Search results for: multiple organ manifestation

Authors: Xiaofei Li, Zhiwei Zhong, Deli Wang

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Large herbivores affect plant growth not only through their direct, consumptive effects, but also through indirect effects that alter species interactions. Indirect effects can be either positive or negative, therefore having the potential to mitigate or enhance the direct impacts of herbivores. However, until recently, we know considerably less about the indirect effects than the direct effects of large herbivores on plants, and few studies have explored multiple indirect pathways simultaneously. Here, we investigated how large domestic herbivores, cattle (Bos taurus), can shape population growth of an intermediately preferred forb species, Artemsisa scoparia, through diverse pathways in a temperate grassland of northeast China. We found that, although exposure to direct consumption of cattle, A. scoparia growth was not inhibited, but rather showed a significant increase in the grazed than ungrazed areas. This unexpected result was due to grazing-induced multiple indirect, positive effects overwhelmed the direct, negative consumption effects of cattle on plant growth. The much more intensive consumption on the dominant Leymus chinensis grass, ground litter removal, and increases in ant nest abundance induced by cattle, exerted significant indirect, positive effects on A. scoparia growth. These pathways benefited A.scoparia growth by lessening interspecific competition, mitigating negative effects of litter accumulation, and increasing soil nutrient availability, respectively. Our results highlight the need to integrate indirect effects into the traditional food web theory, which is based primary on direct, trophic linkages, to fully understand community organization and dynamics. Large herbivores are important conservation and management targets, our results suggest that these mammals should be managed with the understanding that they can affect primary producers through diverse paths.

Keywords: grasslands, large herbivores, plant growth, indirect effects

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Authors: Sireen Irsheid

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Despite concerted efforts to improve education attainment with progress in recent years, student achievement and attainment remain among the most significant challenges for school districts across the United States. Many scholars have argued that students who do not complete high school do not drop out of school voluntarily but are ‘pushed out’ of schools through multiple mechanisms related to structural and socioeconomic barriers, behavioral health challenges, pedagogical practices, and administrative procedures. Extant literature has shown that living in historically disadvantaged neighborhoods or attending under-resourced schools exacerbates student-level risk factors for grade retention and school pushout. Most efforts to respond to the school pushout phenomenon have focused on individual characteristics of students, with relatively little attention to addressing these multiple system-level characteristics related to perpetuating inequities. This study is built on a growing body of social justice-oriented research concerned with the systemic influences that shape the experiences and mental health challenges of young people. Specifically, this study examined how young people who have been experiencing education inequities make meaning and navigate the structural factors related to neighborhood and school disinvestment and access to resources and supports, and their risk for school pushout. Furthermore, schools as political, cultural, and ideologically reproductive spaces often serve as sites of resistance and can support students who are impacted by educational inequity. Study findings provide education, neighborhood, school psychology, social work practice, and policy considerations.

Keywords: education policy, mental health, school prison nexus, school pushout, structural trauma

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Authors: Wajeeha Shahid

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The study was designed to assess the impact of transformational and transactional leadership styles on work motivation and organizational commitment among faculty members of universities of Punjab. 713 faculty members were selected as sample through convenient random sampling technique. Three self-constructed questionnaires namely Leadership Styles Questionnaire (LSQ), Work Motivation Questionnaire (WMQ) and Organizational Commitment Questionnaire (OCMQ) were used as research instruments. Major objectives of the study included assessing the effect and impact of transformational and transactional leadership styles on work motivation and organizational commitment. Theoretical frame work of the study included Idealized Influence, Inspirational Motivation, Intellectual Stimulation, Individualized Consideration, Contingent Rewards and Management by Exception as independent variables and Extrinsic motivation, Intrinsic motivation, Affective commitment, Continuance commitment and Normative commitment as dependent variables. SPSS Version 21 was used to analyze and tabulate data. Cronbach's Alpha reliability, Pearson Correlation and Multiple regression analysis were applied as statistical treatments for the analysis. Results revealed that Idealized Influence correlated significantly with intrinsic motivation and Affective commitment whereas Contingent rewards had a strong positive correlation with extrinsic motivation and affective commitment. Multiple regression models revealed a variance of 85% for transformational leadership style over work motivation and organizational commitment. Whereas transactional style as a predictor manifested a variance of 79% for work motivation and 76% for organizational commitment. It was suggested that changing organizational cultures are demanding more from their leadership. All organizations need to consider transformational leadership style as an important part of their equipment in leveraging both soft and hard organizational targets.

Keywords: leadership styles, work motivation, organizational commitment, faculty member

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Authors: Zafar Iqbal, Nigel P. Grigg, K. Govindaraju, Nicola M. Campbell-Allen

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Quality Function Deployment (QFD) is structured approach. It has been used to improve the quality of products and process in a wide range of fields. Using this systematic tool, practitioners normally rank Voice of Customer ratings (VoCs) in order to produce Improvement Ratios (IRs) which become the basis for prioritising process / product design or improvement activities. In one matrix of the House of Quality (HOQ) competitors are rated. The method of obtaining improvement ratios (IRs) does not always integrate the competitors’ rating in a systematic way that fully utilises competitor rating information. This can have the effect of diverting QFD practitioners’ attention from a potentially important VOC to less important VOC. In order to enhance QFD analysis, we present a more systematic method for integrating competitor ratings, utilising the geometric mean of the customer rating matrix. In this paper we develop a new approach, based on the Analytic Hierarchy Process (AHP), in which we generating a matrix of multiple comparisons of all competitors, and derive a geometric mean for each competitor. For each VOC an improved IR is derived which-we argue herein - enhances the initial VOC importance ratings by integrating more information about competitor performance. In this way, our method can help overcome one of the possible shortcomings of QFD. We then use a published QFD example from literature as a case study to demonstrate the use of the new AHP-based IRs, and show how these can be used to re-rank existing VOCs to -arguably- better achieve the goal of customer satisfaction in relation VOC ratings and competitors’ rankings. We demonstrate how two dimensional AHP-based geometric mean derived from the multiple competitor comparisons matrix can be useful for analysing competitors’ rankings. Our method utilises an established methodology (AHP) applied within an established application (QFD), but in an original way (through the competitor analysis matrix), to achieve a novel improvement.

Keywords: quality function deployment, geometric mean, improvement ratio, AHP, competitors ratings

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Authors: H. Tanyildizi, M. Abuqebitah, I. Cavdar, M. Demir, L. Kabasakal

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Aim: Whole liver radiation has the modest benefit in the treatment of unresectable hepatic metastases but the radiation doses must keep in control. Otherwise, RILD complications may arise. In this study, we aimed to calculate amount of maximum permissible activity (MPA) and critical organ absorbed doses with MIRD methodology, to evaluate tumour doses for treatment response and whole liver doses for RILD and to find optimal liver function test additionally. Materials and Methods: This study includes 29 patients who attended our nuclear medicine department suffering from Y-90 microspheres treatment. 10 mCi Tc-99m MAA was applied to the patients for dosimetry via IV. After the injection, whole body SPECT/CT images were taken in one hour. The minimum therapeutic tumour dose is on the point of being 120 Gy1, the amount of activities were calculated with MIRD methodology considering volumetric tumour/liver rate. A sub-working group was created with 11 patients randomly and liver clearance rate with Tc-99m-Mebrofenin was calculated according to Ekman formalism. Results: The volumetric tumour/liver rates were found between 33-66% (Maksimum Tolarable Dose (MTD) 48-52Gy3) for 4 patients, were found less than 33% (MTD 72Gy3) for 25 patients. According to these results the average amount of activity, mean liver dose and mean tumour dose were found 1793.9±1.46 MBq, 32.86±0.19 Gy, and 138.26±0.40 Gy. RILD was not observed in any patient. In sub-working group, the relationship between Bilirubin, Albumin, INR (which show presence of liver disease and its degree), liver clearance with Tc-99m-Mebrofenin and calculated activity amounts were found r=0.49, r=0.27, r=0.43, r=0.57, respectively. Discussions: The minimum tumour dose was found 120 Gy for positive dose-response relation. If volumetric tumour/liver rate was > 66%, dose 30 Gy; if volumetric tumour/liver rate 33-66%, dose escalation 48 Gy; if volumetric tumour/liver rate < 33%, dose 72 Gy. These dose limitations did not create RILD. Clearance measurement with Mebrofenin was concluded that the best method to determine the liver function. Therefore, liver clearance rate with Tc-99m-Mebrofenin should be considered in calculation of yttrium-90 microspheres dosimetry.

Keywords: clearance, dosimetry, liver, RILD

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Authors: Belayneh Yohannes

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In Ethiopia, onion production is increasing from time to time mainly due to its high profitability per unit area. Onion has a significant contribution to generating cash income for farmers in the Raya Azebo district. Therefore, enhancing onion producers’ access to the market and improving market linkage is an essential issue. Hence, this study aimed to analyze structure-conduct-performance of onion market and identifying factors affecting the market supply of onion producers. Data were collected from both primary and secondary sources. Primary data were collected from 150 farm households and 20 traders. Four onion marketing channels were identified in the study area. The highest total gross margin is 27.6 in channel IV. The highest gross marketing margin of producers of the onion market is 88% in channel II. The result from the analysis of market concentration indicated that the onion market is characterized by a strong oligopolistic market structure, with the buyers’ concentration ratio of 88.7 in Maichew town and 82.7 in Mekelle town. Lack of capital, licensing problems, and seasonal supply was identified as the major entry barrier to onion marketing. Market conduct shows that the price of onion is set by traders while producers are price takers. Multiple linear regression model results indicated that family size in adult equivalent, irrigated land size, access to information, frequency of extension contact, and ownership of transport significantly determined the quantity of onion supplied to the market. It is recommended that strengthening and diversifying extension services in information, marketing, post-harvest handling, irrigation application, and water harvest technology is highly important.

Keywords: oligopoly, onion, market chain, multiple linear regression

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Authors: Tasneem Chopra

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The 1968 Summer Olympics will forever be remembered for the silent protest against racism exhibited by American athletes Tommy Smith and John Carlos. Also standing on the medal podium was Australian Peter Norman, whose silent solidarity as a white sportsman completes the powerful, evocative image of that night in Mexico City. In the 50 years since Norman’s stance of solidarity with his American counterparts, Australian sports has traveled a wide arc of racism narratives, with athletes still experiencing episodes of bigotry, both on the pitch and elsewhere. Aboriginal athletes, like tennis champion Yvonne Goolagong, have endured the plaudits of appreciation for their achievements on both the national and international stage, while simultaneously being subject to both prejudice and even questions as to their right to represent their country as full, acceptable citizens. Racism in Australia is directed toward Australian athletes of colour as well as foreign sportspeople who visit the country. The complex, mutating nature of racism in Australia is also informed by the culture of silence, where fellow athletes stand mute in light of their colleagues’ experience with bigotry. This paper analyses the phenomenon of sports racism in Australia over the past fifty years, culminating in the most recent showdown between Heretier Lumumba, former Collingwood football player, and his public allegations of racism experienced by team mates over his 10 year career. It shall examine the treatment and mistreatment of athletes because of their race and will further assess how such public perceptions both shape Australian culture or are themselves a manifestation of preexisting pathologies of bigotry. Further, it will examine the efficacy of anti-racism initiatives in responding to this hate. This paper will analyse the growing influence of corporate and media entities in crafting the economics of Australian sports and assess the role of such factors in creating the narrative of racism in the nation, both as a sociological reality as well as a marker of national identity. Finally, this paper will examine the political, social and economic forces that contribute to the culture of silence in Australian society in defying racism.

Keywords: aboriginal, Australia, corporations, silence

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Authors: Norhan H. Mahdally, Bathini Thissera Riham A. ElShiekh, Noha M. Elhosseiny, Mona T. Kashef, Ali M. El Halawany, Mostafa E. Rateb, Ahmed S. Attia

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Multidrug-resistant (MDR) pathogens pose a global threat to healthcare settings. The exhaustion of the current antibiotic arsenal and the scarcity of new antimicrobials in the pipeline aggravate this threat and necessitate a prompt and effective response. This study focused on two major pathogens that can cause serious infections: carbapenem-resistant Acinetobacter baumannii (CRAB) and methicillin-resistant Staphylococcus aureus (MRSA). Multiple soil isolates were collected from several locations throughout Egypt and screened for their conventional and non-conventional antimicrobial activities against MDR pathogens. One isolate exhibited potent antimicrobial activity and was subjected to multiple rounds of fractionation. After fermentation and bio-guided fractionation, we identified pure microbial secondary metabolites with two scaffolds that exhibited promising effects against CRAB and MRSA. Scaling up and chemical synthesis of derivatives of the identified metabolite resulted in obtaining a more potent derivative, which we designated as 2HP. Cytotoxicity studies indicated that 2HP is well-tolerated by human cells. Ongoing work is focusing on formulating the new compound into a nano-formulation to enhance its delivery. Also, to have a better idea about how this compound works, a proteomic approach is currently underway. Our findings suggest that 2HP is a potential new broad-spectrum antimicrobial agent. Further studies are needed to confirm these findings and to develop 2HP into a safe and effective treatment for MDR infections.

Keywords: broad-spectrum antimicrobials, carbapenem-resistant acinetobacter baumannii, drug discovery, methicillin-resistant staphylococcus aureus, multidrug-resistant, natural products

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Authors: Sidika Di̇lşad Kaya, Ahmet Seli̇m Kaya, Ibrahi̇m Eri̇k, Havva Yaldiz, Yalçin Kaya

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The aim of this study was to reveal the effects of right brain development on reading, comprehension, learning and concentration levels and rapid processing skills in students with low vision and students with standard development, and to explore the effects of right and left brain integration on students' academic success and the permanence of the learned knowledge. A total of 68 students with a mean age of 10.01±0.12 were included in the study, 58 of them with standard development, 9 partially visually impaired and 1 totally visually disabled student. The student with a total visual impairment could not participate in the reading speed test due to her total visual impairment. The following data were measured in the participant students before the project; Reading speed measurement in 1 minute, Reading comprehension questions, Burdon attention test, 50 questions of math quiz timed with a stopwatch. Participants were trained for 3 weeks, 5 days a week, for a total of two hours a day. In this study, right-brain developing exercises were carried out with the use of an abacus, and it was aimed to develop both mathematical and attention of students with questions prepared with numerical data taken from fairy tale activities. Among these problems, the study was supported with multiple-choice, 5W (what, where, who, why, when?), 1H (how?) questions along with true-false and fill-in-the-blank activities. By using memory cards, students' short-term memories were strengthened, photographic memory studies were conducted and their visual intelligence was supported. Auditory intelligence was supported by aiming to make calculations by using the abacus in the minds of the students with the numbers given aurally. When calculating the numbers by touching the real abacus, the development of students' tactile intelligence is enhanced. Research findings were analyzed in SPSS program, Kolmogorov Smirnov test was used for normality analysis. Since the variables did not show normal distribution, Wilcoxon test, one of the non-parametric tests, was used to compare the dependent groups. Statistical significance level was accepted as 0.05. The reading speed of the participants was 83.54±33.03 in the pre-test and 116.25±38.49 in the post-test. Narration pre-test 69.71±25.04 post-test 97.06±6.70; BURDON pretest 84.46±14.35 posttest 95.75±5.67; rapid math processing skills pretest 90.65±10.93, posttest 98.18±2.63 (P<0.05). It was determined that the pre-test and post-test averages of students with typical development and students with low vision were also significant for all four values (p<0.05). As a result of the data obtained from the participants, it is seen that the study was effective in terms of measurement parameters, and the findings were statistically significant. Therefore, it is recommended to use the method widely.

Keywords: Abacus, reading speed, multiple intelligences, right brain training, visually impaired

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Authors: Małgorzata Tomczyńska, Joanna Saluk-Bijak

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Background: Graves’ disease is a frequent organ-specific autoimmune thyroid disease, which characterized by the presence of different kind autoantibodies, that, in most cases, act as agonists of the thyrotropin receptor, leading to hyperthyroidism. Role of platelets and lymphocytes can be modulated in the pathophysiology of thyroid autoimmune diseases. Interference in the physiology of platelets can lead to enhanced activity of these cells. Activated platelets can bind to circulating lymphocytes and to affect lymphocyte adhesion. Platelets and lymphocytes can regulate mutual functions. Therefore, the activation of T lymphocytes, as well as blood platelets, is associated with the development of inflammation and oxidative stress within the target tissue. The present study was performed to investigate a platelet-lymphocyte relation by assessing the degree of their mutual aggregation in whole blood of patients with Graves’ disease. Also, the purpose of this study was to examine the impact of platelet interaction on lymphocyte migration capacity. Methods: 30 patients with Graves’ disease were recruited in the study. The matched 30 healthy subjects were served as the control group. Immunophenotyping of lymphocytes was carried out by flow cytometry method. A CytoSelect™ Cell Migration Assay Kit was used to evaluate lymphocyte migration and adhesion to blood platelets. Visual assessment of lymphocyte-platelet aggregate morphology was done using confocal microscope after magnetic cell isolation by Miltenyi Biotec. Results: The migration and functional responses of lymphocytes to blood platelets were greater in the group of Graves’ disease patients compared with healthy controls. The group of Graves’ disease patients exhibited a reduced T lymphocyte and a higher B cell count compared with controls. Based on microscopic analysis, more platelet-lymphocyte aggregates were found in patients than in control. Conclusions: Studies have shown that in Graves' disease, lymphocytes show increased platelet affinity, more strongly migrating toward them, and forming mutual cellular conglomerates. This may be due to the increased activation of blood platelets in this disease.

Keywords: blood platelets, cell migration, Graves’ disease, lymphocytes, lymphocyte-platelet aggregates

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Authors: Musaab Mohammed Ahmed Ali, Vladimir Vodichev

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work deals with an universal control technique or single controller for linear and nonlinear stabilization and tracing control systems. These systems may be structured as SISO and MIMO. Parameters of controlled plants can vary over a wide range. Introduced a novel control systems design method, construction of stable platform orbits using derivative balance, solved transfer function stability preservation problem of linear system under partial substitution of a rational function. Universal controller is proposed as a polar system with the multiple orbits to simplify design procedure, where each orbit represent single order of controller transfer function. Designed controller consist of proportional, integral, derivative terms and multiple feedback and feedforward loops. The controller parameters synthesis method is presented. In generally, controller parameters depend on new polynomial equation where all parameters have a relationship with each other and have fixed values without requirements of retuning. The simulation results show that the proposed universal controller can stabilize infinity number of linear and nonlinear plants and shaping desired previously ordered performance. It has been proven that sensor errors and poor performance will be completely compensated and cannot affect system performance. Disturbances and noises effect on the controller loop will be fully rejected. Technical and economic effect of using proposed controller has been investigated and compared to adaptive, predictive, and robust controllers. The economic analysis shows the advantage of single controller with fixed parameters to drive infinity numbers of plants compared to above mentioned control techniques.

Keywords: derivative balance, fixed parameters, stable platform, universal control

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Authors: Rishi Kanth Saripalle

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Medical experts highly recommend to include physical activity in everyone’s daily routine irrespective of gender or age as it helps to improve various medical issues or curb potential issues. Simultaneously, experts are also diligently trying to provide various healthcare services (interventions, plans, exercise routines, etc.) for promoting healthy living and increasing physical activity in one’s ever increasing hectic schedules. With the introduction of wearables, individuals are able to keep track, analyze, and visualize their daily physical activities. However, there seems to be no common agreed standard for representing, gathering, aggregating and analyzing an individual’s physical activity data from disparate multiple sources (exercise pans, multiple wearables, etc.). This issue makes it highly impractical to develop any data-driven physical activity applications and healthcare programs. Further, the inability to integrate the physical activity data into an individual’s Electronic Health Record to provide a wholistic image of that individual’s health is still eluding the experts. This article has identified three primary reasons for this potential issue. First, there is no agreed standard, both structure and semantic, for representing and sharing physical activity data across disparate systems. Second, various organizations (e.g., LA fitness, Gold’s Gym, etc.) and research backed interventions and programs still primarily rely on paper or unstructured format (such as text or notes) to keep track of the data generated from physical activities. Finally, most of the wearable devices operate in silos. This article identifies the underlying problem, explores the idea of reusing existing standards, and identifies the essential modules required to move forward.

Keywords: electronic physical activity record, physical activity in EHR EIM, tracking physical activity data, physical activity data standards

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Authors: Kyung-Sook Bang

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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.

Keywords: child, depression, health, peer relation

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Authors: Shereen Ismail Fawaz, Shin-Ichi Izumi, Nouran Mohamed Salah, Heba G. Saber, Ibrahim Mohamed Roushdi

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Background: Multiple sclerosis (MS) is a chronic, inflammatory, mainly demyelinating disease of the central nervous system, more common in young adults. Cerebellar involvement is one of the most disabling lesions in MS and is usually a sign of disease progression. It plays a major role in the planning, initiation, and organization of movement via its influence on the motor cortex and corticospinal outputs. Therefore, it contributes to controlling movement, motor adaptation, and motor learning, in addition to its vast connections with other major pathways controlling balance, such as the cerebellopropriospinal pathways and cerebellovestibular pathways. Hence, trying to stimulate the cerebellum by facilitatory protocols will add to our motor control and balance function. Non-invasive brain stimulation, both repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), has recently emerged as effective neuromodulators to influence motor and nonmotor functions of the brain. Anodal tDCS has been shown to improve motor skill learning and motor performance beyond the training period. Similarly, rTMS, when used at high frequency (>5 Hz), has a facilitatory effect on the motor cortex. Objective: Our aim was to determine the effect of high-frequency rTMS over the cerebellum in improving balance and functional ambulation of multiple sclerosis patients with Ataxia. Patients and methods: This was a randomized single-blinded placebo-controlled prospective trial on 40 patients. The active group (N=20) received real rTMS sessions, and the control group (N=20) received Sham rTMS using a placebo program designed for this treatment. Both groups received 12 sessions of high-frequency rTMS over the cerebellum, followed by an intensive exercise training program. Sessions were given three times per week for four weeks. The active group protocol had a frequency of 10 Hz rTMS over the cerebellar vermis, work period 5S, number of trains 25, and intertrain interval 25s. The total number of pulses was 1250 pulses per session. The control group received Sham rTMS using a placebo program designed for this treatment. Both groups of patients received an intensive exercise program, which included generalized strengthening exercises, endurance and aerobic training, trunk abdominal exercises, generalized balance training exercises, and task-oriented training such as Boxing. As a primary outcome measure the Modified ICARS was used. Static Posturography was done with: Patients were tested both with open and closed eyes. Secondary outcome measures included the expanded Disability Status Scale (EDSS) and 8 Meter walk test (8MWT). Results: The active group showed significant improvements in all the functional scales, modified ICARS, EDSS, and 8-meter walk test, in addition to significant differences in static Posturography with open eyes, while the control group did not show such differences. Conclusion: Cerebellar high-frequency rTMS could be effective in the functional improvement of balance in MS patients with ataxia.

Keywords: brain neuromodulation, high frequency rTMS, cerebellar stimulation, multiple sclerosis, balance rehabilitation

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Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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Authors: Nicholas Pearce, Eun-jin Kim

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Pathologies of the cardiovascular (CV) system remain a serious and deadly health problem for human society. Computational modelling provides a relatively accessible tool for diagnosis, treatment, and research into CV disorders. However, numerical models of the CV system have largely focused on the function of the ventricles, frequently overlooking the behaviour of the atria. Furthermore, in the study of the pressure-volume relationship of the heart, which is a key diagnosis of cardiac vascular pathologies, previous works often evoke popular yet questionable time-varying elastance (TVE) method that imposes the pressure-volume relationship instead of calculating it consistently. Despite the convenience of the TVE method, there have been various indications of its limitations and the need for checking its validity in different scenarios. A model of the combined left ventricle (LV) and left atrium (LA) is presented, which consistently considers various feedback mechanisms in the heart without having to use the TVE method. Specifically, a synergistic model of the left ventricle is extended and modified to include the function of the LA. The synergy of the original model is preserved by modelling the electro-mechanical and chemical functions of the micro-scale myofiber for the LA and integrating it with the microscale and macro-organ-scale heart dynamics of the left ventricle and CV circulation. The atrioventricular node function is included and forms the conduction pathway for electrical signals between the atria and ventricle. The model reproduces the essential features of LA behaviour, such as the two-phase pressure-volume relationship and the classic figure of eight pressure-volume loops. Using this model, disorders in the internal cardiac electrical signalling are investigated by recreating the mechano-electric feedback (MEF), which is impossible where the time-varying elastance method is used. The effects of AV node block and slow conduction are then investigated in the presence of an atrial arrhythmia. It is found that electrical disorders and arrhythmia in the LA degrade the CV system by reducing the cardiac output, power, and heart rate.

Keywords: cardiovascular system, left atrium, numerical model, MEF

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Authors: Andinet Abera Hailu, Claudia Damu, Aregash Samuel, Saskia de Pee

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Introduction: Ethiopia has made considerable progress in reducing stunting, yet 39% of children under five remain affected. Child wasting, micronutrient deficiencies, and poor quality of diets for children and adults are the main challenges faced by Ethiopians. Availability and access to nutritious foods and potential scenarios to improve affordability were assessed. Methodology: The Fill the Nutrient Gap (FNG) methodology was used. Cost of the diet software was used to optimize the cost and affordability of nutritious diets for a typical household. Monthly food price data (November 2018 to October 2019) was used to calculate the cost of the diet. Modeling of interventions was performed to identify potential entry points for policy implementers. Non-affordability of the modeled diets was estimated. Average per capita diet-related greenhouse gas (GHG) footprints for current diets and modeled diet scenarios were also evaluated. Result: Almost all households would be able to afford energy-only diets. However, only 25% of households could afford a nutritious diet. Diets containing multiple nutrients would cost four times more than energy-sufficient diets. Nutritious diets tended to cost more in areas where fewer foods were found on local markets (correlation coefficient =-0.62). A modeling scenario performed on multiple interventions showed a reduced monthly cost of a nutritious diet. The GHG emissions of optimized diets that meet nutrient needs were below the country’s emission target. Conclusion: Adolescent girls and women were at risk of inadequate diets as the cost of meeting their nutrient requirements was highest. Diet costs were predominantly driven by requirements for vitamin B12, iron, and calcium. Improving access to nutrition can have implications for climate outcomes as well as nutrition.

Keywords: diet cost, affordability, modelling, environment

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Authors: Marcio S. da Silva, Jose Mauricio de B. Bezerra, Antonio E. de A. Nogueira

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This paper aims to make a performance analysis of shield wire transmission lines against atmospheric discharges when it is made the option of sectioning the shield wire and verify if the tolerability of the change. As a goal of this work, it was established to make complete modeling of a transmission line in the ATPDraw program with shield wire grounded in all the towers and in some towers. The methodology used to make the proposed evaluation was to choose an actual transmission line that served as a case study. From the choice of transmission line and verification of all its topology and materials, complete modeling of the line using the ATPDraw software was performed. Then several atmospheric discharges were simulated by striking the grounded shield wires in each tower. These simulations served to identify the behavior of the existing line against atmospheric discharges. After this first analysis, the same line was reconsidered with shield wire segmentation. The shielding wire segmentation technique aims to reduce induced losses in shield wires and is adopted in some transmission lines in Brazil. With the same conditions of atmospheric discharge the transmission line, this time with shield wire segmentation was again evaluated. The results obtained showed that it is possible to obtain similar performances against atmospheric discharges between a shield wired line in multiple towers and the same line with shield wire segmentation if some precautions are adopted as verification of the ground resistance of the wire segmented shield, adequacy of the maximum length of the segmented gap, evaluation of the separation length of the electrodes of the insulator spark, among others. As a conclusion, it is verified that since the correct assessment and adopted the correct criteria of adjustment a transmission line with shielded wire segmentation can perform very similar to the traditional use with multiple earths. This solution contributes in a very important way to the reduction of energy losses in transmission lines.

Keywords: atmospheric discharges, ATPDraw, shield wire, transmission lines

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Authors: Pengfei Meng, Shuangcheng Jia, Qian Li

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We proposed a real-time high-precision semantic segmentation network based on a multi-resolution feature fusion module, the auxiliary feature extracting module, upsampling module, and atrous spatial pyramid pooling (ASPP) module. We designed a feature fusion structure, which is integrated with sufficient features of different resolutions. We also studied the effect of side-branch structure on the network and made discoveries. Based on the discoveries about the side-branch of the network structure, we used a side-branch auxiliary feature extraction layer in the network to improve the effectiveness of the network. We also designed upsampling module, which has better results than the original upsampling module. In addition, we also re-considered the locations and number of atrous spatial pyramid pooling (ASPP) modules and modified the network structure according to the experimental results to further improve the effectiveness of the network. The network presented in this paper takes the backbone network of Bisenetv2 as a basic network, based on which we constructed a network structure on which we made improvements. We named this network deep multiple-resolution bilateral networks for real-time, referred to as DMBR-Net. After experimental testing, our proposed DMBR-Net network achieved 81.2% mIoU at 119FPS on the Cityscapes validation dataset, 80.7% mIoU at 109FPS on the CamVid test dataset, 29.9% mIoU at 78FPS on the COCOStuff test dataset. Compared with all lightweight real-time semantic segmentation networks, our network achieves the highest accuracy at an appropriate speed.

Keywords: multi-resolution feature fusion, atrous convolutional, bilateral networks, pyramid pooling

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Authors: Thani R. Said

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There is a wide concern on the academic literatures that the world is on course to experience “severe and pervasive” negative impacts from climate change unless it takes rapid action to slash its greenhouse gas emissions. The big threat however, is more belligerent in the third world countries, small islands states in particular. Most of the academic literatures claims that the livelihoods, economic and ecological landscapes of most of the coastal communities are into serious danger due to the peril of climate change. However, focusing the climate change alone and paying less intention to the surrounding stressors which sometimes are apparent then the climate change its self has now placed at the greater concern on academic debates. The recently studies have begun to question such narrowed assessment of climate change intervening programs from both its methodological and theoretical perspectives as related with livelihoods and the landscapes of the coastal communities. Looking climate as alone as an ostentatious threat doesn't yield the yield an appropriate mechanisms to address the problem in its totality and tend to provide the partially picture of the real problem striking the majority of the peoples living in the coastal areas of small islands states, Zanzibar in particular. By using the multiples human grounded knowledge approaches, the objective of this study is to go beyond the mere climate change by analyzing other multiples stressors that real challenging and treating the livelihoods, economic and ecological landscapes of the coastal communities through dialectic understanding, vulnerability and adaptive mechanisms at their own localities. To be more focus and to capture the full picture on this study special intention will be given to those areas were climate changes intervening programs have been onto place, the study will further compare and contrast between the two islands communities, Unguja and Pemba taking into account their respective diverse economic and geographical landscapes prevailed.

Keywords: climate change, multiple stressors, livelihoods, vulnerability-adaptation

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Authors: Lynn Mcquarrie, Charlotte Enns

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The goal of this project was to develop a visually-based, signed language phonological awareness training program and to pilot the intervention with signing deaf children (ages 6 -10 years/ grades 1 - 4) who were beginning readers to assess the effects of systematic explicit American Sign Language (ASL) phonological instruction on both ASL vocabulary and English print vocabulary learning. Growing evidence that signing learners utilize visually-based signed language phonological knowledge (homologous to the sound-based phonological level of spoken language processing) when reading underscore the critical need for further research on the innovation of reading instructional practices for visual language learners. Multiple single-case studies using a multiple probe design across content (i.e., sign and print targets incorporating specific ASL phonological parameters – handshapes) was implemented to examine if a functional relationship existed between instruction and acquisition of these skills. The results indicated that for all cases, representing a variety of language abilities, the visually-based phonological teaching approach was exceptionally powerful in helping children to build their sign and print vocabularies. Although intervention/teaching studies have been essential in testing hypotheses about spoken language phonological processes supporting non-deaf children’s reading development, there are no parallel intervention/teaching studies exploring hypotheses about signed language phonological processes in supporting deaf children’s reading development. This study begins to provide the needed evidence to pursue innovative teaching strategies that incorporate the strengths of visual learners.

Keywords: American sign language phonological awareness, dual language strategies, vocabulary learning, word reading

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Authors: Bagher Bayat, Wouter Verhoef, Behnaz Arabi, Christiaan Van der Tol

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The aim of this study was to follow the canopy reflectance patterns in response to soil water deficit and to detect trends of changes in biophysical and biochemical parameters of grass (Poa pratensis species). We used visual interpretation, imaging spectroscopy and radiative transfer model inversion to monitor the gradual manifestation of water stress effects in a laboratory setting. Plots of 21 cm x 14.5 cm surface area with Poa pratensis plants that formed a closed canopy were subjected to water stress for 50 days. In a regular weekly schedule, canopy reflectance was measured. In addition, Leaf Area Index (LAI), Chlorophyll (a+b) content (Cab) and Leaf Water Content (Cw) were measured at regular time intervals. The 1-D bidirectional canopy reflectance model SAIL, coupled with the leaf optical properties model PROSPECT, was inverted using hyperspectral measurements by means of an iterative optimization method to retrieve vegetation biophysical and biochemical parameters. The relationships between retrieved LAI, Cab, Cw, and Cs (Senescent material) with soil moisture content were established in two separated groups; stress and non-stressed. To differentiate the water stress condition from the non-stressed condition, a threshold was defined that was based on the laboratory produced Soil Water Characteristic (SWC) curve. All parameters retrieved by model inversion using canopy spectral data showed good correlation with soil water content in the water stress condition. These parameters co-varied with soil moisture content under the stress condition (Chl: R2= 0.91, Cw: R2= 0.97, Cs: R2= 0.88 and LAI: R2=0.48) at the canopy level. To validate the results, the relationship between vegetation parameters that were measured in the laboratory and soil moisture content was established. The results were totally in agreement with the modeling outputs and confirmed the results produced by radiative transfer model inversion and spectroscopy. Since water stress changes all parts of the spectrum, we concluded that analysis of the reflectance spectrum in the VIS-NIR-MIR region is a promising tool for monitoring water stress impacts on vegetation.

Keywords: hyperspectral remote sensing, model inversion, vegetation responses, water stress

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Authors: Hana Porkertová, Pavel Doboš

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Based on a research project studying the experience of visually disabled people with urban space in the Czech Republic, the conference contribution discusses the limits of social-science methodologies used in sociology and human geography. It draws on actor-network theory, assuming that science does not describe reality but produces it. Methodology connects theory, research questions, ways to answer them (methods), and results. A research design utilizing ableist methodologies can produce ableist realities. Therefore, it was necessary to adjust the methods so that they could mediate blind experience to the scientific community without reproducing ableism. The researchers faced multiple challenges, ranging from questionable validity to how to research experience that differs from that of the researchers who are able-bodied. Finding a suitable theory that could be used as an analytical tool that would demonstrate space and blind experience as multiple, dynamic, and mutually constructed was the first step that could offer a range of potentially productive methods and research questions, as well as bring critically reflected results. Poststructural theory, mainly Deleuze-Guattarian philosophy, was chosen, and two methods were used: interviews and go-along interviews that had to be adjusted to be able to explore blind experience. In spite of a thorough preparation of these methods, new difficulties kept emerging, which exposed the ableist character of scientific knowledge. From the beginning of data collecting, there was an agreement to work in teams with slightly different roles of each of the researchers, which was significant especially during go-along interviews. In some cases, the anticipations of the researchers and participants differed, which led to unexpected and potentially dangerous situations. These were not caused only by the differences between scientific and lay communities but also between able-bodied and disabled people. Researchers were sometimes assigned to the assistants’ roles, and this new position – doing research together – required further negotiations, which also opened various ethical questions.

Keywords: ableist methodology, blind experience, go-along interviews, research ethics, scientific knowledge

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Authors: Alison Marshall

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“Santo Niño in Canada – Religion, Migration, and the Filipino Underside” seeks to explore the intersection of religion, migration and the Filipino underside through research participant narratives, archival research, and fieldwork on the cult of Santo Niño in Canada. Santo Niño is the single most revered saint in Filipino religiosity. According to popular lore, the original statue of Santo Niño was brought to the Philippines by Portuguese explorer Ferdinand Magellan in 1521, who claimed the islands on behalf of Spain. While Santo Niño is meant to be a manifestation of Jesus as a child, in Filipino thought and culture he very much resembles pre-Hispanic spirits, as well as patron saints introduced by the Spanish. Santo Niño shrines appear in churches, restaurants, businesses, and homes throughout the diaspora suggesting that he was much more than a Catholic image. He represents a deity who often shares a business or home shrine with non-Christian statues such as lucky cats, the Buddha, Guanyin, and Guangong, and sometimes the Chinese God of the Earth. He represents how Christian culture has been refashioned through indigenous, Chinese, Malay, and Indonesian influences. He embodies the religious superstructure that defines Christian piety and habits. On the one hand, he stands for Jesus, a pious son of God, and yet, on the other hand, he can be a simple vindictive child who punishes those who ignore him. Santo Niño is a complex character linked to the past before Christianity. As Filipinos engage with Santo Niño in Canada, they connect to him as Jesus, the son of God. They are also connecting to a childlike figure who sometimes uses his spiritual power to punish. A hybrid figure who comes came into being at the beginning of the Spanish colonial moment, he is maintained throughout the American one and continues to be a powerful reminder of Filipino identity and resilience when people leave the Philippines for migrant work. As this paper argues, Santo Niño beliefs, practices, and stories unite people in the diaspora regardless of language, gender, or nation. Santo Niño enables one to think about and understand what it means to be Filipino and living migrant lives in the diaspora today. In this way, the cult of Santo Niño expresses both Catholic orthodoxy and the heterodox Filipino underside that includes the use of magical amulets, healing, visions, and spirit mediumship.

Keywords: ethnography, migration, Philippines, religion

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Authors: Matej Patzelt, Jana Mrzilkova, Jan Dudak, Frantisek Krejci, Jan Zemlicka, Zdenek Wurst, Petr Zach, Vladimir Musil

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Introduction: Micro-CT is well used for examination of bone structures and teeth. On the other hand visualization of the soft tissues is still limited. The goal of our study was to elaborate methodology for soft tissue samples imaging in micro-CT. Methodology: We used organs of rats and mice. We either did a preparation of the organs and fixation in contrast solution or we did cannulation of blood vessels and their injection for imaging of the vascular system. First, we scanned native specimens, then we created corrosive specimens by resins. In the next step, we injected vascular system either by Aurovist contrast agent or by Exitron. In the next step, we focused on soft tissues contrast increase. We scanned samples fixated in Lugol solution, samples fixated in pure ethanol and in formaldehyde solution. All used methods were afterwards compared. Results: Native specimens did not provide sufficient contrast of the tissues in any of organs. Corrosive samples of the blood stream provided great contrast and details; on the other hand, it was necessary to destroy the organ. Further examined possibility was injection of the AuroVist contrast that leads to the great bloodstream contrast. Injection of Exitron contrast agent comparing to Aurovist did not provide such a great contrast. The soft tissues (kidney, heart, lungs, brain, and liver) were best visualized after fixation in ethanol. This type of fixation showed best results in all studied tissues. Lugol solution had great results in muscle tissue. Fixation by formaldehyde solution showed similar quality of contrast in the tissues like ethanol. Conclusion: Before imaging, we need to, first, determinate which structures of the soft tissues we want to visualize. In the case of the bloodstream, the best was AuroVist and corrosive specimens. Muscle tissue is best visualized by Lugol solution. In the case of the organs containing cavities, like kidneys or brain, the best way was ethanol fixation.

Keywords: experimental imaging, fixation, micro-CT, soft tissues

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Authors: Rodrigo T. Lourenço, Margarida Mano

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Higher Education Institutions (HEI), and other levels of Education, face important challenges. One of the most relevant one is the ability to adapt to a society that is changing over time, whilst guarantying levels of training that do not merely react to such changes. Thus, interacting with society, particularly with surrounding communities and key stakeholders, has become an essential requirement for the sustainability of these institutions. One of the formal mechanisms implemented in European educational institutions has been the design of organizational structures that include a top governance body sharing its constitution with both internal members, students and external members. Such frame holds the core mission of involving communities in the governance of educational institutions, assuming, both strategic decision-making functions, with the approval of the institutions’ strategic plans, and a supervision function, approved by activity reports. It also plays an essential role in the life of institutions by holding the responsibility of electing its top executives. In Portugal, it has been almost a decade since the publication of RJIES, the legal framework of Higher Education, such bodies being designated by General Councils. Thus, one may highlight that there has been a better understanding of the operative process of these bodies, as well as their added value to the education system. It has also been possible to analyse the extent to which their core mission has been fulfilled and to understand its growing relevance, particularly regarding the autonomy of institutions. This article aims to contribute to this theme by presenting the results of a study on the role of these bodies in the governance of Public Portuguese HEI, with a special focus on the supervisory competence of organizational performance. Through questionnaires made to board members and interviews with chairpersons of the bodies and top managers of the institutions, it was possible to conclude that there is a high concern with the connections to the external environment. However, regarding organizational performance and the role of the Council as a supervisor of that performance, the activity of the bodies has fallen short of what would be expected. Several reasons may be identified. It is important to emphasize the importance of the profile of the external members and the relationship between the organ’s standard functioning and the election of the head of the institution.

Keywords: governance, stakeholders, supervision, performance

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Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

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The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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Authors: Sanjal Gavande, Thomas Mazzuchi, Shahram Sarkani

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In a complex aerospace operational environment, identifying failures in a procedure involving multiple human-machine interactions are difficult. These failures could lead to accidents causing loss of hardware or human life. The likelihood of failure further increases if operational procedures are tested for a novel system with multiple human-machine interfaces and with no prior performance data. The existing approach in the literature of reviewing complex operational tasks in a flowchart or tabular form doesn’t provide any insight into potential system failures due to human decision-making ability. To address these challenges, this research explores an agent-based simulation approach for reliability assessment and fault detection in complex human-machine systems while utilizing a human decision-making model. The simulation will predict the emergent behavior of the system due to the interaction between humans and their decision-making capability with the varying states of the machine and vice-versa. Overall system reliability will be evaluated based on a defined set of success-criteria conditions and the number of recorded failures over an assigned limit of Monte Carlo runs. The study also aims at identifying high-likelihood failure locations for the system. The research concludes that system reliability and failures can be effectively calculated when individual human and machine agent states are clearly defined. This research is limited to the operations phase of a system lifecycle process in an aerospace environment only. Further exploration of the proposed agent-based and human decision-making model will be required to allow for a greater understanding of this topic for application outside of the operations domain.

Keywords: agent-based model, complex human-machine system, human decision-making model, system reliability assessment

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Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

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Authors: Gyeongbeom Yi

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The purpose of this study is to introduce the analytic solution for determining the optimal capacity (lot-size) of a multiproduct, multistage production and inventory system to meet the finished product demand. Reasonable decision-making about the capacity of processes and storage units is an important subject for industry. The industrial solution for this subject is to use the classical economic lot sizing method, EOQ/EPQ (Economic Order Quantity/Economic Production Quantity) model, incorporated with practical experience. However, the unrealistic material flow assumption of the EOQ/EPQ model is not suitable for chemical plant design with highly interlinked processes and storage units. This study overcomes the limitation of the classical lot sizing method developed on the basis of the single product and single stage assumption. The superstructure of the plant considered consists of a network of serially and/or parallelly interlinked processes and storage units. The processes involve chemical reactions with multiple feedstock materials and multiple products as well as mixing, splitting or transportation of materials. The objective function for optimization is minimizing the total cost composed of setup and inventory holding costs as well as the capital costs of constructing processes and storage units. A novel production and inventory analysis method, PSW (Periodic Square Wave) model, is applied. The advantage of the PSW model comes from the fact that the model provides a set of simple analytic solutions in spite of a realistic description of the material flow between processes and storage units. The resulting simple analytic solution can greatly enhance the proper and quick investment decision for plant design and operation problem confronted in diverse economic situations.

Keywords: analytic solution, optimal design, process-storage network

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