Search results for: early childhood education and care

Authors: Zahra Kazemi Saleh, Bénédicte Poulin-Charronnat, Annie Vinter

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This study examines the effects of aging on visual statistical learning, using eye-tracking techniques to investigate this cognitive phenomenon. Visual statistical learning is a fundamental brain function that enables the automatic and implicit recognition, processing, and internalization of environmental patterns over time. Some previous research has suggested the robustness of this learning mechanism throughout the aging process, underscoring its importance in the context of education and rehabilitation for the elderly. The study included three distinct groups of participants, including 21 young adults (Mage: 19.73), 20 young-old adults (Mage: 67.22), and 17 old-old adults (Mage: 79.34). Participants were exposed to a series of 12 arbitrary black shapes organized into 6 pairs, each with different spatial configurations and orientations (horizontal, vertical, and oblique). These pairs were not explicitly revealed to the participants, who were instructed to passively observe 144 grids presented sequentially on the screen for a total duration of 7 min. In the subsequent test phase, participants performed a two-alternative forced-choice task in which they had to identify the most familiar pair from 48 trials, each consisting of a base pair and a non-base pair. Behavioral analysis using t-tests revealed notable findings. The mean score for the first group was significantly above chance, indicating the presence of visual statistical learning. Similarly, the second group also performed significantly above chance, confirming the persistence of visual statistical learning in young-old adults. Conversely, the third group, consisting of old-old adults, showed a mean score that was not significantly above chance. This lack of statistical learning in the old-old adult group suggests a decline in this cognitive ability with age. Preliminary eye-tracking results showed a decrease in the number and duration of fixations during the exposure phase for all groups. The main difference was that older participants focused more often on empty cases than younger participants, likely due to a decline in the ability to ignore irrelevant information, resulting in a decrease in statistical learning performance.

Keywords: aging, eye tracking, implicit learning, visual statistical learning

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Authors: Irakli Gamkrelidze, David Shengelia, Giorgi Chichinadze, Tamara Tsutsunava, Giorgi Beridze, Tamara Tsamalashvili, Ketevan Tedliashvili, Irakli Javakhishvili

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The Caucasus is situated between the Eurasian and Africa-Arabian plates and represents a component of the Mediterranean (Alpine-Himalayan) collision belt. The Loki crystalline massif crops out within one of the terranes of the Caucasus – Baiburt-Sevanian terrane. By the end of 2018, a digital geological map (1:50 000) of the Loki massif was compiled. The presented map is of great importance for the region since there is no large-scale geological map which reflects the present standards of the geological study of the massif up to the last time. The existing State Geological Map of the Loki massif is very outdated. A new map drown by using GIS (Geographic Information System) technology is loaded with multi-informative details that include: specified contours of geological units and separate tectonic scales, key mineral assemblages and facies of metamorphism, temperature conditions of metamorphism, ages of metamorphism events and the massif rocks, genetic-geodynamic types of magmatic rocks. Explanatory note, attached to the map includes the large specter of scientific information. It contains characterization of the geological setting, composition and petrogenetic and geodynamic models of the massif formation. To create a geological map of the Loki crystalline massif, appropriate methodologies were applied: a sampling of rocks, GIS technology-based mapping of geological units, microscopic description of the material, composition analysis of rocks, microprobe analysis of minerals and a new interpretation of obtained data. To prepare a digital version of the map the appropriated activities were held including the creation of a common database. Finally, the design was created that includes the elaboration of legend and the final visualization of the map. The results of the study presented in the explanatory note are given below. The autochthonous gneissose quartz diorites of normal alkalinity and sub-alkaline gabbro-diorites included in them belong to different phases of magmatism. They represent “igneous” granites corresponding to mixed mantle-crustal type granites. Four tectonic plates of the allochthonous metamorphic complex–Lower Gorastskali, Sapharlo–Lok-Jandari, Moshevani, and Lower Gorastskali differ from each other by structure and degree of metamorphism. The initial rocks of these plates are formed in different geodynamic conditions and during the Early Bretonian orogeny while overthrusting due to tectonic compression they form a thick tectonic sheet. The Lower Gorastskali overthrust sheet is a fragment of ophiolitic association corresponding to the Paleotethys oceanic crust. The protolith of the ophiolitic complex basites corresponds to the tholeiitic series of basalts. The Sapharlo–Lok-Jandari overthrust sheet is metapelites, metamorphosed in conditions of greenschist facies of regional metamorphism. The regional metamorphism of Moshevani overthrust sheet crystalline schists quartzites corresponds to a range from greenschist to hornfels facies. The “mélange” is built of rock fragments and blocks of above-mentioned overthrust sheets. Sub-alkaline and normal alkaline post-metamorphic granites of the Loki crystalline massif belong to “igneous” and rarely to “sialic” and “anorogenic” types of granites.

Keywords: digital geological map, 1:50 000 scale, crystalline massif, the caucasus

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Authors: Siti Salina Abdullah

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Drug abuse is a global problem that affects individuals everywhere. The onset of drug use is usually during adolescence. The use of most drugs has been found to be more prevalent among adolescents than among adults. Drug abuse among adolescents is receiving more attention from parents, friends, communities, and policymakers. Adolescent drug use has been linked to higher rates of physical and mental illness, as well as decreased overall health and well-being. Furthermore, adolescents who use drugs are more susceptible to addiction. The increasing trend of drug use among young generations, particularly in Malaysia, is causing significant concerns. Adolescent drug use is commonly linked to peers, environment, and families. The National Anti-Drugs Agency (NADA) is the main agency in Malaysia that works with the Ministry of Home Affairs to prevent drug and substance abuse. NADA operates by providing preventive drug education, enforcement and security measures, treatment, medical rehabilitation, and international relations. The objective of this study is to examine the involvement of parents living in high-risk drug environments in drug prevention programs. It also discusses the difficulties they face when participating in drug prevention programs. This study was conducted in high-risk areas identified by National Anti-Drug Agencies (Malaysia). A total of 515 drug-free parents were interviewed in this study. The findings showed that B40 families were the majority among families living in high-risk drug environments. The study shows that drug prevention programs have a low participation rate among respondents. Previous research has demonstrated that drug prevention programs have a low rate of participation. The NADA campaign 'Prevention Start from Home' requires that this issue is addressed. To ensure that this campaign works, families, especially those at risk, should be empowered to participate in drug prevention programs. To fight drug problems among teenagers, it is crucial for families to take the first step in conducting prevention measures. To ensure that families with young children are equipped with drug prevention information, more advocacy programs are required. In addition, the drug prevention program should be accessible and reachable to families.

Keywords: drug prevention program, drug abuse, family, malaysia

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Authors: B. Donkova, M. Nedyalkova, D. Mehandjiev

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Sparingly soluble manganese oxalate is an appropriate precursor for the preparation of nanosized manganese oxides, which have a wide range of technological application. During the precipitation of manganese oxalate, three crystal forms could be obtained – α-MnC₂O₄.2H₂O (SG C2/c), γ-MnC₂O₄.2H₂O (SG P212121) and orthorhombic MnC₂O₄.3H₂O (SG Pcca). The thermolysis of α-MnC₂O₄.2H₂O has been extensively studied during the years, while the literature data for the other two forms has been quite scarce. The aim of the present communication is to highlight the influence of the initial crystal structure on the decomposition mechanism of these three forms, their magnetic properties, the structure of the anhydrous oxalates, as well as the nature of the obtained oxides. For the characterization of the samples XRD, SEM, DTA, TG, DSC, nitrogen adsorption, and in situ magnetic measurements were used. The dehydration proceeds in one step with α-MnC₂O₄.2H2O and γ-MnC₂O₄.2H₂O, and in three steps with MnC₂O₄.3H2O. The values of dehydration enthalpy are 97, 149 and 132 kJ/mol, respectively, and the last two were reported for the first time, best to our knowledge. The magnetic measurements show that at room temperature all samples are antiferomagnetic, however during the dehydration of α-MnC₂O₄.2H₂O the exchange interaction is preserved, for MnC₂O₄.3H₂O it changes to ferromagnetic above 35°C, and for γ-MnC₂O₄.2H₂O it changes twice from antiferomagnetic to ferromagnetic above 70°C. The experimental results for magnetic properties are in accordance with the computational results obtained with Wien2k code. The difference in the initial crystal structure of the forms used determines different changes in the specific surface area during dehydration and different extent of Mn(II) oxidation during decomposition in the air; both being highest at α-MnC₂O₄.2H₂O. The isothermal decomposition of the different oxalate forms shows that the type and physicochemical properties of the oxides, obtained at the same annealing temperature depend on the precursor used. Based on the results from the non-isothermal and isothermal experiments, and from different methods used for characterization of the sample, a comparison of the nature, mechanism and peculiarities of the thermolysis of the different crystal forms of manganese oxalate was made, which clearly reveals the influence of the initial crystal structure. Acknowledgment: 'Science and Education for Smart Growth', project BG05M2OP001-2.009-0028, COST Action MP1306 'Modern Tools for Spectroscopy on Advanced Materials', and project DCOST-01/18 (Bulgarian Science Fund).

Keywords: crystal structure, magnetic properties, manganese oxalate, thermal behavior

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Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

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Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

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Authors: Carmen García Sánchez

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The UN's 17 Sustainable Development Goals – specifically the nº 3 and nº 11- urgently call for new architectural design solutions at different design scales to increase human contact with nature in the health and wellbeing promotion of primarily urban communities. The discipline of Interior Design offers an important alternative to large-scale nature-inclusive actions which are not always possible due to space limitations. These circumstances provide an immense opportunity to integrate biophilic design, a complex emerging and under-developed approach that pursues sustainable design strategies for increasing the human-nature connection through the experience of the built environment. Biophilic design explores the diverse ways humans are inherently inclined to affiliate with nature, attach meaning to and derive benefit from the natural world. It represents a biological understanding of architecture which categorization is still in progress. The internationally renowned Danish domestic architecture built in the 1950´s and early 1960´s - a golden age of Danish modern architecture - left a leading legacy that has greatly influenced the domestic sphere and has further led the world in terms of good design and welfare. This study examines how four existing post-war domestic buildings establish a dialogue with nature and her variations over time. The case-studies unveil both memorable and unique biophilic resources through sophisticated and original design expressions, where transformative processes connect the users to the natural setting and reflect fundamental ways in which they attach meaning to the place. In addition, fascinating analogies in terms of this nature interaction with particular traditional Japanese architecture inform the research. They embody prevailing lessons for our time today. The research methodology is based on a thorough literature review combined with a phenomenological analysis into how these case-studies contribute to the connection between humans and nature, after conducting fieldwork throughout varying seasons to document understanding in nature transformations multi-sensory perception (via sight, touch, sound, smell, time and movement) as a core research strategy. The cases´ most outstanding features have been studied attending the following key parameters: 1. Space: 1.1. Relationships (itineraries); 1.2. Measures/scale; 2. Context: Context: Landscape reading in different weather/seasonal conditions; 3. Tectonic: 3.1. Constructive joints, elements assembly; 3.2. Structural order; 4. Materiality: 4.1. Finishes, 4.2. Colors; 4.3. Tactile qualities; 5. Daylight interplay. Departing from an artistic-scientific exploration this groundbreaking study provides sustainable practical design strategies, perspectives, and inspiration to boost humans´ contact with nature through the experience of the interior built environment. Some strategies are associated with access to outdoor space or require ample space, while others can thrive in a dense urban context without direct access to the natural environment. The objective is not only to produce knowledge, but to phase in biophilic design in the built environment, expanding its theory and practice into a new dimension. Its long-term vision is to efficiently enhance the health and well-being of urban communities through daily interaction with Nature.

Keywords: sustainability, biophilic design, architectural design, interior design, nature, Danish architecture, Japanese architecture

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Authors: Abdulaziz Alakeel, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Methotrexate (MTX) is an antimetabolite used to treat multiple conditions, including neoplastic diseases, severe psoriasis, and rheumatoid arthritis. Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The aim of this review is to evaluate the risk of skin cancer associated with the use of methotrexate and to suggest regulatory recommendations if required. Methodology: Signal Detection team at Saudi Food and Drug Authority (SFDA) performed a safety review using National Pharmacovigilance Center (NPC) database as well as the World Health Organization (WHO) VigiBase, alongside with literature screening to retrieve related information for assessing the causality between skin cancer and methotrexate. The search conducted in July 2020. Results: Four published articles support the association seen while searching in literature, a recent randomized control trial published in 2020 revealed a statistically significant increase in skin cancer among MTX users. Another study mentioned methotrexate increases the risk of non-melanoma skin cancer when used in combination with immunosuppressant and biologic agents. In addition, the incidence of melanoma for methotrexate users was 3-fold more than the general population in a cohort study of rheumatoid arthritis patients. The last article estimated the risk of cutaneous malignant melanoma (CMM) in a cohort study shows a statistically significant risk increase for CMM was observed in MTX exposed patients. The WHO database (VigiBase) searched for individual case safety reports (ICSRs) reported for “Skin Cancer” and 'Methotrexate' use, which yielded 121 ICSRs. The initial review revealed that 106 cases are insufficiently documented for proper medical assessment. However, the remaining fifteen cases have extensively evaluated by applying the WHO criteria of causality assessment. As a result, 30 percent of the cases showed that MTX could possibly cause skin cancer; five cases provide unlikely association and five un-assessable cases due to lack of information. The Saudi NPC database searched to retrieve any reported cases for the combined terms methotrexate/skin cancer; however, no local cases reported up to date. The data mining of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by the WHO Uppsala Monitoring Centre to measure the reporting ratio. Positive IC reflects higher statistical association, while negative values translated as a less statistical association, considering the null value equal to zero. Results showed that a combination of 'Methotrexate' and 'Skin cancer' observed more than expected when compared to other medications in the WHO database (IC value is 1.2). Conclusion: The weighted cumulative pieces of evidence identified from global cases, data mining, and published literature are sufficient to support a causal association between the risk of skin cancer and methotrexate. Therefore, health care professionals should be aware of this possible risk and may consider monitoring any signs or symptoms of skin cancer in patients treated with methotrexate.

Keywords: methotrexate, skin cancer, signal detection, pharmacovigilance

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Authors: Pinn Tsin Isabel Yee

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With the advent of internet technologies, students are increasingly turning toward social media and cross-platform messaging apps such as WhatsApp, Line, and WeChat to support their teaching and learning processes. Although each messaging app has varying features, WhatsApp remains one of the most popular cross-platform apps that allow for fast, simple, secure messaging and free calls anytime, anywhere. With a plethora of advantages, students could easily assimilate WhatsApp as a supportive technology in their learning process. There could be peer to peer learning, and a teacher will be able to share knowledge digitally via the creation of WhatsApp groups. Content analysis techniques were utilized to analyze data collected by closed-ended question forms. Studies demonstrated that 98.8% of college students (n=80) from the Monash University foundation year agreed that the employment of WhatsApp groups was helpful as a learning tool. Approximately 71.3% disagreed that notifications and alerts from the WhatsApp group were disruptions in their studies. Students commented that they could silence the notifications and hence, it would not disturb their flow of thoughts. In fact, an overwhelming majority of students (95.0%) found it enjoyable to participate in WhatsApp groups for educational purposes. It was a common perception that some students felt pressured to post a reply in such groups, but data analysis showed that 72.5% of students did not feel pressured to comment or reply. It was good that 93.8% of students felt satisfactory if their posts were not responded to speedily, but was eventually attended to. Generally, 97.5% of students found it useful if their teachers provided their handphone numbers to be added to a WhatsApp group. If a teacher posts an explanation or a mathematical working in the group, all students would be able to view the post together, as opposed to individual students asking their teacher a similar question. On whether students preferred using Facebook as a learning tool, there was a 50-50 divide in the replies from the respondents as 51.3% of students liked WhatsApp, while 48.8% preferred Facebook as a supportive technology in teaching and learning. Taken altogether, the utilization of WhatsApp groups as a supportive technology in teaching and learning should be implemented in all classes to continuously engage our generation Y students in the ever-changing digital landscape.-

Keywords: education, learning, messaging app, technology, WhatsApp groups

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Authors: Grace Scaplehorn, Muhammad Adeel Akhtar, Jane Gibson

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Background: Canoe Slalom entails the skilful navigation of a carbon composite canoe or kayak through a series of 18-25 hanging gates, strategically positioned along the course, either upstream or downstream, amidst currents of whitewater rapids in natural and man-made river settings. Athletes compete individually in timed trials, competing for the fastest course time, typically around 80 to 120 seconds. In the new discipline of Kayak Cross, descents of the course are initiated by groups of four athletes freefalling simultaneously from a starting platform situated 3m above the river. Kayak Cross athletes, in contrast to Canoe Slalom, can make physical contact with suspended gates without incurring time penalties and are required to perform a kayak roll half way down the course. The Canoe Slalom World Championships were held at Lee Valley Whitewater Centre, London, from 19th to 24th September 2023. The event comprised 299 international athletes competing for 10 World Championship titles in Canoe/Kayak Slalom events (Olympic Debut Munich 1972), and the new Kayak Cross discipline (Olympic Debut Paris 2024). The inaugural appearance of Kayak Cross at the World Championships occurred in 2017, in Pau, France. There is limited literature surrounding Kayak Cross and the incidence of athlete injuries compared to traditional Canoe Slalom, hence it was felt important to undertake this review to address the perception that the event is dangerous. Aim: The study aimed to quantify and collate data collected from athletes presenting to the event medical centre. Methods: Athletes’ details were collected at initial assessments from the start of the practice period (16th–18th September) and throughout the event. Demographics such as age, sex and nationality were recorded along with presenting complaints, treatment, medication administered and outcome. Specifically, injuries were then sub-classified into body regions. The data does not include athletes who sought medical attention from their own governing body’s medical team. Results: During the 8-day period, there were 11 individual presentations to the medical centre, 3.7% of the athlete population (n=299). The mean age was 23.9 years (n=7), 6 were male (n=10). The most common presentation was minor injury (n=9), with 6 being musculoskeletal and 3 comprising skin damage, followed by insect sting/allergy (n=1) and pain relief requests (n=1). Five presentations were event-related, all being musculoskeletal injuries; 2 shoulder/arm, 1 head/neck, 1 hand/wrist and 1 other (data was not recorded). Of these injuries, the only intervention was 2 cases of 400mg Ibuprofen, which was given to both shoulder/arm injuries. Four of the 11 presentations were pre-existing injuries, which had been exacerbated due to increased intensity of practice. Two patients were advised to return for review, with 100% compliance. There were no unplanned re-presentations, and no emergency transfers to secondary care. Both the Kayak Cross and Canoe Slalom competitions resulted in 1 new event-related athlete presentation each. Conclusion: The event resulted in a negligible incidence of presentations at the medical centre, for both Kayak Cross and Canoe Slalom. This data holds significance in informing risk assessments and medical protocols necessary for the organisation of canoe slalom events.

Keywords: canoe slalom, kayak cross, athlete injuries, event injuries

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Authors: Mehravar Javid, Sadrieh Khajavi Mazanderani, Kelly Gleischman, Zoe Andris

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The present study was conducted with the aim of investigating the effectiveness of transactional analysis group training on self-knowledge and Its dimensions (self, child, and adult) in counselors working in public and private high schools in Tehran. Counseling has become an important job for society, and there is a need for consultants in organizations. Providing better and more efficient counseling is one of the goals of the education system. The personal characteristics of counselors are important for the success of the therapy. In TA, humans have three ego states, which are named parent, adult, and child, and the main concept in the transactional analysis is self-state, which means a stable feeling and pattern of thinking related to behavioral patterns. Self-knowledge, considered a prerequisite to effective communication, fosters psychological growth, and recognizing it, is pivotal for emotional development, leading to profound insights. The research sample included 30 working counselors (22 women and 8 men) in the academic year 2019-2020 who achieved the lowest scores on the self-knowledge questionnaire. The research method was quasi-experimental with a control group (15 people in the experimental group and 15 people in the control group). The research tool was a self-awareness questionnaire with 29 questions and three subscales (child, parent, and adult Ego state). The experimental group was exposed to transactional analysis training for 10 once-weekly 2-hour sessions; the questionnaire was implemented in both groups (post-test). Multivariate covariance analysis was used to analyze the data. The data showed that the level of self-awareness of counselors who received transactional analysis training is higher than that of counselors who did not receive any training (p<0.01). The result obtained from this analysis shows that transactional analysis training is an effective therapy for enhancing self-knowledge and its subscales (Adult ego state, Parent ego state, and Child ego state). Teaching transactional analysis increases self-knowledge, and self-realization and helps people to achieve independence and remove irresponsibility to improve intra-personal and interpersonal relationships.

Keywords: ego state, group, transactional analysis, self-knowledge

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Authors: Parag Katira, Frederika Rentzeperis, Zuzanna Nowicka, Giada Fiandaca, Thomas Veith, Jack Farinhas, Noemi Andor

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Resource limitations shape the outcome of competitions between genetically heterogeneous pre-malignant cells. One example of such heterogeneity is in the ploidy (DNA content) of pre-malignant cells. A whole-genome duplication (WGD) transforms a diploid cell into a tetraploid one and has been detected in 28-56% of human cancers. If a tetraploid subclone expands, it consistently does so early in tumor evolution, when cell density is still low, and competition for nutrients is comparatively weak – an observation confirmed for several tumor types. WGD+ cells need more resources to synthesize increasing amounts of DNA, RNA, and proteins. To quantify resource limitations and how they relate to ploidy, we performed a PAN cancer analysis of WGD, PET/CT, and MRI scans. Segmentation of >20 different organs from >900 PET/CT scans were performed with MOOSE. We observed a strong correlation between organ-wide population-average estimates of Oxygen and the average ploidy of cancers growing in the respective organ (Pearson R = 0.66; P= 0.001). In-vitro experiments using near-diploid and near-tetraploid lineages derived from a breast cancer cell line supported the hypothesis that DNA content influences Glucose- and Oxygen-dependent proliferation-, death- and migration rates. To model how subpopulations with variable DNA content compete in the resource-limited environment of the human brain, we developed a stochastic state-space model of the brain (S3MB). The model discretizes the brain into voxels, whereby the state of each voxel is defined by 8+ variables that are updated over time: stiffness, Oxygen, phosphate, glucose, vasculature, dead cells, migrating cells and proliferating cells of various DNA content, and treat conditions such as radiotherapy and chemotherapy. Well-established Fokker-Planck partial differential equations govern the distribution of resources and cells across voxels. We applied S3MB on sequencing and imaging data obtained from a primary GBM patient. We performed whole genome sequencing (WGS) of four surgical specimens collected during the 1ˢᵗ and 2ⁿᵈ surgeries of the GBM and used HATCHET to quantify its clonal composition and how it changes between the two surgeries. HATCHET identified two aneuploid subpopulations of ploidy 1.98 and 2.29, respectively. The low-ploidy clone was dominant at the time of the first surgery and became even more dominant upon recurrence. MRI images were available before and after each surgery and registered to MNI space. The S3MB domain was initiated from 4mm³ voxels of the MNI space. T1 post and T2 flair scan acquired after the 1ˢᵗ surgery informed tumor cell densities per voxel. Magnetic Resonance Elastography scans and PET/CT scans informed stiffness and Glucose access per voxel. We performed a parameter search to recapitulate the GBM’s tumor cell density and ploidy composition before the 2ⁿᵈ surgery. Results suggest that the high-ploidy subpopulation had a higher Glucose-dependent proliferation rate (0.70 vs. 0.49), but a lower Glucose-dependent death rate (0.47 vs. 1.42). These differences resulted in spatial differences in the distribution of the two subpopulations. Our results contribute to a better understanding of how genomics and microenvironments interact to shape cell fate decisions and could help pave the way to therapeutic strategies that mimic prognostically favorable environments.

Keywords: tumor evolution, intra-tumor heterogeneity, whole-genome doubling, mathematical modeling

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Authors: Maria Dora Horvath, Norbert Buzas, Zsanett Tesch

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Diabetes management poses many unique challenges for children and their parents. The use of a diabetes management device should not be one of these challenges as the purpose of these devices is to make the management more convenient. The objective of our study was to examine how demographical, psychological and diabetes-related factors determine the choices parents make regarding their child’s diabetes management technologies and how they perceive advanced devices. We conducted the study using an online questionnaire with 318 parents (mostly mothers). The questions of the survey were about demographical, diabetes-related and psychological factors (diabetes management problems, diabetes management competence). In addition, we asked the parents opinions about advanced diabetes management devices. We expanded our data with semi-structured in-depth interviews. 61 % of the participants Self-Monitored Blood Glucose (SMBG), and 39 % used a Continuous Glucose Monitoring System (CGM). Considering insulin administration, 58 % used Multiple Daily Insulin Injections (MDII) and 42 % used Continuous Subcutaneous Insulin Infusion (CSII). Parents who used diverse combinations of diabetes management devices showed significant differences in age (parents’ and child’s), the monthly cost of diabetes, the duration of diabetes, the highest level of education and average monthly household income. CGM users perceived diabetes management problems significantly more severe than SMBG users and CSII users felt significantly more competent in diabetes management than MDII users. Avoiding CGM use due to lack of financial resources was determined by diagnosis duration. While avoiding its use by the cause of the child rejecting, it was determined by the child’s age and diabetes competence. Using MDII instead of CSII because of the child’s rejection was determined by the monthly cost of diabetes and child’s age. We conducted a complex empirical study in which we examined perceptions and experiences of advanced and less advanced diabetes management technologies comprehensively. Our study highlights the factors that fundamentally influence parents’ motivations and choices about diabetes management technologies. These results could contribute to developing diabetes management technologies more suitable for children living with type 1 diabetes and their parents.

Keywords: advanced diabetes management technologies, children living with type 1 diabetes, diabetes management, motivation, parents

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Authors: Thapa M., J.P. Dutta, K.R. Pandey, R.R. Kattel

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Nepal is extremely vulnerable to the impact of climate change. To mitigate the climate change effects on agricultural production and productivity a range of adaptive strategies needs to be considered. The study was conducted to assess organic paddy production as a coping strategy to the adverse impact of climate change in Phulbari, VDC of Chitwan district. Altogether, 120 respondents (60 adopters of organic farming and 60 from non adopter) were selected using snowball technique of sampling. Pre- tested interview schedule, direct observation, focus group discussion, key informant interview as well as secondary data were used to collect the required information. Factors determining the adoption of organic farming were found to be age, year of schooling, training, frequency of extension contact, perception about climate change, economically active members and poor. A unit increase in these factors except poor would increase the probability of adoption by 4.1%, 7.5%, 7.8%, 43.1%, 41.8% and 7% respectively. However, for poor, it would decrease the probability of adoption of organic farming by 5.1%. Average organic matter content in the adopters' field was higher (2.7%) than the non-adopters' field (2.5%). The regression result showed that type of farmer, price and area under rice cultivation had positive and significant relationship with income; however dependency ratio had negative relationship. As the year of adoption of organic farming increases, the production of rice decline in the first two years then after goes on increasing but the cost of production goes on decreasing with the year of adoption. The respondents adapted to the changing climate through diversification of crops, use of resistance varieties and following good cropping pattern. Gradually growing consumers' awareness about health, preference towards quality food products are the strong points behind organic farming, whereas lacks of bio-fertilizers, lack of effective extension services, no price differentiation between organic and inorganic products were the weak points. There is need for more training and education to change the attitude of farmers and enhance their confidence about the role of organic farming to cope with climate change impact.

Keywords: Organic farming, climate change, sustainable development

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Authors: Adewole Taiwo Adelabu

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The study investigated the factors militating the organization of intramural sports programs in secondary schools in Ekiti State, Nigeria. The purpose of the study was to identify the factors affecting the organization of sports in secondary schools and also to proffer possible solutions to these factors. The study employed the inferential statistics of chi-square (x2). Five research hypotheses were formulated. The population for the study was all the students in the government-owned secondary schools in Ekiti West Local Government of Ekiti State Nigeria. The sample for the study was 60 students in three schools within the local government selected through simple random sampling techniques. The instrument used for the study was a self-developed questionnaire by the researcher for data collection. The instrument was presented to experts and academicians in the field of Human Kinetics and Health Education for construct and content validation. A reliability test was conducted which involves 10 students who are not part of the study. The test-retest coefficient of 0.74 was obtained which attested to the fact that the instrument was reliable enough for the study. The validated questionnaire was administered to the students in their various schools by the researcher with the help of two research assistants; the questionnaires were filled and returned to the researcher immediately. The data collected were analyzed using the descriptive statistics of frequency count, percentage and mean to analyze demographic data in section A of the questionnaire, while inferential statistics of chi-square was used to test the hypotheses at 0.05 alpha level. The results of the study revealed that personnel, fund, schedule (time) were significant factors that affect the organization of intramural sport programs among students in secondary schools in Ekiti West Local Government Area of the State. The study also revealed that organization of intramural sports programs among students of secondary schools will improve and motivate students’ participation in sports beyond the local level. However, facilities and equipment is not a significant factor affecting the organization of intramural sports among secondary school students in Ekiti West Local Government Area.

Keywords: challenge, intramural sport, militating, programmes

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Authors: Ntandoni Gloria Biyela

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During traditional times, there were no formal institutions of learning as they are today, where children attend classes to acquire or develop knowledge. This does not mean that there was no learning in indigenous African societies. Grandparents used to tell their grandchildren stories or teach them educational games around the fireplace, which this study refers to as a ‘traditional classroom’. A story recreated in symbolic or allegorical way, forms a base for a society’s beliefs, customs, accepted norms and language learning. Through folklore narratives, a society develops its own self awareness and education. So narrative characters, especially animals may be mythical products of the pre-literate folklore world and thus show the closeness that the Zulu society had with the wildlife. Oral cultures strive to create new facets of meaning by the use of animal metaphors to reflect the relationship of humans with the animal realm and to contribute to the language learning or literature in cross-cultural studies. Although animal metaphors are widespread in Zulu language because of the Zulu nation’s traditional closeness to wildlife, little field-research has been conducted on the social behavior of animals on the way in which their characteristics were transferred with precision to depictions of King Shaka’s behavior and activities during the amalgamation of Nguni clans into a Zulu kingdom. This study attempts to fill the gap by using first-hand interviews with local informants in areas traditionally linked to the king in KwaZulu-Natal province, South Africa. Departing from the conceptual metaphor theory, the study concentrates on King Shaka’s praise-poems in which the praise-poet describes his physical and dispositional characteristics through bold animal metaphors of the ‘Big Five’; namely, the lion, the leopard, the buffalo, the rhinoceros and the elephant, which are often referred to as Zulu royal favorites. These metaphors are still learnt by young and old in the 21st century because they reflect the responsibilities, status, and integrity of the king and the respect in which he is held by his people. They also project the crescendo growth of the Zulu nation, which, through the fulfillment of his ambitions, grew from a small clan to a mighty kingdom.

Keywords: animal, indigenous, learning, metaphor

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Authors: Park Eri, Sklad Marcin, Tsirogianni Stavroula

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In a world where there is increasing exchange and movement of populations groups, and interconnectedness, there are plenty of opportunities for mutual cultural enrichment. However, in everyday life, relations among different cultural groups do not go that smoothly often resulting in discrimination, inequalities and violence. The increasing differentiation of roles, values and worldviews raise a lot of tensions and dilemmas for the state and people -especially in western liberal societies- about issues of acceptance, fairness, justice, autonomy, plurality, freedom, equality and cohesion. Cultural diversity requires a deeper understanding of the roots, meaning and consequences of group differences. We argue, that a psychology from the standpoint of the subject needs to be developed further according to new societal needs. This means within a globalised society, issues regarding the construction of the other as another have become of utmost importance. In constructing the other human beings construct their ideal and possible worlds and meanings about their lives and their significance by drawing on a set of cultural norms, beliefs and values embedded in the different contexts whereby they find themselves in. In this article, we are describing a series of exercises developed in collaboration with University students in the Netherlands that have been piloted with undergraduate 2nd year University Psychology students. These exercises aimed at making tangible and obvious how students apply different moral principles and norms to regulate relationships, which are linked to hegemonic ideological forces. The exercises were in the form of thought experiments that included 8 moral dilemmas, inspired by the moral foundations theory, that touched on different moral principles. The moral dilemmas were built onto each other in incremental steps: from a very tangible/hands-on level to more challenging and demanding ones which require to step into pre-existing networks on knowledge and discourses. After the execution of every dilemma, a discussion followed, which is focused on building links between the ‘theme of the exercise’ and participants’ own lives experiences. In this paper, we provide an evaluation of the methodology used through a discursive analysis of the discussion between the students and the teacher.

Keywords: citizenship, moral dilemmas, social justice, education

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Authors: Jonas Sanon

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The valorization of research is becoming a transversal instrument linking different sectors (academic, public and industrial). The practice of valorization seems to impact innovation techniques within companies where, there is often the implementation of industrial conventions of training through research (CIFRE), continuous training programs for employees, collaborations and partnerships around joint research and R&D laboratories focused on the needs of companies to improve or develop more efficient innovations. Furthermore, many public initiatives to support innovation and technology transfer have been developed at the international, European and national levels, with significant budget allocations. Thus, in the context of this work, we tried to analyze the way in which research transfer structures are evaluated within the Saclay ecosystem. In fact, the University-Paris-Saclay is one of the best French universities; it is made up of 10 university components, more than 275 laboratories and is in partnership with the largest French research centers This work mainly focused on how evaluations affected research transfer structures, how evaluations were conducted, and what the managers of research transfer structures thought about assessments. Thus, with the aid of the conducted interviews, it appears that the evaluations do not have a significant impact on the qualitative aspect of research and innovation, but is rather present a directive aspect to allow the structures to benefit or not from the financial resources to develop certain research work, sometimes directed and influenced by the market, some researchers might try to accentuate their research and experimentation work on themes that are not necessarily their areas of interest, but just to comply with the calls for proposed thematic projects. The field studies also outline the primary indicators used to assess the effectiveness of valorization structures as "the number of start-ups generated, the license agreements signed, the structure's patent portfolio, and the innovations of items developed from public research.". Finally, after mapping the actors, it became clear that the ecosystem of the University of Paris-Saclay benefits from a richness allowing it to better value its research in relation to the three categories of actors it has (internal, external and transversal), united and linked by a relationship of proximity of sharing and endowed with a real opportunity to innovate openly.

Keywords: research valorization, technology transfer, innovation, evaluation, impacts and performances, innovation policy

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Authors: Wondmnew Derebe Yohannis

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Farming irrigation plays a crucial role in rural development strategies, impacting both annual household income and livelihood. This research aims to evaluate the factors influencing irrigation participation and assess the impact of small-scale irrigation on rural households' annual income. The study collected data from 287 farmers in the Dahana district of northern Ethiopia. The research investigates the driving forces behind farmers' decisions to adopt small-scale irrigation and its effect on annual income gain. The findings reveal that several factors positively influence the probability of adoption, including access to credit, cultivated land size, livestock holding, extension contact, and the education level of the household head. Conversely, the distance to local markets and water schemes negatively affects the likelihood of adoption. To understand the differences in annual income between farm households that adopted irrigation and those that did not, a simultaneous equations model with endogenous switching regression is estimated. This accounts for the heterogeneity in the adoption decision and unobservable characteristics of farmers and their farms. The analysis compares the expected income gain under actual and counterfactual scenarios, considering whether the farm household adopted irrigation or not. The study reveals that the group of farm households that adopted irrigation has distinct characteristics compared to those that did not adopt it. Furthermore, the research demonstrates that the adoption of irrigation practices leads to an increase in annual income. Interestingly, the impact of small-scale irrigation on annual income is greater for the farm households that actually adopted irrigation compared to those in the counterfactual scenario where they did not adopt. Based on the findings, the researcher concludes that small-scale irrigation is a practical solution for meeting household financial needs in the study area. It is recommended that investments in small-scale irrigation continue to further improve the livelihoods of rural farming communities by enhancing annual income gains.

Keywords: small-scale irrigation, income, rural farm households, endogenous switching regression, user, non-user

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Authors: Hanaa Sameen Ameen Bajilan

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Human rights should be protected and promoted without regard to race, ethnicity, religion, political philosophy, or sexual orientation, following our firm convictions. Thus, any infringement of these rights or disdain for; any use of violence against women undermines the principles and human values of equality and endangers the entire society, including its potential to live in peace and to make growth and development. This paper represents the condition of the new Iraqi women regarding issues such as the gender wage gap, education, health, and violence against women. The study aims to determine the impact of traditions and customs on the legal position of Iraqi women. First, it seeks to assess the effects of culture as a historical agency on the legal status of Iraqi women. Second, the influence of cultural developments in the later part of the twentieth century on Iraqi women's legal standing, and third, the importance of cultural variety as a progressive cultural component in women's legal position. Finally, the study highlights the representation of women in Iraq: Gender wage Gap, Women's liberation between culture and law, and the role of women within Iraqi society based on an Iraqi novel named (Orange Light) in Arabic: برتقالو ضو. in her book, the Iraqi writer Nadia Al-Abru succeeds in portraying the post-war society's devotion to the sexual, emotional and mental marginalization of women in terms of the value of attendance. Since the study of Iraqi women's literature in Arabic-English translation is a new avenue of research that contributes to all three areas, this investigation aims to establish critical lines of engagement between contemporary Iraqi women's literature in English translation and feminist translation conceptual frameworks, and this is accomplished by first focusing on why analyzing Iraqi women writers' novels in Arabic-English translation is a timeline of inquiry that contributes to existing and emerging knowledge fields concerning Iraqi women writers' contemporary critical contexts and scholarship on Arab women's literature in Arabic-English translation.

Keywords: women in İraq, equality, violence, gender wage gap, Nadia Al-Abru, (orange light), women's liberation, İraqi women's literature,

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Authors: Fiza Azam, Sahar Zia, Fatima Nazir Ali, Aysha Hanif

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Health is a fundamental human right, and a healthy population is essential for the prosperity and sustainable development of any country. This research is aligned with United Nations' Goal 3: Good Health and Well-being. It aims to assess and rank key health indicators across selected South Asian countries. The study focuses on urban areas in these nations, drawing on data from the World Bank’s primary collection of relevant indicators and specific health determinants outlined by the World Health Organization (WHO). These determinants include the physical environment, income and social status, education, social support networks, and personal behavior. To evaluate disparities in urban health across the region, the Urban Health Index (UHI) developed by Georgia State University, USA, is employed, followed by a mapping technique including visualization through a choropleth map to identify the pattern of spatial variations in our key variables, such as socioeconomic indicators across the region. This index serves as a comparative tool to rank health outcomes, where higher UHI values indicate better health conditions. The findings reveal notable disparities across South Asia. Afghanistan, with the lowest UHI score of 0.0423, ranks first, indicating the least favorable urban health conditions. Pakistan follows with a UHI score of 0.1190. Bangladesh and India rank third and fourth with UHI scores of 0.3099 and 0.3250, respectively. The Maldives and Sri Lanka rank fifth and sixth, with UHI scores of 0.3432 and 0.3495. Bhutan is ranked seventh with a score of 0.4750. Nepal, with a UHI score of 0.5012, ranks eighth, indicating the best urban health conditions among the countries studied. The findings of this research are crucial for addressing health disparities, improving living conditions, and enhancing social well-being in the region. These insights can inform policy measures aimed at reducing inequalities and promoting sustainable urban health in South Asia.

Keywords: urban health index, health disparities, sustainable development, South Asia, World Health Organization, United Nations, living conditions, public health

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Authors: Afshan Golriz

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This paper addresses the nuances in the relationship between the rural community of Volcan, Costa Rica, and the presence of multinational pineapple giant Pineapple Development Corporation (PINDECO). The paper analyzes the continuous negotiation between the need for environmental protection in the face of pineapple monoculture and the socioeconomic dependencies of the community on the company. Drawing on eight years of ethnographic work in Volcan de Buenos Aires and relying on intergenerational interviews that document oral histories, this article provides a socio-historical account of the economic and environmental impact of the presence of PINDECO in the southern zone of the country. The paper draws on interviews and in-depth participant observation, conducted by the author in intermittent periods over eight years. The research sheds light on the tensions between the village and PINDECO, as simultaneous acceptance of and opposition to the company persist by different stakeholders in the region. In doing so, this paper examines the strikingly powerful affinity toward the company and the community's regard for PINDECO as the town patriarch despite social and environmental injustices. In demonstrating these tensions, the author problematizes the practice of conducting foreign environmental research in developing countries, and more importantly, proposing changes to environmental conservation and socioeconomic structures without understanding community reliance on the presence of corporations such as PINDECO and the threats that changes to existing structures could pose to community members' livelihoods. In complicating these common western academic practices, the author takes an anti-colonial approach to environmental research, refusing the assumption that the affinity toward the company by the community of Volcan is rooted in ignorance, lack of education, or lack of interest in environmental conservation. The author instead highlights local knowledge and agency, demonstrating the many ways in which the community itself is producing knowledge and taking action. Through this paper, common assumptions regarding the agency of such communities are contested, and the grassroots environmental initiatives of Volcan, Costa Rica are brought to life.

Keywords: environmental conservation, grassroots movements, local knowledge, agricultural multinational

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Charalabos Antonatos, Mariza Panoutsopoulou, Georgios K. Georgakilas, Evangelos Evangelou, Yiannis Vasilopoulos

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The extended tissue damage and severe clinical outcomes of autoimmune diseases, accompanied by the high annual costs to the overall health care system, highlight the need for an efficient therapy. Increasing knowledge over the pathophysiology of specific chronic inflammatory diseases, namely Psoriasis (PsO), Inflammatory Bowel Diseases (IBD) consisting of Crohn’s disease (CD) and Ulcerative colitis (UC), and Rheumatoid Arthritis (RA), has provided insights into the underlying mechanisms that lead to the maintenance of the inflammation, such as Tumor Necrosis Factor alpha (TNF-α). Hence, the anti-TNFα biological agents pose as an ideal therapeutic approach. Despite the efficacy of anti-TNFα agents, several clinical trials have shown that 20-40% of patients do not respond to treatment. Nowadays, high-throughput technologies have been recruited in order to elucidate the complex interactions in multifactorial phenotypes, with the most ubiquitous ones referring to transcriptome quantification analyses. In this context, a random effects meta-analysis of available gene expression cDNA microarray datasets was performed between responders and non-responders to anti-TNFα therapy in patients with IBD, PsO, and RA. Publicly available datasets were systematically searched from inception to 10th of November 2020 and selected for further analysis if they assessed the response to anti-TNFα therapy with clinical score indexes from inflamed biopsies. Specifically, 4 IBD (79 responders/72 non-responders), 3 PsO (40 responders/11 non-responders) and 2 RA (16 responders/6 non-responders) datasetswere selected. After the separate pre-processing of each dataset, 4 separate meta-analyses were conducted; three disease-specific and a single combined meta-analysis on the disease-specific results. The MetaVolcano R package (v.1.8.0) was utilized for a random-effects meta-analysis through theRestricted Maximum Likelihood (RELM) method. The top 1% of the most consistently perturbed genes in the included datasets was highlighted through the TopConfects approach while maintaining a 5% False Discovery Rate (FDR). Genes were considered as Differentialy Expressed (DEGs) as those with P ≤ 0.05, |log2(FC)| ≥ log2(1.25) and perturbed in at least 75% of the included datasets. Over-representation analysis was performed using Gene Ontology and Reactome Pathways for both up- and down-regulated genes in all 4 performed meta-analyses. Protein-Protein interaction networks were also incorporated in the subsequentanalyses with STRING v11.5 and Cytoscape v3.9. Disease-specific meta-analyses detected multiple distinct pro-inflammatory and immune-related down-regulated genes for each disease, such asNFKBIA, IL36, and IRAK1, respectively. Pathway analyses revealed unique and shared pathways between each disease, such as Neutrophil Degranulation and Signaling by Interleukins. The combined meta-analysis unveiled 436 DEGs, 86 out of which were up- and 350 down-regulated, confirming the aforementioned shared pathways and genes, as well as uncovering genes that participate in anti-inflammatory pathways, namely IL-10 signaling. The identification of key biological pathways and regulatory elements is imperative for the accurate prediction of the patient’s response to biological drugs. Meta-analysis of such gene expression data could aid the challenging approach to unravel the complex interactions implicated in the response to anti-TNFα therapy in patients with PsO, IBD, and RA, as well as distinguish gene clusters and pathways that are altered through this heterogeneous phenotype.

Keywords: anti-TNFα, autoimmune, meta-analysis, microarrays

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Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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Authors: Chia-Pei Chen, Yu-Ju Chen, Yu-Juei Hsu

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The prevalence and incidence of end-stage renal disease in Taiwan ranks the highest in the world. According to the statistical survey of the Ministry of Health and Welfare in 2019, kidney disease is the ninth leading cause of death in Taiwan. It leads to autonomic dysfunction, inflammatory response and symptom distress, and further increases the damage to the structure and function of the kidneys, leading to increased demand for renal replacement therapy and risks of cardiovascular disease, which also has medical costs for the society. If we can intervene in a feasible manual to effectively regulate the autonomic nerve function of CKD patients, reduce the inflammatory response and symptom distress. To prolong the progression of the disease, it will be the main goal of caring for CKD patients. This study aims to test the effect of heart rate variability biofeedback (HRVBF) on improving autonomic nerve function (Heart Rate Variability, HRV), inflammatory response (Interleukin-6 [IL-6], C reaction protein [CRP] ), symptom distress (Piper fatigue scale, Pittsburgh Sleep Quality Index [PSQI], and Beck Depression Inventory-II [BDI-II] ) in patients with chronic kidney disease. This study was experimental research, with a convenience sampling. Participants were recruited from the nephrology clinic at a medical center in northern Taiwan. With signed informed consent, participants were randomly assigned to the HRVBF or control group by using the Excel BINOMDIST function. The HRVBF group received four weekly hospital-based HRVBF training, and 8 weeks of home-based self-practice was done with StressEraser. The control group received usual care. We followed all participants for 3 months, in which we repeatedly measured their autonomic nerve function (HRV), inflammatory response (IL-6, CRP), and symptom distress (Piper fatigue scale, PSQI, and BDI-II) on their first day of study participation (baselines), 1 month, and 3 months after the intervention to test the effects of HRVBF. The results were analyzed by SPSS version 23.0 statistical software. The data of demographics, HRV, IL-6, CRP, Piper fatigue scale, PSQI, and BDI-II were analyzed by descriptive statistics. To test for differences between and within groups in all outcome variables, it was used by paired sample t-test, independent sample t-test, Wilcoxon Signed-Rank test and Mann-Whitney U test. Results: Thirty-four patients with chronic kidney disease were enrolled, but three of them were lost to follow-up. The remaining 31 patients completed the study, including 15 in the HRVBF group and 16 in the control group. The characteristics of the two groups were not significantly different. The four-week hospital-based HRVBF training combined with eight-week home-based self-practice can effectively enhance the parasympathetic nerve performance for patients with chronic kidney disease, which may against the disease-related parasympathetic nerve inhibition. In the inflammatory response, IL-6 and CRP in the HRVBF group could not achieve significant improvement when compared with the control group. Self-reported fatigue and depression significantly decreased in the HRVBF group, but they still failed to achieve a significant difference between the two groups. HRVBF has no significant effect on improving the sleep quality for CKD patients.

Keywords: heart rate variability biofeedback, autonomic nerve function, inflammatory response, symptom distress, chronic kidney disease

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Authors: Saraswati Kerketta

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Tea industry is one of the oldest organised sector of India. It employs roughly 1.5 million people directly. Since the last decade Indian tea industry, especially in the northern region is experiencing worst crisis in the post-independence period. Due to many reason the prices of tea show steady decline. The workers are paid one of the lowest wage in tea industry in the world (1.5$ a day) below the UN's $2 a day for extreme poverty. The workers rely on addition benefits from plantation which includes food, housing and medical facilities. These have been effective means of enslavement of generations of labourers by the owners. There is hardly any change in the tea estates where the owners determine the fate of workers. When the tea garden is abandoned or is closed all the facilities disappear immediately. The workers are the descendants of tribes from central India also known as 'tea tribes'. Alienated from their native place, the geographical and social isolation compounded their vulnerability of these people. The economy of the region being totally dependent on tea has resulted in absolute unemployment for the workers of these tea gardens. With no other livelihood and no land to grow food, thousands of workers faced hunger and starvation. The Plantation Labour Act which ensures the decent working and living condition is violated continuously. The labours are forced to migrate and are also exposed to the risk of human trafficking. Those who are left behind suffers from starvation, malnutrition and disease. The condition in the sick tea plantation is no better. Wage are not paid regularly, subsidised food, fuel are also not supplied properly. Health care facilities are in very bad shape. Objectives: • To study the socio-cultural and demographic characteristics of the tea garden labourers in the study area. • To examine the social situation of workers in sick estates in dooars region. • To assess the magnitude of deprivation the impact of economic crisis on abandoned and closed tea estates in the region. Data Base: The study is based on data collected from field survey. Methods: Quantative: Cross-Tabulation, Regression analysis. Qualitative: Household Survey, Focussed Group Discussion, In-depth interview of key informants. Findings: Purchasing power parity has declined since in last three decades. There has been many fold increase in migration. Males migrates long distance towards central and west and south India. Females and children migrates both long and short distance. No one has reported to migrate back to the place of origin of their ancestors. Migrant males work mostly as construction labourers and as factory workers whereas females and children work as domestic help and construction labourers. In about 37 cases either they haven't contacted their families in last six months or are not traceable. The families with single earning members are more likely to migrate. Burden of disease and the duration of sickness, abandonment and closure of plantation are closely related. Death tolls are likely to rise 1.5 times in sick tea gardens and three times in closed tea estates. Sixty percent of the people are malnourished in the sick tea gardens and more than eighty five per cent in abandoned and sick tea gardens.

Keywords: migration, trafficking, starvation death, tea garden workers

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Authors: Nazia Roushan, Maria Kipti

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The sensitive issue of a large-scale entry of Rohingya refugees to Bangladesh has arisen again since August of 2017. Incited by ethnic and religious conflict, the Rohingyas—an ethnic group concentrated in the north-west state of Rakhine in Myanmar—have been fleeing to what is now Bangladesh from as early as the late 1700s in four main exoduses. This long-standing persecution has recently escalated, and accommodating the recent wave of exodus has been especially challenging due to the sheer volume of a million refugees concentrated in refugee camps in two small administrative units (upazilas) in the south-east of the country: the host area. This drastic change in the host area’s social fabric is putting a lot of strain on the country’s economic, demographic and environmental stability, and security. Although Bangladesh’s long-term experience with disaster management has enabled it to respond rapidly to the crisis, the government is failing to cope with this enormous problem and has taken insufficient steps towards improving the living conditions to inhibit the inflow of more refugees. On top of that, the absence of a comprehensive national refugee policy, and the density of the structures of the camps are constricting the upgrading of the shelters to international standards. As of December 2016, the combined number of internally displaced persons (IDPs) due to conflict and violence (stock), and new displacements due to disasters (flow) in Bangladesh had exceeded 1 million. These numbers have increased dramatically in the last few months. Moreover, by 2050, Bangladesh will have as much as 25 million climate refugees just from its coastal districts. To enhance the resilience of the vulnerable, it is crucial to methodically factorize further interventions between Disaster Risk Reduction for Resilience (DRR) and the concept of Building Back Better (BBB) in the rehabilitation-reconstruction period. Considering these points, this paper provides a palette of options for design guidelines related to the living spaces and infrastructures for refugees. This will encourage the development of national standards for refugee camps, and the national and local level rehabilitation-reconstruction practices. Unhygienic living conditions, vulnerability, and the general lack of control over life are pervasive throughout the camps. This paper, therefore, proposes site-specific strategic and physical planning and design for shelters for refugees in Bangladesh that will lead to sustainable living environments through the following: a) site survey of existing two registered and one makeshift unregistered refugee camps to document and study their physical conditions, b) questionnaires and semi-structured focus group discussions carried out among the refugees and stakeholders to understand what the lived experiences and needs are; and c) combining the findings with international minimum standards for shelter and settlement from International Federation of Red Cross and Red Crescent (IFRC), Médecins Sans Frontières (MSF), United Nations High Commissioner for Refugees (UNHCR). These proposals include temporary shelter solutions that balance between lived spaces and regimented, repetitive plans using readily available and cheap materials, erosion control and slope stabilization strategies, and most importantly, coping mechanisms for the refugees to be self-reliant and resilient.

Keywords: architecture, Bangladesh, refugee camp, resilience, Rohingya

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Authors: Ali Kharazi, Hassanali Aghajani, Hesami Azizi

Abstract:

Tourism entrepreneurship is a growing field that has the potential to create new opportunities for sustainable development. The purpose of this study is to identify and classify the entrepreneurial opportunities in the blind tourism industry in Khuzestan Province of Iran that can be created through the operation of blinds’ tours. This study used a mixed methods approach. The qualitative data was collected through semi-structured interviews with 15 tourist guides and tourism activists, while the quantitative data was collected through a questionnaire survey of 40 blind people who had participated in blinds’ tours. The findings of this study suggest that there are a number of entrepreneurial opportunities in the blind tourism industry in Khuzestan Province, including (1) developing and providing accessible tourism services, such as tours, accommodations, restaurants, and transportation, (2) creating and marketing blind-friendly tourism products and experiences (3) training and educating tourism professionals on how to provide accessible and inclusive tourism services. This study contributes to the theoretical understanding of tourism entrepreneurship by providing insights into the entrepreneurial opportunities in the blind tourism industry. The findings of this study can be used to develop policies and programs that support the development of the blind tourism industry. The qualitative data were analyzed using content analysis. The quantitative data were analyzed using descriptive statistics and inferential statistics. This study examines the entrepreneurial opportunities within the blind tourism industry in Khuzestan Province, Iran. In addition, Khuzestan province has made relatively good development in the field of blinds’ tourism. Blind tourists have become loyal customers of blinds’ tours, which has increased their self-confidence and social participation. Tourist guides and centers of tourism services are interested in participating in blinds’ tours more than before, and even other parts outside the tourism field have encouraged sponsorship. Education had a great impact on the quality of tourism services, especially for the blind. It has played a significant role in improving the quality of tourism services for the blind. However, the quality and quantity of infrastructure should be increased in different sectors of tourism services to foster future growth. These opportunities can be used to create new businesses and jobs and to promote sustainable development in the region.

Keywords: entrepreneurship, tourism, blind, sustainable development, Khuzestan

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Authors: Carlos Amnael Orozco-Diaz, Robert David Moorehead, Gwendolen Reilly, Fiona Gilchrist, Cheryl Ann Miller

Abstract:

The current gold-standard for maxillofacial reconstruction surgery (MRS) utilizes auto-grafted cancellous bone as a filler. This study was aimed towards developing a polylactic-acid/hydroxyapatite (PLA-HA) composite suitable for fused-deposition 3D printing. Functionalization of the polymer through the addition of HA was directed to promoting bone-regeneration properties so that the material can rival the performance of cancellous bone grafts in terms of bone-lesion repair. This kind of composite enables the production of MRS implants based off 3D-reconstructions from image studies – namely computed tomography – for anatomically-correct fitting. The present study encompassed in-vitro degradation and in-vitro biocompatibility profiling for 3D-printed PLA and PLA-HA composites. PLA filament (Verbatim Co.) and Captal S hydroxyapatite micro-scale HA powder (Plasma Biotal Ltd) were used to produce PLA-HA composites at 5, 10, and 20%-by-weight HA concentration. These were extruded into 3D-printing filament, and processed in a BFB-3000 3D-Printer (3D Systems Co.) into tensile specimens, and were mechanically challenged as per ASTM D638-03. Furthermore, tensile specimens were subjected to accelerated degradation in phosphate-buffered saline solution at 70°C for 23 days, as per ISO-10993-13-2010. This included monitoring of mass loss (through dry-weighing), crystallinity (through thermogravimetric analysis/differential thermal analysis), molecular weight (through gel-permeation chromatography), and tensile strength. In-vitro biocompatibility analysis included cell-viability and extracellular matrix deposition, which were performed both on flat surfaces and on 3D-constructs – both produced through 3D-printing. Discs of 1 cm in diameter and cubic 3D-meshes of 1 cm3 were 3D printed in PLA and PLA-HA composites (n = 6). The samples were seeded with 5000 MG-63 osteosarcoma-like cells, with cell viability extrapolated throughout 21 days via resazurin reduction assays. As evidence of osteogenicity, collagen and calcium deposition were indirectly estimated through Sirius Red staining and Alizarin Red staining respectively. Results have shown that 3D printed PLA loses structural integrity as early as the first day of accelerated degradation, which was significantly faster than the literature suggests. This was reflected in the loss of tensile strength down to untestable brittleness. During degradation, mass loss, molecular weight, and crystallinity behaved similarly to results found in similar studies for PLA. All composite versions and pure PLA were found to perform equivalent to tissue-culture plastic (TCP) in supporting the seeded-cell population. Significant differences (p = 0.05) were found on collagen deposition for higher HA concentrations, with composite samples performing better than pure PLA and TCP. Additionally, per-cell-calcium deposition on the 3D-meshes was significantly lower when comparing 3D-meshes to discs of the same material (p = 0.05). These results support the idea that 3D-printable PLA-HA composites are a viable resorbable material for artificial grafts for bone-regeneration. Degradation data suggests that 3D-printing of these materials – as opposed to other manufacturing methods – might result in faster resorption than currently-used PLA implants.

Keywords: bone regeneration implants, 3D-printing, in vitro testing, biocompatibility, polymer degradation, polymer-ceramic composites

Procedia PDF Downloads 155

Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

Abstract:

There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

Procedia PDF Downloads 77