Search results for: food composition data

Authors: Benedicta Asante, Catherine Trask, Brenna Bath

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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, there is the increase in reports of injuries, particularly for common and debilitating musculoskeletal disorders such as low back disorder (LBD). WCWs are likely exposed to diverse work-related hazards that could contribute to LBD. However, there is currently no summary of the state of knowledge on the prevalence and risk factors of LBD within this workforce. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back disorder’ and ‘waste collection workers’. Two reviewers screened articles at title, abstract, and full-text stages. Data were extracted on study design, sampling strategy, socio-demographics, geographical region, and exposure definition, the definition of LBD, response rate, statistical techniques, LBD prevalence and risk factors. The risk of bias was assessed with a standardized tool. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; only thirteen full-text articles met the study criteria and underwent data extraction. The majority of articles reported a 12-month prevalence of LBD between 16-74%. Although none of the included studies quantified relationships between risk factors and LBD, the suggested risk factors for LBD among WCWs included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Conclusion: LBD is a major occupational health issue among WCWs. In light of these risks and future growth in this industry, further research should focus on the investigation of risk factors, with more focus on ergonomic exposure assessment, and LBD prevention efforts.

Keywords: low back pain, scavenger, waste pickers, waste collection workers

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Authors: Sima Hajiazizi

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Tehran is a capital of Iran, with the capitals of the world to natural disasters such as earthquake and flood vulnerable has known. City has stated on three faults, Ray, Mosha, and north according to report of JICA in 2000, the most casualties and destruction was the result of active fault Ray. In 2003, the prevention and management of crisis in Tehran to conduct prevention and rehabilitation of the city, under the Ministry has active. Given the breadth and lack of appropriate access in the city, was considered decentralized management for crisis management support, in each region, in order to position the crisis management headquarters at the time of crises and implementation of programs for prevention and education of the citizens and also to position the bases given in some areas of the neighboring provinces at the time of the accident for help and a number of databases to store food and equipment needed at the time of the disaster. In this study, the bases for one, six, nine and eleven regions of Tehran in the field of management and training are evaluated. Selected areas had local accident and experience of practice for disaster management and local training has been experiencing challenges. The research approach was used qualitative research methods underlying Ground theory. At first, the information obtained through the study of documents and Semi-structured interviews by administrators, officials of training and participant observation in the classroom, line by line, and then it was coded in two stages, by comparing and questioning concepts, categories and extract according to the indicators is obtained from literature studies, subjects were been central. Main articles according to the frequency and importance of the phenomenon were called and they were drawn diagram paradigm and at the end with the intersections phenomena and their causes with indicators extracted from the texts, approach each phenomenon and the effectiveness of the bases was measured. There are two phenomenons in management; 1. The inability to manage the vast and complex crisis events and to resolve minor incidents due to the mismatch between managers. 2. Weaknesses in the implementation of preventive measures and preparedness to manage crisis is causal of situations, fields and intervening. There are five phenomenons in the field of education; 1. In the six-region participation and interest is high. 2. In eleven-region training partnerships for crisis management were to low that next by maneuver in schools and local initiatives such as advertising and use of aid groups have increased. 3. In nine-region, contributions to education in the area of crisis management at the beginning were low that initiatives like maneuver in schools and communities to stimulate and increase participation have increased sensitivity. 4. Managers have been disagreement with the same training in all areas. Finally for the issues that are causing the main issues, with the help of concepts extracted from the literature, recommendations are provided.

Keywords: crises management, crisis management support bases, vulnerability, crisis management headquarters, prevention

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Authors: Tingke Wu, Man Yuan

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“National Territorial Planning (2016-2030)” was issued by the State Council of China in 2017. As an important initiative of putting it into effect, territorial planning at provincial level makes overall arrangement of territorial development, resources and environment protection, comprehensive renovation and security system construction. Hubei province, as the pivot of the “Rise of Central China” national strategy, is now confronted with great opportunities and challenges in territorial development, protection, and renovation. Territorial spatial pattern experiences long time evolution, influenced by multiple internal and external driving forces. It is not clear what are the main causes of its formation and what are effective ways of optimizing it. By analyzing land use data in 2016, this paper reveals present status of territory in Hubei. Combined with economic and social data and construction information, driving forces of territorial spatial pattern are then analyzed. Research demonstrates that the three types of territorial space aggregate distinctively. The four aspects of driving forces include natural background which sets the stage for main functions, population and economic factors which generate agglomeration effect, transportation infrastructure construction which leads to axial expansion and significant provincial strategies which encourage the established path. On this basis, targeted strategies for optimizing territory spatial pattern are then put forward. Hierarchical protection pattern should be established based on development intensity control as respect for nature. By optimizing the layout of population and industry and improving the transportation network, polycentric network-based development pattern could be established. These findings provide basis for Hubei Territorial Planning, and reference for future territorial planning in other provinces.

Keywords: driving forces, Hubei, optimizing strategies, spatial pattern, territory

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Authors: Sara Alzahrani, Samia Bokari, Patan Khan, Muneera Alshareef, Rania Safwat, Mohammed Galal, Hamdi Alqadi, Ameerah Alzahrani, Rehab Alboraie

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Introduction & Background: Diabetes in COVID-19 patients is individual risk factor and documented in worldwide studies to contribute to disease severity, increased length of stay and higher mortality. Aggressive management of blood sugars and acute diabetic complications reduce the length of stay and mortality. Methods: Randomly selected 200 patients admitted with diabetes and COVID-19 studied. The unified treatment protocol applied for all patients and blood sugars monitored closely and optimized .Data collected on bimonthly basis and analyzed. Patients’ characteristics taken from data extraction tool (Oasis) of hospital. Median values for length of stay and post discharge FBS and RBS were calculated via Microsoft Excel tool. Mortality rates were calculated by percentages. The results monitored in the post discharge clinic was 130 mg/dl and 170 mg/dl respectively. The results compared with the standard international studies. Discussion: Diabetes in COVID-19 patients posed great challenge as increased severity and mortalities reported compared to non-diabetic. Taking a pre-emptive strategy to combat this problem by aggressively manage diabetes help in reducing length of stay and morbidity. The length of stay in studded population was 3 days as compared to 13 days in a major international study. Financial saving come from rapid turnover of beds. The mortality was 2.5 % compared to reported 7.3% in a major study, reflecting the implications of aggressive management of diabetes. Regular follow-up and support by running post-discharge clinic definitely help reducing readmissions and acute complications of uncontrolled diabetes. Conclusion: Aggressive management of diabetes in COVID-19 patients by tailored treatment protocols and dedicated teams will help to decrease the morbidity and mortality.

Keywords: diabetes, covid-19, management, mortality

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Authors: Aditya Jayadas

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During a pandemic like the one we are in with COVID-19, older adults, especially those who live in a senior retirement facility, experience even bigger challenges as they are often dependent on other individuals for care. Many older adults are dependent on caregivers to assist with their instrumented activities of daily living (IADL). With travel restrictions imposed during a pandemic, there is a critical need to ensure that older adults who are homebound continue to be able to participate in physical exercise, cognitive exercise, and social interaction programs. The objective of this study was to better understand the challenges that older adults faced during the pandemic and what they were doing specifically to cope with the pandemic physically, mentally, and through social interaction. A focus group was conducted with ten older adults (age: 82.70 ± 7.81 years; nine female and one male) who resided in a senior retirement facility. During the course of one hour, seven open-ended questions were posed to the participants: a) What has changed in your life since the start of the pandemic, b) What has been most challenging for you, c) What are you doing to take care of yourself, d) Are you doing anything specifically as it relates to your physical health, e) Are you doing anything specifically as it relates to your mental health, f) What did you do for social interaction during the pandemic, g) Is there anything else you would like to share as it relates to your experience during the pandemic. The focus group session was audio-taped, and verbatim transcripts were created to evaluate the responses of the participants. The transcript consisted of 4,698 words and 293 lines of text. The data was analyzed using content analysis. The unit of analysis was the text from the audio recordings that were transcribed. From the review of the transcribed text, themes and sub-themes were identified, along with salient quotes under each sub-theme. The major themes that emerged from the data were: having a routine, engaging in activities, attending exercise classes, use of technology, family, community, and prayer. The quotes under the sub-themes provided compelling evidence of how older adults coped during the pandemic while addressing the challenges they faced and developing strategies to address their physical and mental health while interacting with others. Lessons learned from this focus group can be used to develop specific physical exercise, cognitive exercise, and social interaction programs that benefit the health and well-being of older adults.

Keywords: cognitive exercise, pandemic, physical exercise, social interaction

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Authors: Md Rezaul Karim, Farha Taznin

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The purpose of this study was to assess and describe the individual and household characteristics of farmers, to measure the attitude of farmers towards climate adaptation farming practices and to explore the individual and household factors contributing in predicting their attitude towards climate adaptation farming practices. Data were collected through personal interviews using a pre-tested interview schedule. The data collection was done at Biral Upazila under Dinajpur district in Bangladesh from 1st November to 15 December 2018. Besides descriptive statistical parameters, Pearson’s Product Moment Correlation Coefficient (r), multiple regression and step-wise multiple regression analysis were used for the statistical analysis. Findings indicated that the highest proportion (77.6 percent) of the farmers had moderately favorable attitudes, followed by only 11.2 percent with highly favorable attitudes and 11.2 percent with slightly favorable attitudes towards climate adaptation farming practices. According to the computed correlation coefficients (r), among the 10 selected factors, five of them, such as education of household head, farm size, annual household income, organizational participation, and information access by extension services, had a significant relationship with the attitude of farmers towards climate-smart practices. The step-wise multiple regression results showed that two characteristics as education of household head and information access by extension services, contributed 26.2% and 5.1%, respectively, in predicting farmers' attitudes towards climate adaptation farming practices. In addition, more than two-thirds of farmers cited their opinion to the problems in response to ‘price of vermi species is high and it is not easily available’ as 1st ranked problem, followed by ‘lack of information for innovative climate-smart technologies’. This study suggests that policy implications are necessary to promote extension education and information services and overcome the obstacles to climate adaptation farming practices. It further recommends that research study should be conducted in diverse contexts of nationally or globally.

Keywords: factors, attitude, climate adaptation, farming practices, Bangladesh

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: P. P. L. Kwan, D. K. S. Chan

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Organizations are constantly changing in today’s business environment. Research findings have revealed that overcoming resistance and getting employees ready for change is a crucial driver for organizational change success. Thus, change adaptability has become a more prominent selection criterion used in many organizations. Although change readiness could be situation-specific, employees’ personality, emotion, and cognition should also be crucial factors in shaping their readiness. However, relatively little research has focused on the roles of individual characteristics in organizational changes. The present study examines the relations between individual characteristics and change readiness with the aim to validate a model, which proposes three types of individual attributes as antecedents to change readiness. The three attributes considered are trait cynicism, positive affectivity, and personal valence covering personality, emotional, and cognitive aspects respectively. The model also hypothesizes that relations between the three antecedents and change readiness will be moderated by a positive mental resource known as psychological capital (PsyCap), which consists of hope, optimism, efficacy and resilience; and a learning culture within the organization. We are currently collecting data from a targeted sample size of 300 Hong Kong employees. Specifically, participants complete a questionnaire which was designed to measure their perceived change efficacy in response to three scenarios commonly happened in the workplace (i.e., business acquisition, team restructuring, and information system change) as a measure of change readiness, as well as the aforementioned individual characteristics. Preliminary analysis provides some support to the hypotheses. That is, employees who are less cynical in personality and more positive in their cognition and affectivity particularly welcome the potential changes in their organizations. Further data collection and analyses are continuously carried out for a more definitive conclusion. Our findings will shed light on employee selection; and on how strengthening positive psychological resources and promoting the culture of learning organization among employees may enhance the chance to succeed for organizations undergoing change.

Keywords: learning organization, psychological capital, readiness for change, employee selection

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Authors: Assem Abdel Hamed Mousa

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The Internet of Things probably already influences your life. And if it doesn’t, it soon will, say computer scientists; Ubiquitous computing names the third wave in computing, just now beginning. First were mainframes, each shared by lots of people. Now we are in the personal computing era, person and machine staring uneasily at each other across the desktop. Next comes ubiquitous computing, or the age of calm technology, when technology recedes into the background of our lives. Alan Kay of Apple calls this "Third Paradigm" computing. Ubiquitous computing is essentially the term for human interaction with computers in virtually everything. Ubiquitous computing is roughly the opposite of virtual reality. Where virtual reality puts people inside a computer-generated world, ubiquitous computing forces the computer to live out here in the world with people. Virtual reality is primarily a horse power problem; ubiquitous computing is a very difficult integration of human factors, computer science, engineering, and social sciences. The approach: Activate the world. Provide hundreds of wireless computing devices per person per office, of all scales (from 1" displays to wall sized). This has required new work in operating systems, user interfaces, networks, wireless, displays, and many other areas. We call our work "ubiquitous computing". This is different from PDA's, dynabooks, or information at your fingertips. It is invisible; everywhere computing that does not live on a personal device of any sort, but is in the woodwork everywhere. The initial incarnation of ubiquitous computing was in the form of "tabs", "pads", and "boards" built at Xerox PARC, 1988-1994. Several papers describe this work, and there are web pages for the Tabs and for the Boards (which are a commercial product now): Ubiquitous computing will drastically reduce the cost of digital devices and tasks for the average consumer. With labor intensive components such as processors and hard drives stored in the remote data centers powering the cloud , and with pooled resources giving individual consumers the benefits of economies of scale, monthly fees similar to a cable bill for services that feed into a consumer’s phone.

Keywords: internet, cloud computing, ubiquitous computing, big data

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Authors: S. Cichosz, A. Masek

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A new cellulose hybrid modification approach, which is undoubtedly a scientific novelty, is introduced. The study reports the properties of cellulose (Arbocel UFC100 – Ultra Fine Cellulose) and characterizes cellulose filled polymer composites based on an ethylene-norbornene copolymer (TOPAS Elastomer E-140). Moreover, the approach of physicochemical two-stage cellulose treatment is introduced: solvent exchange (to ethanol or hexane) and further chemical modification with maleic anhydride (MA). Furthermore, the impact of the drying process on cellulose properties was investigated. Suitable measurements were carried out to characterize cellulose fibers: spectroscopic investigation (Fourier Transform Infrared Spektrofotometer-FTIR, Near InfraRed spectroscopy-NIR), thermal analysis (Differential scanning calorimetry, Thermal gravimetric analysis ) and Karl Fischer titration. It should be emphasized that for all UFC100 treatments carried out, a decrease in moisture content was evidenced. FT-IR reveals a drop in absorption band intensity at 3334 cm-1, the peak is associated with both –OH moieties and water. Similar results were obtained with Karl Fischer titration. Based on the results obtained, it may be claimed that the employment of ethanol contributes greatly to the lowering of cellulose water absorption ability (decrease of moisture content to approximately 1.65%). Additionally, regarding polymer composite properties, crucial data has been obtained from the mechanical and thermal analysis. The highest material performance was noted in the case of the composite sample that contained cellulose modified with MA after a solvent exchange with ethanol. This specimen exhibited sufficient tensile strength, which is almost the same as that of the neat polymer matrix – in the region of 40 MPa. Moreover, both the Payne effect and filler efficiency factor, calculated based on dynamic mechanical analysis (DMA), reveal the possibility of the filler having a reinforcing nature. What is also interesting is that, according to the Payne effect results, fibers dried before the further chemical modification are assumed to allow more regular filler structure development in the polymer matrix (Payne effect maximum at 1.60 MPa), compared with those not dried (Payne effect in the range 0.84-1.26 MPa). Furthermore, taking into consideration the data gathered from DSC and TGA, higher thermal stability is obtained in case of the materials filled with fibers that were dried before the carried out treatments (degradation activation energy in the region of 195 kJ/mol) in comparison with the polymer composite samples filled with unmodified cellulose (degradation activation energy of approximately 180 kJ/mol). To author’s best knowledge this work results in the introduction of a novel, new filler hybrid treatment approach. Moreover, valuable data regarding the properties of composites filled with cellulose fibers of various moisture contents have been provided. It should be emphasized that plant fiber-based polymer bio-materials described in this research might contribute significantly to polymer waste minimization because they are more readily degraded.

Keywords: cellulose fibers, solvent exchange, moisture content, ethylene-norbornene copolymer

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Authors: Michelle Belinda S. Weerawardana, Gobika Thiripuranathar, Priyani A. Paranagama

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Most of fresh vegetables and fruits available in the retail markets undergo a physiological disorder in its appearance and coloration, which indeed discourages consumer purchase. A loss of millions of dollars yearly to the food industry had been due to this pronounced color reaction called Enzymatic Browning which is driven due to the catalytic activity by an oxidoreductase enzyme, polyphenol oxidase (PPO). The enzyme oxidizes the phenolic compounds which are abundantly available in fruits and vegetables as substrates into quinones, which could react with proteins in its surrounding to generate black pigments, called melanins, which are highly UV-active compounds. Annona muricata (Katu anoda) and Musa acuminata (Ash plantains) is a fruit and a vegetable consumed by Sri Lankans widely due to their high nutritional values, medicinal properties and economical importance. The objective of the present study was to evaluate and determine the effective natural anti-browning inhibitors that could prevent PPO activity in the selected fruit and vegetable. Enzyme extracts from Annona muricata (Katu anoda) and Musa acuminata (Ash plantains), were prepared by homogenizing with analytical grade acetone, and pH of each enzyme extract was maintained at 7.0 using a phosphate buffer. The extracts of inhibitors were prepared using powdered ginger rhizomes and essential oil from the bark of Cinnamomum zeylanicum. Water extracts of ginger were prepared and the essential oil from Ceylon cinnamon bark was extracted using steam distillation method. Since the essential oil is not soluble in water, 0.1µl of cinnamon bark oil was mixed with 0.1µl of Triton X-100 emulsifier and 5.00 ml of water. The effect of each inhibitor on the PPO activity was investigated using catechol (0.1 mol dm-3) as the substrate and two samples of enzyme extracts prepared. The dosages of the prepared Cinnamon bark oil, and ginger (2 samples) which were used to measure the activity were 0.0035 g/ml, 0.091 g/ml and 0.087 g/ml respectively. The measurements of the inhibitory activity were obtained at a wavelength of 525 nm using the UV-visible spectrophotometer. The results evaluated thus revealed that % inhibition observed with cinnamon bark oil, and ginger for Annona muricata was 51.97%, and 60.90% respectively. The effects of cinnamon bark oil, and ginger extract on PPO activity of Musa acuminata were 49.51%, and 48.10%. The experimental findings thus revealed that Cinnamomum zeylanicum bark oil was a more effective inhibitor for PPO enzyme present in Musa acuminata and ginger was effective for PPO enzyme present in Annona muricata. Overall both the inhibitors were proven to be more effective towards the activities of PPO enzyme present in both samples. These inhibitors can thus be corroborated as effective, natural, non-toxic, anti-browning extracts, which when added to the above fruit and vegetable will increase the shelf life and also the acceptance of the product by the consumers.

Keywords: anti-browning agent, enzymatic browning, inhibitory activity, polyphenol oxidase

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Authors: Arpita Banerjee

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We now live in a world where half of the human population is city dwellers. The migration of people from rural to urban areas is rising continuously. But, the promise of a greater wage and better quality of life cannot keep up with the pace of migration. The rate of urbanization is much higher in developing countries. The UN predicts that 95 percent of this urban expansion will take place in the developing world in the next few decades. The population in the urban settlements of the developing nations is soaring, and megacities like Mumbai, Dhaka, Jakarta, Karachi, Manila, Shanghai, Rio de Janeiro, Lima, and Kinshasa are crammed with people, a majority of whom are migrants. Rural-urban migration has taken a new shape with the rising number of smaller cities. Apart from the increase in non-agricultural economic activities, growing demand for resources and energy, an increase in wastes and pollution, and a greater ecological footprint, there is another significant characteristic of the current wave of urbanization. This paper analyses that important marker of urbanization. It is the invisibility of production sites. The growing urban space ensures that the producers, the production sites, or the process stay beyond urban visibility. In cities and towns, living is majorly about earning money in either the informal service and small scale manufacturing sectors (a major part of which is food preparation), or the formal service sector. In the cases of both the informal service and small scale manufacturing or the formal service sector, commodity creation cannot be seen. The urban space happens to be the marketplace, where nature and its services, along with the non-urban labour, cannot be seen unless it is sold in the market. Hence, the consumers are now increasingly becoming disengaged from the producers. This paper compares the rate of increase in the size of and employment in the informal sector and/or that of the formal sector of some selected urban areas of India. Also, a comparison over the years of the aforementioned characteristics is presented in this paper, in order to find out how the anonymity of the producers to the urban consumers have grown as urbanization has risen. This paper also analyses the change in the transport cost of goods into the cities and towns of India and supports that claim made here that the invisibility of production is a crucial marker of modern-day urban-centric economic development. Such urbanization has an important ecological impact. The invisibility of the production site saves the urban consumer society from dealing with the ethical and ecological aspects of the production process. Once the real sector production is driven out of the cities and towns, the invisible ethical and ecological impacts of the growing urban consumption frees the consumers from associating themselves with any responsibility towards those impacts.

Keywords: ecological impact of urbanization, informal sector, invisibility of production, urbanization

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Authors: Marzieh Zarei

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Well instability is one of the most fundamental challenges faced by the oil and gas industry. Well wall stability analysis is a gap to be filled in the oil industry. The collection of static data such as well logging leads to the construction of a geomechanical numerical model, which will help in assessing the probable risks in future drilling. In this paper, geomechanical model was designed, and mechanical properties of the rock was determined at all points of the model. It was found the safe mud window was determined and the minimum and maximum mud pressures were determined in the ranges of 70-60 MPa and 110-100 MPa, respectively.

Keywords: geomechanics, numerical model, well stability, in-situ stress, underbalanced drilling

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Authors: I. Georgousopoulou, S. Vouyiouka, C. Papaspyrides

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The hydrolytic degradation of poly(butylene succinate) (PBS) was investigated when exposed to different humidity-temperature environments. To this direction different PBS grades were submitted to hydrolysis runs. Results indicated that the increment of hydrolysis temperature and relative humidity induced significant decrease in the molecular weight and thermal properties of the bioplastic. Τhe derived data can be considered to construct degradation kinetics based on carboxyl content variation versus time.

Keywords: hydrolytic degradation, physical ageing, poly(butylene succinate), polyester

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Authors: Naniek Widayati Priyomarsono

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Introduction: In beginning of Karaton formation, namely, era of Javanese kingdom town had the power region outside castle town (called as Mancanegara), settlement of karaton can function as “the space-between” and “space-defense”, besides it was one of components from governmental structure and karaton power at that time (internal servant/abdi dalem and sentana dalem). Upon the Independence of Indonesia in 1945 “Kingdom-City” converted its political status into part of democratic town managed by statutes based on the classification. The latter affects local culture hierarchy alteration due to the physical development and events. Dynamics of social economy activities in Kampung Karaton surrounded by buildings of Complex of Karaton Kasunanan ini, have impact on the urban system disturbed into the región. Also cultural region image fades away with the weak visual access from existant cultural artefacts. That development lacks of giving appreciation to the established region image providing identity of Karaton Kasunanan particularly and identity of Surakarta city in general. Method used is strategy of grounded theory research (research providing strong base of a theory). Research is focused on actors active and passive relevantly getting involved in change process of Karaton settlement. Data accumulated is “Investigation Focus” oriented on actors affecting that change either internal or external. Investigation results are coupled with field observation data, documentation, literature study, thus it takes accurate findings. Findings: Karaton village has potential products as attraction, possessing human resource support, strong motivation from society still living in that settlement, possessing facilities and means supports, tourism event-supporting facilities, cultural art institution, available fields or development area. Data analyzed: To get the expected result it takes restoration in social cultural development direction, and economy, with ways of: Doing social cultural development strategy, economy, and politics. To-do steps are program socialization of Karaton village as Tourism Village, economical development of local society, regeneration pattern, filtering, and selection of tourism development, integrated planning system development, development with persuasive approach, regulation, market mechanism, social cultural event sector development, political development for region activity sector. Summary: In case the restoration is done by getting society involved as subject of that settlement (active participation in the field), managed and packed interestingly and naturally with tourism-supporting facilities development, village of Karaton Kasunanan Surakarta is ready to receive visit of domestic and foreign tourists.

Keywords: karaton village, finding, restoration, economy, Indonesia

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Authors: Tammy Shel (Aboody)

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The integration of philosophy with ethnography, i.e., ethno-philosophy, or any qualitative method, is multi-dimensional. It is, thus, vital to the discourse on caring in the philosophy of education, and in therapy. These two significant dimensions are focal in this proposal’s discussion. The integration of grounded data with philosophy can shed light on cultural, gender, socio-economic and political diversities in the relationships and interactions between and among individuals and societies. This approach can explain miscommunication and, eventually, violent conflicts. The ethno-philosophy study in this proposal focuses on the term caring, through case studies of 5 non-white male and female elementary school teachers in Los Angeles County. The study examined the teachers’ views on caring and, consequently, the implications on their pedagogy. Subsequently, this method turned out to also be a caring approach in therapy. Ethnographic data was juxtaposed with western philosophy. Research discussion unraveled transformable gaps between western patriarchal and feminist philosophy on caring, and that of the teachers. Multiple interpretations and practices of caring were found due to cultural, gender, and socio-economic-political differences. Likewise, two dominant categories emerged. The first is inclusive caring, which is perceived as an ideal, as the compass of humanity that aims towards emancipation from the shackles of inner and external violence. The second is tribal caring, which illuminates the inherently dialectical substantial diversity in the interpretations and praxes of caring. Such angles are absent or minor in traditional western literature. Both categories teach of the incessant dynamic definition of caring, and its subliminal and repressed mechanisms. The multi-cultural aspects can teach us, however, that despite the inclusive common ground we share on caring, and despite personal and social awareness of cultural and gender differences, the hegemonic ruling-class governs the standardized conventional interpretation of caring. Second is the dimension of therapy in ethno-philosophy. Each patient is like a case study per se, and is a self-ethnographer. Thus, the patient is the self-observer and data collector, and the therapist is the philosopher who helps deconstruct into fragments the consciousness that comprises our well-being and self-esteem and acceptance. Together, they both identify and confront hurdles that hinder the pursuit of a more composed attitude towards ourselves and others. Together, they study and re-organize these fragments into a more comprehensible and composed self-acceptance. Therefore, the ethno-philosophy method, which stems from a caring approach, confronts the internal and external conflicts that govern our relationships with others. It sheds light on the dark and subliminal spots in our minds and hearts that operate us. Unveiling the hidden spots helps identify a shared ground that can supersede miscommunication and conflicts among and between people. The juxtaposition of ethnography with philosophy, as a caring approach in education and therapy, emphasizes that planet earth is like a web. Hence, despite the common mechanism that stimulates a caring approach towards the other, ethno-philosophy can help undermine the ruling patriarchal oppressive forces that define and standardize caring relationships, and to subsequently bridge gaps between people.

Keywords: caring, philosophy of education, ethnography, therapy, research

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Authors: Vivienne Cloude C. Bersabe, Nuelle Anne Castro, Christy P. Gonzales, Nathalie Ann D. Ocbo, Araceli Chuwaley C. Padcayan, Michelle Gaile Lianne S. Peralta, Cecile A. Perez, Eiden Mae A. Roque, Frances Bea S. Sabaten, Korina Louise A. Saculles, Jada Kristen O. Taska, Jose Reinhard C. Laoingco, Don Leonardo N. Dacumos

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The rationale of the study: Since discussion about sexuality is considered taboo in the Filipino culture, provision of quality holistic care often lacks sexuality aspect. This research was conducted to highlight the need for nurses to incorporate sexuality in their care of older adults. Research Objectives: To measure the levels of older adults’ sexual desire, sexual behavior, and sexual intimacy and relate them to sex, living arrangement, educational level, and presence of chronic illness, whether with or without treatment. Methods: This study is of quantitative descriptive design that utilized purposive sampling. 400 older adults of Baguio City participated. The study used a 30 point researcher-made questionnaire, one-on-one interview and focused group discussion to gather data. Data were treated using weighted mean, t-test, F-test, and Scheffe's test. Results and Conclusions: The overall findings revealed that Filipino older adults have a low level of sexuality expressed by the participants’ sexual desire, behavior, and intimacy. Males have significantly higher level of sexual desire, behavior, and intimacy. Living arrangement does not seem to influence the level of sexuality in all its 3 facets. Sexual desire was significantly higher among those with tertiary education and without chronic illness. Recommendation: It is recommended that nurses carry out their assessment of clients to include the exploration of their sexuality especially the older adults. A similar study may be done to explore other variables like demographic location, i.e., rural or urban setting; socio-cultural factors; and functional performance status. It is also recommended that a similar study may be done exploring the different facets of sexuality among homosexual older persons.

Keywords: geriatrics, older adults, Philippines, sexuality

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Authors: Antonio Marques, Graça Guedes

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The Portuguese footwear industry had in the last five years a remarkable performance in the exportation values, the trade balance and others economic indicators. After a long period of difficulties and with a strong reduction of companies and employees since 1994 until 2009, the Portuguese footwear industry changed the strategy and is now a success case between the international players of footwear. Only the Italian industry sells footwear with a higher value than the Portuguese and the distance between them is decreasing year by year. This paper analyses how the Portuguese footwear companies innovate and make innovation, according the classification proposed by the Oslo Manual. Also analyses the strategy follow in the innovation process, as suggested by Freeman and Soete, and shows the linkage between the type of innovation and the strategy of innovation. The research methodology was qualitative and the strategy for data collection was the case study. The qualitative data will be analyzed with the MAXQDA software. The economic results of the footwear companies studied shows differences between all of them and these differences are related with the innovation strategy adopted. The companies focused in product and marketing innovation, oriented to their target market, have higher ratios “turnover per worker” than the companies focused in process innovation. However, all the footwear companies in this “low-tech” industry create value and contribute to a positive foreign trade of 1.310 million euros in 2013. The growth strategies implemented has the participation of the sectorial organizations in several innovative projects. And it’s obvious that cooperation between all of them is a critical element to the performance achieved by the companies and the innovation observed. Can conclude that the Portuguese footwear sector has in the last years an excellent performance (economic results, exportation values, trade balance, brands and international image) and his performance is strongly related with the strategy in innovation followed, the type of innovation and the networks in the cluster. A simplified model, called “Ace of Diamonds”, is proposed by the authors and explains the way how this performance was reached by the seven companies that participate in the study (two of them are the leaders in the setor), and if this model can be used in others traditional and “low-tech” industries.

Keywords: footwear, innovation, “low-tech” industry, Oslo manual

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Authors: Jawaher Bakheet Almudarra

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An Educational Supervisor assists teachers to develop their competence and skills in teaching, solving educational problems, and to improve the teaching methods to suit the educational process. They evaluate their teachers and write reports based on their assessments. In 1957, the Saudi Ministry of Education instituted Educational Supervision to facilitate effective management of schools, however, there have been concerns that the Educational Supervision has not been effective in executing its mandate. Studies depicted that Educational supervision has not been effective because it has been marred by poor and autocratic leadership practices such as stringent inspection, commanding and judging. Therefore, there is need to consider some of the ways in which school outcomes can be enhanced through the improvement of Educational supervision practices. Emotional intelligence is a relatively new concept that can be integrated into the Saudi education system that is yet to be examined in-depth and embraced particularly in the realm of educational leadership. Its recognition and adoption may improve leadership practices among Educational supervisors. This study employed a qualitative interpretive approach that will focus on decoding, describing and interpreting the connection between emotional intelligence and leadership. The study also took into account the social constructions that include consciousness, language and shared meanings. The data collection took place in the Office of Educational Supervisors in Riyadh and involved 4 Educational supervisors and 20 teachers from both genders- male and female. The data collection process encompasses three methods namely; qualitative emotional intelligence self-assessment questionnaires, reflective semi-structured interviews, and open workshops. The questionnaires would explore whether the Educational supervisors understand the meaning of emotional intelligence and its significance in enhancing the quality of education system in Saudi Arabia. Subsequently, reflective semi-structured interviews were carried out with the Educational supervisors to explore the connection between their leadership styles and the way they conceptualise their emotionality. The open workshops will include discussions on emotional aspects of Educational supervisors’ practices and how Educational supervisors make use of the emotional intelligence discourse in their leadership and supervisory relationships.

Keywords: directors of educational supervision, emotional intelligence, educational leadership, education management

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Authors: Amer Ait Sidhoum

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Interest in sustainability has gained ground among practitioners, academics and policy-makers due to growing stakeholders’ awareness of environmental and social concerns. This is particularly true for agriculture. However, relatively little research has been conducted on the quantification of social sustainability and the contribution of social issues to the agricultural production efficiency. This research's main objective is to propose a method for evaluating prices of social outputs, more precisely shadow prices, by allowing for the stochastic nature of agricultural production that is to say for production uncertainty. In this article, the assessment of social outputs’ shadow prices is conducted within the methodological framework of nonparametric Data Envelopment Analysis (DEA). An output-oriented directional distance function (DDF) is implemented to represent the technology of a sample of Catalan arable crop farms and derive the efficiency scores the overall production technology of our sample is assumed to be the intersection of two different sub-technologies. The first sub-technology models the production of random desirable agricultural outputs, while the second sub-technology reflects the social outcomes from agricultural activities. Once a nonparametric production technology has been represented, the DDF primal approach can be used for efficiency measurement, while shadow prices are drawn from the dual representation of the DDF. Computing shadow prices is a method to assign an economic value to non-marketed social outcomes. Our research uses cross sectional, farm-level data collected in 2015 from a sample of 180 Catalan arable crop farms specialized in the production of cereals, oilseeds and protein (COP) crops. Our results suggest that our sample farms show high performance scores, from 85% for the bad state of nature to 88% for the normal and ideal crop growing conditions. This suggests that farm performance is increasing with an improvement in crop growth conditions. Results also show that average shadow prices of desirable state-contingent output and social outcomes for efficient and inefficient farms are positive, suggesting that the production of desirable marketable outputs and of non-marketable outputs makes a positive contribution to the farm production efficiency. Results also indicate that social outputs’ shadow prices are contingent upon the growing conditions. The shadow prices follow an upward trend as crop-growing conditions improve. This finding suggests that these efficient farms prefer to allocate more resources in the production of desirable outputs than of social outcomes. To our knowledge, this study represents the first attempt to compute shadow prices of social outcomes while accounting for the stochastic nature of the production technology. Our findings suggest that the decision-making process of the efficient farms in dealing with social issues are stochastic and strongly dependent on the growth conditions. This implies that policy-makers should adjust their instruments according to the stochastic environmental conditions. An optimal redistribution of rural development support, by increasing the public payment with the improvement in crop growth conditions, would likely enhance the effectiveness of public policies.

Keywords: data envelopment analysis, shadow prices, social sustainability, sustainable farming

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Authors: Reena Aggarwal, Neha Kestwal

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The Himalayan Nettle (Girardinia diversifolia) has been used for centuries as fibre and food source by Himalayan communities. Himalayan Nettle is a natural cellulosic fibre that can be handled in the same way as other cellulosic fibres. The Uttarakhand Bamboo and Fibre Development Board based in Uttarakhand, India is working extensively with the nettle fibre to explore the potential of nettle for textile production in the region. The fiber is a potential resource for rural enterprise development for some high altitude pockets of the state and traditionally the plant fibre is used for making domestic products like ropes and sacks. Himalayan Nettle is an unconventional natural fiber with functional characteristics of shrink resistance, degree of pathogen and fire resistance and can blend nicely with other fibres. Most importantly, they generate mainly organic wastes and leave residues that are 100% biodegradable. The fabrics may potentially be reused or re-manufactured and can also be used as a source of cellulose feedstock for regenerated cellulosic products. Being naturally bio- degradable, the fibre can be composted if required. Though a lot of research activities and training are directed towards fibre extraction and processing techniques in different craft clusters villagers of different clusters of Uttarkashi, Chamoli and Bageshwar of Uttarakhand like retting and Degumming process, very little is been done to analyse the crucial properties of nettle fiber like shrinkage and wash fastness. These properties are very crucial to obtain desired quality of fibre for further processing of yarn making and weaving and in developing these fibers into fine saleable products. This research therefore is focused towards various on-field experiments which were focused on shrinkage properties conducted on cotton, nettle and cotton/nettle blended yarn samples. The objective of the study was to analyze the scope of the blended fiber for developing into wearable fabrics. For the study, after conducting the initial fiber length and fineness testing, cotton and nettle fibers were mixed in 60:40 ratio and five varieties of yarns were spun in open end spinning mill having yarn count of 3s, 5s, 6s, 7s and 8s. Samples of 100% Nettle 100% cotton fibers in 8s count were also developed for the study. All the six varieties of yarns were tested with shrinkage test and results were critically analyzed as per ASTM method D2259. It was observed that 100% Nettle has a least shrinkage of 3.36% while pure cotton has shrinkage approx. 13.6%. Yarns made of 100% Cotton exhibits four times more shrinkage than 100% Nettle. The results also show that cotton and Nettle blended yarn exhibit lower shrinkage than 100% cotton yarn. It was thus concluded that as the ratio of nettle increases in the samples, the shrinkage decreases in the samples. These results are very crucial for Uttarakhand people who want to commercially exploit the abundant nettle fiber for generating sustainable employment.

Keywords: Himalayan nettle, sustainable, shrinkage, blending

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Authors: Mangala. Sadasivan, Mary Hughes, Bryan Kelly

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Medical Education must focus on bridging the gap between teaching and learning when training pre-clinical year students in skills needed to keep up with medical knowledge and to meet the demands of health care in the future. The authors were interested in showing that a 3-S Model (building strength, developing stamina, and increasing speed) using a bridged curriculum design helps connect teaching and learning and improves students’ retention of basic science and clinical knowledge. The authors designed three learning modules using the 3-S Model within a systems course in a pre-clerkship medical curriculum. Each module focused on a bridge (concept map) designed by the instructor for specific content delivered to students in the course. This with-in-subjects design study included 304 registered MSU osteopathic medical students (3 campuses) ranked by quintile based on previous coursework. The instructors used the bridge to create self-directed learning exercises (building strength) to help students master basic science content. Students were video coached on how to complete assignments, and given pre-tests and post-tests designed to give them control to assess and identify gaps in learning and strengthen connections. The instructor who designed the modules also used video lectures to help students master clinical concepts and link them (building stamina) to previously learned material connected to the bridge. Boardstyle practice questions relevant to the modules were used to help students improve access (increasing speed) to stored content. Unit Examinations covering the content within modules and materials covered by other instructors teaching within the units served as outcome measures in this study. This data was then compared to each student’s performance on a final comprehensive exam and their COMLEX medical board examinations taken some time after the course. The authors used mean comparisons to evaluate students’ performances on module items (using 3-S Model) to non-module items on unit exams, final course exam and COMLEX medical board examination. The data shows that on average, students performed significantly better on module items compared to non-module items on exams 1 and 2. The module 3 exam was canceled due to a university shut down. The difference in mean scores (module verses non-module) items disappeared on the final comprehensive exam which was rescheduled once the university resumed session. Based on Quintile designation, the mean scores were higher for module items than non-module items and the difference in scores between items for Quintiles 1 and 2 were significantly better on exam 1 and the gap widened for all Quintile groups on exam 2 and disappeared in exam 3. Based on COMLEX performance, all students on average as a group, whether they Passed or Failed, performed better on Module items than non-module items in all three exams. The gap between scores of module items for students who passed COMLEX to those who failed was greater on Exam 1 (14.3) than on Exam 2 (7.5) and Exam 3 (10.2). Data shows the 3-S Model using a bridge effectively connects teaching and learning

Keywords: bridging gap, medical education, teaching and learning, model of learning

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Authors: Ahmed Eid, Amita Gupta

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Abstract: Background: Background Medical gases are estimated to contribute to 5% of the carbon footprints produced by hospitals, Desflurane has the largest impact, but all increase significantly when used with N2O admixture. Climate Change Act 2008, we must reduce our carbon emission by 80% of the 1990 baseline by 2050.NHS carbon emissions have reduced by 18.5% (2007-2017). The NHS Long Term Plan has outlined measures to achieve this objective, including a 2% reduction by transforming anaesthetic practices. FGF is an important variable that determines the utilization of inhalational agents and can be tightly controlled by the anaesthetist. Aims and Objectives Environmental safety, Identification of areas of high N20 and different anaesthetic agents used across the St Helier operating theatres and consider improvising on the current practice. Methods: Data was collected from St Helier operating theatres and retrieved daily from Care Station 650 anaesthetic machines. 60 cases were included in the sample. Collected data (average flow rate, amount and type of agent used, duration of surgery, type of surgery, duration, and the total amount of Air, O2 and N2O used. AAGBI impact anaesthesia calculator was used to identify the amount of CO2 produced and also the cost per hour for every pt. Communication via reminder emails to staff emphasized the significance of low-flow anaesthesia and departmental meeting presentations aimed at heightening awareness of LFA, Distribution of AAGBI calculator QR codes in all theatres enables the calculation of volatile anaesthetic consumption and CO2e post each case, facilitating informed environmental impact assessment. Results: A significant reduction in the flow rate use in the 2nd sample was observed, flow rate usage between 0-1L was 60% which means a great reduction of the consumption of volatile anaesthetics and also Co2e. By using LFA we can save money but most importantly we can make our lives much greener and save the planet.

Keywords: low flow anesthesia, sustainability project, N₂0, Co2e

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Authors: Gwo-Hwa Wan, Tai-Ho Hung, Fen-Fang Chung, Wan-Ying Lee, Hui-Ching Yang

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Air pollutant exposure results in elevated concentrations of oxidative stress and inflammatory biomarkers in general populations. Increased concentrations of inflammatory biomarkers in pregnant women would be associated with preterm labor and low birth weight. To our best knowledge, the associations between air pollutants exposure and inflammation in pregnant women and fetuses are unknown, as well as their effects on fetal growth. This study aimed to evaluate the influences of outdoor air pollutants in northern Taiwan areas on the inflammatory biomarker (high sensitivity C-reactive protein, hs-CRP) concentration in the blood of healthy pregnant women and how the biomarker impacts fetal growth. In this study, 38 healthy pregnant women who are in their first trimester and live in northern Taiwan area were recruited from the Taipei Chang Gung Memorial Hospital. Personal characteristics and prenatal examination data (e.g., blood pressure) were obtained from recruited subjects. The concentrations of inflammatory mediators, hs-CRP, in the blood of healthy pregnant women were analyzed. Additionally, hourly data of air pollutants (PM10, SO2, NO2, O3, CO) concentrations were obtained from air quality monitoring stations in Taipei area, established by the Taiwan Environmental Protection Administration. The definition of lag 0 and lag 01 are the exposure to air pollutants on the day of blood withdrawal, and the average exposure to air pollutants one day before and on the day of blood withdrawal, respectively. The statistical analyses were conducted using SPSS software version 22.0 (SPSS, Inc., Chicago, IL, USA). This analytical result indicates that the healthy pregnant women aged between 28 and 42 years old. The body mass index before pregnancy averaged 21.51 (sd = 2.51) kg/m2. Around 90% of the pregnant women had never smoking habit, and 28.95% of them had allergic diseases. Approximately around 84% and 5.26% of the pregnant women worked at indoor and outdoor environments, respectively. The mean hematocrit level of the pregnant women was 37.10%, and the hemoglobin levels were ranged between 10.1 and 14.7 g/dL with 12.47 g/dL of mean value. The blood hs-CRP concentrations of healthy pregnant women in the first trimester ranged between 0.32 and 32.5 mg/L with 2.83 (sd = 5.69) mg/L of mean value. The blood hs-CRP concentrations were positively associated with ozone concentrations at lag 0-14 (r = 0.481, p = 0.017) in healthy pregnant women. Significant lag effects were identified in ozone at lag 0-14 with a positive excess concentration of blood hs-CRP.

Keywords: air pollutant, hs-CRP, pregnant woman, ozone, first trimester

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Authors: Jean Patrick Mve

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The increasing quest for efficiency, accountability, and transparency has led to the implementation of massive governance reforms among higher education systems worldwide. This is causing many changes in the governance of higher education institutions. Governments over the world are trying to adopt business-like organizational strategies to enhance the performance of higher education institutions. This study explores the changes that have taken place in the Cameroonian higher education sector. It also attempts to draw a picture of the likely future of higher education governance and the actions to be taken for the promotion of institutional effectiveness among higher education institutions. The “governance equalizer” is used as an analytical tool to this end. It covers the five dimensions of the New Public Management (NPM), namely: state regulation, stakeholder guidance, academic self-governance, managerial self-governance, and competition. Qualitative data are used, including semi-structured interviews with key informants at the organizational level and other academic stakeholders, documents and archival data from the university and from the ministry of higher education. It has been found that state regulation among higher education institutions in Cameroon is excessively high, causing the institutional autonomy to be very low, especially at the level of financial management, staffing and promotion, and other internal administrative affairs; at the level of stakeholder guidance there is a higher degree of stakeholders consideration in the academic and research activities among universities, though the government’s interest to keep its hands in most management activities is still high; academic self-governance is also very weak as the assignment of academics is done more on the basis of political considerations than competence; there is no real managerial self-governance among higher education institutions due to the lack of institutional capacity and insufficient autonomy at the level of decision making; there is a plan to promote competition among universities but a real competitive environment is not yet put into place. The study concludes that the government’s policy should make state control more relaxed and concentrate on steering and supervision. As well, real institutional autonomy, professional competence building for top management and stakeholder participation should be considered to guarantee competition and institutional effectiveness.

Keywords: Cameroon higher education, effective institutional governance, governance equalizer, institutional autonomy, institutional effectiveness

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Authors: Tiberiu Boros, Angela Ionita, Maria Visan

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Wildfires are one of the frequent and uncontrollable phenomena that currently affect large areas of the world where the climate, geographic and social conditions make it impossible to prevent and control such events. In this paper we introduce the ground concepts that lie behind the SIAFIM (Satellite Image Analysis for Fire Monitoring) project in order to create a context and we introduce a set of newly created tools that are external to the project but inherently in interventions and complex decision making based on geospatial information and spatial data infrastructures.

Keywords: wildfire, forest fire, natural language processing, mobile applications, communication, GPS

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Authors: Dimuthu Manage

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Introduction: The prevalence of obesity and obesity-related non-communicable diseases are becoming a massive health concern in the whole world. Physical activity is recognized as an effective solution for this matter. The published data on the effectiveness of High-Intensity Interval Training (HIIT) in improving health parameters in overweight and obese individuals in Sri Lanka is sparse. Hence this study is conducted. Methodology: This is a quasi-experimental study that was conducted at the Sports medicine clinic, General Hospital, Kalutara. Participants have engaged in a programme of HIIT three times per week for six weeks. Data collection was based on precise measurements by using structured and validated methods. Ethical clearance was obtained. Results: Registered number for the study was 48, and only 52% have completed the study. The mean age was 32 (SD=6.397) years, with 64% males. All the anthropometric measurements which were assessed (i.e. waist circumference(P<0.001), weight(P<0.001) and BMI(P<0.001)), body fat percentage(P<0.001), VO2 max(P<0.001), and lipid profile (ie. HDL(P=0.016), LDL(P<0.001), cholesterol(P<0.001), triglycerides(P<0.010) and LDL: HDL(P<0.001)) had shown statistically significant improvement after the intervention with the HIIT programme. Conclusions: This study confirms HIIT as a time-saving and effective exercise method, which helps in preventing obesity as well as non-communicable diseases. HIIT ameliorates body anthropometry, fat percentage, cardiopulmonary status, and lipid profile in overweight and obese individuals markedly. As with the majority of studies, the design of the current study is subject to some limitations. The first is the study focused on a correlational study. If it is a comparative study, comparing it with other methods of training programs would have given more validity. Although the validated tools used to measure variables and the same tools used in pre and post-exercise occasions with the available facilities, it would have been better to measure some of them using gold-standard methods. However, this evidence should be further assessed in larger-scale trials using comparative groups to generalize the efficacy of the HIIT exercise program.

Keywords: HIIT, lipid profile, BMI, VO2 max

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Authors: Shishay Kidanu, Abdullah Alhaj

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Sinkholes in the karst terrain of Greene County, Missouri, pose significant geohazards, imposing challenges on construction and infrastructure development, with potential threats to lives and property. To address these issues, understanding the influencing factors and modeling sinkhole susceptibility is crucial for effective mitigation through strategic changes in land use planning and practices. This study utilizes geographic information system (GIS) software to collect and process diverse data, including topographic, geologic, hydrogeologic, and anthropogenic information. Nine key sinkhole influencing factors, ranging from slope characteristics to proximity to geological structures, were carefully analyzed. The Frequency Ratio method establishes relationships between attribute classes of these factors and sinkhole events, deriving class weights to indicate their relative importance. Weighted integration of these factors is accomplished using the Analytic Hierarchy Process (AHP) and the Weighted Linear Combination (WLC) method in a GIS environment, resulting in a comprehensive sinkhole susceptibility index (SSI) model for the study area. Employing Jenk's natural break classifier method, the SSI values are categorized into five distinct sinkhole susceptibility zones: very low, low, moderate, high, and very high. Validation of the model, conducted through the Area Under Curve (AUC) and Sinkhole Density Index (SDI) methods, demonstrates a robust correlation with sinkhole inventory data. The prediction rate curve yields an AUC value of 74%, indicating a 74% validation accuracy. The SDI result further supports the success of the sinkhole susceptibility model. This model offers reliable predictions for the future distribution of sinkholes, providing valuable insights for planners and engineers in the formulation of development plans and land-use strategies. Its application extends to enhancing preparedness and minimizing the impact of sinkhole-related geohazards on both infrastructure and the community.

Keywords: sinkhole, GIS, analytical hierarchy process, frequency ratio, susceptibility, Missouri

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Authors: Andrew N. Saylor, James R. Peters

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Scoliosis is a complex 3D deformity of the thoracic and lumbar spines, clinically diagnosed by measurement of a Cobb angle of 10 degrees or more on a coronal X-ray. The Cobb angle is the angle made by the lines drawn along the proximal and distal endplates of the respective proximal and distal vertebrae comprising the curve. Traditionally, Cobb angles are measured manually using either a marker, straight edge, and protractor or image measurement software. The task of measuring the Cobb angle can also be represented by a function taking the spine geometry rendered using X-ray imaging as input and returning the approximate angle. Although the form of such a function may be unknown, it can be approximated using artificial neural networks (ANNs). The performance of ANNs is affected by many factors, including the choice of activation function and network architecture; however, the effects of these parameters on the accuracy of scoliotic deformity measurements are poorly understood. Therefore, the objective of this study was to systematically investigate the effect of ANN architecture and activation function on Cobb angle measurement from the coronal X-rays of scoliotic subjects. The data set for this study consisted of 609 coronal chest X-rays of scoliotic subjects divided into 481 training images and 128 test images. These data, which included labeled Cobb angle measurements, were obtained from the SpineWeb online database. In order to normalize the input data, each image was resized using bi-linear interpolation to a size of 500 × 187 pixels, and the pixel intensities were scaled to be between 0 and 1. A fully connected (dense) ANN with a fixed cost function (mean squared error), batch size (10), and learning rate (0.01) was developed using Python Version 3.7.3 and TensorFlow 1.13.1. The activation functions (sigmoid, hyperbolic tangent [tanh], or rectified linear units [ReLU]), number of hidden layers (1, 3, 5, or 10), and number of neurons per layer (10, 100, or 1000) were varied systematically to generate a total of 36 network conditions. Stochastic gradient descent with early stopping was used to train each network. Three trials were run per condition, and the final mean squared errors and mean absolute errors were averaged to quantify the network response for each condition. The network that performed the best used ReLU neurons had three hidden layers, and 100 neurons per layer. The average mean squared error of this network was 222.28 ± 30 degrees2, and the average mean absolute error was 11.96 ± 0.64 degrees. It is also notable that while most of the networks performed similarly, the networks using ReLU neurons, 10 hidden layers, and 1000 neurons per layer, and those using Tanh neurons, one hidden layer, and 10 neurons per layer performed markedly worse with average mean squared errors greater than 400 degrees2 and average mean absolute errors greater than 16 degrees. From the results of this study, it can be seen that the choice of ANN architecture and activation function has a clear impact on Cobb angle inference from coronal X-rays of scoliotic subjects.

Keywords: scoliosis, artificial neural networks, cobb angle, medical imaging

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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