realistic or plausible simulation but expression of some factors such as details and capability of light material requires improvements. While the use of virtual costumes was viewed as more interesting and futuristic replacements to physical objects by the public group, the fashion student group noted more differences in detail and preferred physical garments highlighting the absence of tangibility. However, the advantages and potential of virtual costumes as effective and useful visual references for educational and exhibitory purposes were underlined by both groups. Although 3D apparel CAD has sufficient capacity to assist garment design process, it has limits in identical replication and more study on accurate reproduction of details and drape is needed for its technical improvements. Nevertheless, the virtual costumes in this study demonstrated the possibility of the technology to contribute to cultural and knowledgeable value creation through its applicability and as an interesting way to offer 3D visual information.

Keywords: digital clothing technology, garment simulation, 3D Apparel CAD, virtual costume

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Authors: Pedro A. Marques, Francisco Monteiro, Alessandra Zumbo, Alessia Simonini, Miguel A. Mendez

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Cryogenic fuels such as Liquid Hydrogen (LH₂) must be transported and stored at extremely low temperatures. Without expensive active cooling solutions, preventing fuel boil-off over time is impossible. Hence, one must resort to venting systems at the cost of significant energy and fuel mass loss. These losses increase significantly in propellant tanks installed on vehicles, as the presence of external accelerations induces sloshing. Sloshing increases heat and mass transfer rates and leads to significant pressure oscillations, which might further trigger propellant venting. To make LH₂ economically viable, it is essential to minimize these factors by using advanced control techniques. However, these require accurate modelling and a full understanding of the tank's thermodynamics. The present research aims to implement a simple thermodynamic model capable of predicting the state of a cryogenic fuel tank under different operating conditions (i.e., filling, pressurization, fuel extraction, long-term storage, and sloshing). Since this model relies on a set of closure parameters to drive the system's transient response, it must be calibrated using experimental or numerical data. This work focuses on the former approach, wherein the model is calibrated through an experimental campaign carried out on a reduced-scale model of a cryogenic tank. The thermodynamic model of the system is composed of three control volumes: the ullage, the liquid, and the insulating walls. Under this lumped formulation, the governing equations are derived from energy and mass balances in each region, with mass-averaged properties assigned to each of them. The gas-liquid interface is treated as an infinitesimally thin region across which both phases can exchange mass and heat. This results in a coupled system of ordinary differential equations, which must be closed with heat and mass transfer coefficients between each control volume. These parameters are linked to the system evolution via empirical relations derived from different operating regimes of the tank. The derivation of these relations is carried out using an inverse method to find the optimal relations that allow the model to reproduce the available data. This approach extends classic system identification methods beyond linear dynamical systems via a nonlinear optimization step. Thanks to the data-driven assimilation of the closure problem, the resulting model accurately predicts the evolution of the tank's thermodynamics at a negligible computational cost. The lumped model can thus be easily integrated with other submodels to perform complete system simulations in real time. Moreover, by setting the model in a dimensionless form, a scaling analysis allowed us to relate the tested configurations to a representative full-size tank for naval applications. It was thus possible to compare the relative importance of different transport phenomena between the laboratory model and the full-size prototype among the different operating regimes.

Keywords: destratification, hydrogen, modeling, pressure-drop, pressurization, sloshing, thermodynamics

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Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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In February 2022 Colombia achieved a historic milestone in ensuring universal access to abortion rights with ruling C-055 of 2022 decriminalising abortion up to 24 weeks of gestation. In the context of this triumph and the expansion of telemedicine services in the wake of the COVID-19 pandemic, this research studied the acceptability of self-care abortion in young people (13 - 28 years) through a telemedicine service and also explored the primary needs that should be the focus of such care. The results shine light on a more comprehensive understanding of opportunities and challenges of teleabortion practices in a context that combines overall higher access to technology and low access to reliable information of safe abortion, stigma, and scarcity especially felt by transnational migrants, racialised people, trans men and non-binary people. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 in-person interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings of the research suggest that self-care abortion is practice with growing acceptability among young people, but important adjustments must be made to meet quality of care expectations of users. Elements like quick responses from providers, lower costs, and accessible information were defined by users as decisive factors to choose over the abortion service provider. In general, the narratives in participants about quality care were centred on the promotion of autonomy and the provision of accompaniment and care practices, also perceived as transformative and currently absent of most health care services. The most staggering findings from the investigation are related to current barriers faced by young people in abortion contexts even when the legal barriers have: high rates of scepticism and distrust associated with pitfalls of telehealth and structural challenges associated with lacking communications infrastructure, among a few of them. Other important barriers to safe self-care abortion identified by participants surfaced like lack of privacy and confidentiality (especially in rural areas of the country), difficulties accessing reliable information, high costs of procedures and expenses related to travel costs or having to cease economic activities, waiting times, and stigma are among the primary barriers to abortion identified by participants. Especially in a scenario marked by unprecedented social, political and economic disruptions due to the COVID-19 pandemic, the commitment to design better care services that can be adapted to the identities, experiences, social contexts and possibilities of the user population is more necessary than ever. In this sense, the possibility of expanding access to services through telemedicine brings us closer to the opportunity to rethink the role of health care models in transforming the role of individuals and communities to make autonomous, safe and informed decisions about their own health and well-being.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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Authors: Akane Uda, Ami Tabata, Mi An, Misa Komaki, Ryotaro Ito, Mayumi Inoue, Takehiro Sasai, Yusuke Kusano, Toshihiro Kato

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Early intervention is recommended for children with autism spectrum disorder (ASD), and an increasing number of children have received support and intervention before school age in recent years. In this study, we systematically reviewed preschool interventions focused on repetitive behaviors observed in children with ASD, which are often observed at younger ages. Inclusion criteria were as follows : (1) Child of preschool status (age ≤ 7 years) with a diagnosis of ASD (including autism, Asperger's, and pervasive developmental disorder) or a parent (caregiver) with a preschool child with ASD, (2) Physician-confirmed diagnosis of ASD (autism, Asperger's, and pervasive developmental disorder), (3) Interventional studies for repetitive behaviors, (4) Original articles published within the past 10 years (2012 or later), (5) Written in English and Japanese. Exclusion criteria were as follows: (1) Systematic reviews or meta-analyses, (2) Conference reports or books. We carefully scrutinized databases to remove duplicate references and used a two-step screening process to select papers. The primary screening included close scrutiny of titles and abstracts to exclude articles that did not meet the eligibility criteria. During the secondary screening, we carefully read the complete text to assess eligibility, which was double-checked by six members at the laboratory. Disagreements were resolved through consensus-based discussion. Our search yielded 304 papers, of which nine were included in the study. The level of evidence was as follows: three randomized controlled trials (level 2), four pre-post studies (level 4b), and two case reports (level 5). Seven articles selected for this study described the effectiveness of interventions. Interventions for repetitive behaviors in preschool children with ASD were categorized as five interventions that directly involved the child and four educational programs for caregivers and parents. Studies that directly intervened with children used early intensive intervention based on applied behavior analysis (Early Start Denver Model, Early Intensive Behavioral Intervention, and the Picture Exchange Communication System) and individualized education based on sensory integration. Educational interventions for caregivers included two methods; (a) education regarding combined methods and practices of applied behavior analysis in addition to classification and coping methods for repetitive behaviors, and (b) education regarding evaluation methods and practices based on children’s developmental milestones in play. With regard to the neurophysiological basis of repetitive behaviors, environmental factors are implicated as possible contributors. We assumed that applied behavior analysis was shown to be effective in reducing repetitive behaviors because analysis focused on the interaction between the individual and the environment. Additionally, with regard to educational interventions for caregivers, the intervention was shown to promote behavioral change in children based on the caregivers' understanding of the classification of repetitive behaviors and the children’s developmental milestones in play and adjustment of the person-environment context led to a reduction in repetitive behaviors.

Keywords: autism spectrum disorder, early intervention, repetitive behaviors, systematic review

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Authors: Ahmad Ali, Muhammad Imran Ghani, Haiyan Ding, Zhihui Cheng, Muhammad Iqbal

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Background and Aims: In recent years, protected cultivation trend, especially in the northern parts of China, spread dynamically where production area, structure, and crops diversity have expanded gradually under plastic greenhouse vegetable cropping (PGVC) system. Under this growing system, continuous monoculture with excessive synthetic fertilizers inputs are common cultivation practices frequently adopted by commercial producers. Such long-term cumulative wild exercise year after year sponsor the continuous cropping obstacles in PGVC soil, which have greatly threatened the regional soil eco-sustainability and further impose the continuous assault on soil ecological diversity leading to the exhaustion of agriculture productivity. The aim of this study was to develop new allelopathic insights by exploiting available biological resources in the favor of sustainable PGVC to illuminate the continuous obstacle factors in plastic greenhouse. Method: A greenhouse study was executed under plastic tunnel located at the Horticulture Experimental Station of the College of Horticulture, Northwest A&F University, Yangling, Shaanxi Province, one of the prominent regions for intensive commercial PGVC in China. Post-harvest garlic residues (stalk, leaves) mechanically smashed, homogenized into powder size and incorporated at the ratio of 1:100; 3:100; 5:100 as a soil amendment in a replanted soil that have been used for continuous cucumber monoculture for 7 years (annually double cropping system in a greenhouse). Results: Incorporated C-rich garlic stalk significantly influenced the soil condition through various ways; organic matter decomposition and mineralization, moderately adjusted the soil pH, enhanced the soil nutrient availability, increased enzymatic activities, and promoted 20% more cucumber yield in short-time. Using Illumina MiSeq sequencing analysis of bacterial 16S rRNA and fungal 18S rDNA genes, the current study revealed that addition of garlic stalk/residue could also improve the microbial abundance and community composition in extensively exploited soil, and contributed in soil functionality, caused prosper changes in soil characteristics, reinforced to good crop yield. Conclusion: Our study provided evidence that addition of garlic stalk as soil fertility amendment is a feasible, cost-effective and efficient resource utilization way for renovation of degraded soil health, ameliorate soil quality components and improve ecological environment in short duration. Our study may provide a better scientific understanding for efficient crop residue management typically from allelopathic source.

Keywords: garlic stalk, microbial community dynamics, plant growth, soil amendment, soil-plant system

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Authors: Alfredo Fortunato, Carmelofrancesco Origlia, Sara Laurita, Rossella Nicoletti

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In the post-pandemic recovery phase of tourism, the role of a Destination Management Organization (DMO) as a coordinated management system of all the elements that make up a destination (attractions, access, marketing, human resources, brand, pricing, etc.) is also becoming relevant for local territories. The objective of a DMO is to maximize the visitor's perception of value and quality while ensuring the competitiveness and sustainability of the destination, as well as the long-term preservation of its natural and cultural assets, and to catalyze benefits for the local economy and residents. In carrying out the multiple functions to which it is called, the DMO can leverage a collective intelligence that comes from the ability to pool information, explicit and tacit knowledge, and relationships of the various stakeholders: policymakers, public managers and officials, entrepreneurs in the tourism supply chain, researchers, data journalists, schools, associations and committees, citizens, etc. The DMO potentially has at its disposal large volumes of data and many of them at low cost, that need to be properly processed to produce value. Based on these assumptions, the paper presents a conceptual framework for building an information system to support the DMO in the intelligent management of a tourist destination tested in an area of southern Italy. The approach adopted is data-informed and consists of four phases: (1) formulation of the knowledge problem (analysis of policy documents and industry reports; focus groups and co-design with stakeholders; definition of information needs and key questions); (2) research and metadatation of relevant sources (reconnaissance of official sources, administrative archives and internal DMO sources); (3) gap analysis and identification of unconventional information sources (evaluation of traditional sources with respect to the level of consistency with information needs, the freshness of information and granularity of data; enrichment of the information base by identifying and studying web sources such as Wikipedia, Google Trends, Booking.com, Tripadvisor, websites of accommodation facilities and online newspapers); (4) definition of the set of indicators and construction of the information base (specific definition of indicators and procedures for data acquisition, transformation, and analysis). The framework derived consists of 6 thematic areas (accommodation supply, cultural heritage, flows, value, sustainability, and enabling factors), each of which is divided into three domains that gather a specific information need to be represented by a scheme of questions to be answered through the analysis of available indicators. The framework is characterized by a high degree of flexibility in the European context, given that it can be customized for each destination by adapting the part related to internal sources. Application to the case study led to the creation of a decision support system that allows: •integration of data from heterogeneous sources, including through the execution of automated web crawling procedures for data ingestion of social and web information; •reading and interpretation of data and metadata through guided navigation paths in the key of digital story-telling; •implementation of complex analysis capabilities through the use of data mining algorithms such as for the prediction of tourist flows.

Keywords: collective intelligence, data framework, destination management, smart tourism

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Authors: Aleksandra Bylinska, Samantha Slight-Webb, Kevin Thomas, Miles Smith, Susan Macwana, Nicolas Dominguez, Eliza Chakravarty, Joan T. Merrill, Judith A. James, Joel M. Guthridge

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Background: Systemic Lupus Erythematosus (SLE) is an interferon-related autoimmune disease characterized by B cell dysfunction. One of the main hallmarks is a loss of tolerance to self-antigens leading to increased levels of autoantibodies against nuclear components (ANAs). However, up to 20% of healthy ANA+ individuals will not develop clinical illness. SLE is more prevalent among women and minority populations (African, Asian American and Hispanics). Moreover, African Americans have a stronger interferon (IFN) signature and develop more severe symptoms. The exact mechanisms involved in ethnicity-dependent B cell dysregulation and the progression of autoimmune disease from ANA+ healthy individuals to clinical disease remains unclear. Methods: Peripheral blood mononuclear cells (PBMCs) from African (AA) and European American (EA) ANA- (n=12), ANA+ (n=12) and SLE (n=12) individuals were assessed by multimodal scRNA-Seq/CITE-Seq methods to examine differential gene signatures in specific B cell subsets. Library preparation was done with a 10X Genomics Chromium according to established protocols and sequenced on Illumina NextSeq. The data were further analyzed for distinct cluster identification and differential gene signatures in the Seurat package in R and pathways analysis was performed using Ingenuity Pathways Analysis (IPA). Results: Comparing all subjects, 14 distinct B cell clusters were identified using a community detection algorithm and visualized with Uniform Manifold Approximation Projection (UMAP). The proportion of each of those clusters varied by disease status and ethnicity. Transitional B cells trended higher in ANA+ healthy individuals, especially in AA. Ribonucleoprotein high population (HNRNPH1 elevated, heterogeneous nuclear ribonucleoprotein, RNP-Hi) of proliferating Naïve B cells were more prevalent in SLE patients, specifically in EA. Interferon-induced protein high population (IFIT-Hi) of Naive B cells are increased in EA ANA- individuals. The proportion of memory B cells and plasma cells clusters tend to be expanded in SLE patients. As anticipated, we observed a higher signature of cytokine-related pathways, especially interferon, in SLE individuals. Pathway analysis among AA individuals revealed an NRF2-mediated Oxidative Stress response signature in the transitional B cell cluster, not seen in EA individuals. TNFR1/2 and Sirtuin Signaling pathway genes were higher in AA IFIT-Hi Naive B cells, whereas they were not detected in EA individuals. Interferon signaling was observed in B cells in both ethnicities. Oxidative phosphorylation was found in age-related B cells (ABCs) for both ethnicities, whereas Death Receptor Signaling was found only in EA patients in these cells. Interferon-related transcription factors were elevated in ABCs and IFIT-Hi Naive B cells in SLE subjects of both ethnicities. Conclusions: ANA+ healthy individuals have altered gene expression pathways in B cells that might drive apoptosis and subsequent clinical autoimmune pathogenesis. Increases in certain regulatory pathways may delay progression to SLE. Further, AA individuals have more elevated activation pathways that may make them more susceptible to SLE.

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