Search results for: frequent earthquake

Authors: Sasibhushan Yengala, Nelson Muthu, Subramani Kanagaraj

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The abstract reports on the design related to a modular and affordable standing cum sitting device to meet the requirements of paraplegic patients of the different physiques. Paraplegic patients need the assistance of an external arrangement to the lower limbs and trunk to help patients adopt the correct posture while standing abreast gravity. This support can be from a tilt table or a standing frame which the patient can use to stay in a vertical posture. Standing frames are devices fitting to support a person in a weight-bearing posture. Commonly, these devices support and lift the end-user in shifting from a sitting position to a standing position. The merits of standing for a paraplegic patient with a spinal injury are numerous. Even when there is limited control on muscles that ordinarily support the user using the standing frame in a vertical position, the standing stance improves the blood pressure, increases bone density, improves resilience and scope of motion, and improves the user's feelings of well-being by letting the patient stand. One limitation with standing frames is that these devices are typically function definitely; cannot be used for different purposes. Therefore, users are often compelled to purchase more than one of these devices, each being purposefully built for definite activities. Another concern frequent in standing frames is manoeuvrability; it is crucial to provide a convenient adjustment scope for all users. Thus, there is a need to provide a standing frame with multiple uses that can be economical for a larger population. There is also a need to equip added readjustment means in a standing frame to lessen the shear and to accommodate a broad range of users. The proposed Versatile Standing cum Sitting Device (VSD) is designed to change from standing to a comfortable sitting position using a series of mechanisms. First, a locking mechanism is provided to lock the VSD in a standing stance. Second, a dampening mechanism is provided to make sure that the VSD shifts from a standing to a sitting position gradually when the lock mechanism gets disengaged. An adjustment option is offered for the height of the headrest via the use of lock knobs. This device can be used in clinics for rehabilitation purposes irrespective of patient's anthropometric data due to its modular adjustments. It can facilitate the patient's daily life routine while in therapy and giving the patient the comfort to sit when tired. The device also provides the availability of rehabilitation to a common person.

Keywords: paraplegic, rehabilitation, spinal cord injury, standing frame

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Authors: Subhanan Mandal, Bidisha Hore

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The linguistic process whereby repetition of all or part of the base word with or without internal change before or after the base itself takes place is regarded as reduplication. The reduplicated morphological construction annotates with itself a new grammatical category and meaning. Reduplication is a very frequent and abundant phenomenon in the eastern Indian languages from the states of West Bengal and Odisha, i.e. Bengali and Odia respectively. Bengali, an Indo-Aryan language and a part of the Indo-European language family is one of the largest spoken languages in India and is the national language of Bangladesh. Despite this classification, Bengali has certain influences in terms of vocabulary and grammar due to its geographical proximity to Tibeto-Burman and Austro-Asiatic language speaking communities. Bengali along with Odia belonged to a single linguistic branch. But with time and gradual linguistic changes due to various factors, Odia was the first to break away and develop as a separate distinct language. However, less of contrasts and more of similarities still exist among these languages along the line of linguistics, leaving apart the script. This paper deals with the procedure of echo word formations in Bengali and Odia. The morphological research of the two languages concerning the field of reduplication reveals several linguistic processes. The revelation is based on the information elicited from native language speakers and also on the analysis of echo words found in discourse and conversational patterns. For the purpose of partial reduplication analysis, prefixed class and suffixed class word formations are taken into consideration which show specific rule based changes. For example, in suffixed class categorization, both consonant and vowel alterations are found, following the rules: i) CVx à tVX, ii) CVCV à CVCi. Further classifications were also found on sentential studies of both languages which revealed complete reduplication complexities while forming echo words where the head word lose its original meaning. Complexities based on onomatopoetic/phonetic imitation of natural phenomena and not according to any rule-based occurrences were also found. Taking these aspects into consideration which are very prevalent in both the languages, inferences are drawn from the study which bring out many similarities in both the languages in this area in spite of branching away from each other several years ago.

Keywords: consonant alteration, onomatopoetic, partial reduplication and complete reduplication, reduplication, vowel alteration

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Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina Andremanisa

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Background: Madagascar has one of the least developed road networks in the world with a majority of its national and local roads being earth roads and in poor condition. In addition, the country is affected by frequent natural disasters that further affect the road conditions limiting the accessibility to some parts of the country. In 2021 and 2022, 2.21 million people were affected by drought in the Grand Sud region, and by cyclones and floods in the coastal regions, with disruptions of the health system including last mile distribution of lifesaving maternal health commodities and reproductive health commodities in the health facilities. Program intervention: The intervention uses drone technology to deliver maternal health and family planning commodities in hard-to-reach health facilities in the Grand Sud and Sud-Est of Madagascar, the regions more affected by natural disasters. Methodology The intervention was developed in two phases. A first phase, conducted in the Grand Sud, used drones leased from a private company to deliver commodities in isolated health facilities. Based on the lesson learnt and encouraging results of the first phase, in the second phase (2023) the intervention has been extended to the Sud Est regions with the purchase of drones and the recruitment of pilots to reduce costs and ensure sustainability. Key findings: The drones ensure deliveries of lifesaving commodities in the Grand Sud of Madagascar. In 2023, 297 deliveries in commodities in forty hard-to-reach health facilities have been carried out. Drone technology reduced delivery times from the usual 3 - 7 days necessary by road or boat to only a few hours. Program Implications: The use of innovative drone technology demonstrated to be successful in the Madagascar context to reduce dramatically the distribution time of commodities in hard-to-reach health facilities and avoid stockouts of life-saving medicines. When the intervention reaches full scale with the completion of the second phase and the extension in the Sud-Est, 150 hard-to-reach facilities will receive drone deliveries, avoiding stockouts and improving the quality of maternal health and family planning services offered to 1,4 million people in targeted areas.

Keywords: commodities, drones, last-mile distribution, lifesaving supplies

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Authors: Nadia Soledad Peralta

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Within the framework of socio-cognitive interaction, argumentation is understood as a psychological process that supports and induces reasoning and learning. Most authors emphasize the great potential of argumentation to negotiate with contradictions and complex decisions. So argumentation is a target for researchers who highlight the importance of social and cognitive processes in learning. In the context of social interaction among university students, different types of arguments are analyzed according to group size (dyads and triads) and the type of task (reading of frequency tables, causal explanation of physical phenomena, the decision regarding moral dilemma situations, and causal explanation of social phenomena). Eighty-nine first-year social sciences students of the National University of Rosario participated. Two groups were formed from the results of a pre-test that ensured the heterogeneity of points of view between participants. Group 1 consisted of 56 participants (performance in dyads, total: 28), and group 2 was formed of 33 participants (performance in triads, total: 11). A quasi-experimental design was performed in which effects of the two variables (group size and type of task) on the argumentation were analyzed. Three types of argumentation are described: authentic dialogical argumentative resolutions, individualistic argumentative resolutions, and non-argumentative resolutions. The results indicate that individualistic arguments prevail in dyads. That is, although people express their own arguments, there is no authentic argumentative interaction. Given that, there are few reciprocal evaluations and counter-arguments in dyads. By contrast, the authentically dialogical argument prevails in triads, showing constant feedback between participants’ points of view. It was observed that, in general, the type of task generates specific types of argumentative interactions. However, it is possible to emphasize that the authentically dialogic arguments predominate in the logical tasks, whereas the individualists or pseudo-dialogical are more frequent in opinion tasks. Nerveless, these relationships between task type and argumentative mode are best clarified in an interactive analysis based on group size. Finally, it is important to stress the value of dialogical argumentation in educational domains. Argumentative function not only allows a metacognitive reflection about their own point of view but also allows people to benefit from exchanging points of view in interactive contexts.

Keywords: sociocognitive interaction, argumentation, university students, size of the grup

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Authors: Darshini Mahadevia, Kanika Gounder, Saumya Lathia

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Cities, an outcome of natural growth and migration, are ever-expanding due to urban sprawl. In the Global South, urban areas are experiencing a switch from public transport to private vehicles, coupled with intensified urban agglomeration, leading to frequent longer commutes by automobiles. This increase in travel distance and motorized vehicle kilometres lead to unsustainable cities. To achieve the nationally pledged GHG emission mitigation goal, the government is prioritizing a modal shift to low-carbon transport modes like mass transit and paratransit. Mixed land-use and urban densification are crucial for the economic viability of these projects. Informed by desktop assessment of mobility plans and in-person primary surveys, the paper explores the challenges around urban densification and travel patterns in two Indian cities of contrasting nature- Surat, a metropolitan industrial city with a 5.9 million population and a very compact urban form, and Udaipur, a heritage city attracting large international tourists’ footfall, with limited scope for further densification. Dense, mixed-use urban areas often improve access to basic services and economic opportunities by reducing distances and enabling people who don't own personal vehicles to reach them on foot/ cycle. But residents travelling on different modes end up contributing to similar trip lengths, highlighting the non-uniform distribution of land-uses and lack of planned transport infrastructure in the city and the urban-peri urban networks. Additionally, it is imperative to manage these densities to reduce negative externalities like congestion, air/noise pollution, lack of public spaces, loss of livelihood, etc. The study presents a comparison of the relationship between transport systems with the built form in both cities. The paper concludes with recommendations for managing densities in urban areas along with promoting low-carbon transport choices like improved non-motorized transport and public transport infrastructure and minimizing personal vehicle usage in the Global South.

Keywords: India, low-carbon transport, travel behaviour, trip length, urban densification

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Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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Authors: Ahmed. Abdel Bary, Omneya. Khowessah, Mojahed. al-jamrah

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Introduction: The major challenge with the design of oral dosage forms lies with their poor bioavailability. The most frequent causes of low oral bioavailability are attributed to poor solubility and low permeability. The aim of this study was to develop solid nanodispersed tablet formulation of Glimepiride for the enhancement of the solubility and bioavailability. Methodology: Solid nanodispersions of Glimepiride (GMP) were prepared using two different ratios of 2 different carriers, namely; PEG6000, pluronic F127, and by adopting two different techniques, namely; solvent evaporation technique and fusion technique. A full factorial design of 2 3 was adopted to investigate the influence of formulation variables on the prepared nanodispersion properties. The best chosen formula of nanodispersed powder was formulated into tablets by direct compression. The Differential Scanning Calorimetry (DSC) analysis and Fourier Transform Infra-Red (FTIR) analysis were conducted for the thermal behavior and surface structure characterization, respectively. The zeta potential and particle size analysis of the prepared glimepiride nanodispersions was determined. The prepared solid nanodispersions and solid nanodispersed tablets of GMP were evaluated in terms of pre-compression and post-compression parameters, respectively. Results: The DSC and FTIR studies revealed that there was no interaction between GMP and all the excipients used. Based on the resulted values of different pre-compression parameters, the prepared solid nanodispersions powder blends showed poor to excellent flow properties. The resulted values of the other evaluated pre-compression parameters of the prepared solid nanodispersion were within the limits of pharmacopoeia. The drug content of the prepared nanodispersions ranged from 89.6 ± 0.3 % to 99.9± 0.5% with particle size ranged from 111.5 nm to 492.3 nm and the resulted zeta potential (ζ ) values of the prepared GMP-solid nanodispersion formulae (F1-F8) ranged from -8.28±3.62 mV to -78±11.4 mV. The in-vitro dissolution studies of the prepared solid nanodispersed tablets of GMP concluded that GMP- pluronic F127 combinations (F8), exhibited the best extent of drug release, compared to other formulations, and to the marketed product. One way ANOVA for the percent of drug released from the prepared GMP-nanodispersion formulae (F1- F8) after 20 and 60 minutes showed significant differences between the percent of drug released from different GMP-nanodispersed tablet formulae (F1- F8), (P<0.05). Conclusion: Preparation of glimepiride as nanodispersed particles proven to be a promising tool for enhancing the poor solubility of glimepiride.

Keywords: glimepiride, solid Nanodispersion, nanodispersed tablets, poorly water soluble drugs

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Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

Abstract:

Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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Authors: Carolina S. Monteiro, Eugénia Pinto, Miguel A. Faria, Sara C. Cunha

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Rice (Oryza sativa) production plays a vital role in reducing hunger and poverty and assumes particular importance in low-income and developing countries. Rice is a sensitive plant, and production occurs strictly where suitable temperature and water conditions are found. Climatic changes are likely to affect worldwide, and some models have predicted increased temperatures, variations in atmospheric CO₂ concentrations and modification in precipitation patterns. Therefore, the ongoing climatic changes threaten rice production by increasing biotic and abiotic stress factors, and crops will grow in different environmental conditions in the following years. Around the world, the effects will be regional and can be detrimental or advantageous depending on the region. Mediterranean zones have been identified as possible hot spots, where dramatic temperature changes, modifications of CO₂ levels, and rainfall patterns are predicted. The actual estimated atmospheric CO₂ concentration is around 400 ppm, and it is predicted that it can reach up to 1000–1200 ppm, which can lead to a temperature increase of 2–4 °C. Alongside, rainfall patterns are also expected to change, with more extreme wet/dry episodes taking place. As a result, it could increase the migration of pathogens, and a shift in the occurrence of mycotoxins, concerning their types and concentrations, is expected. Mycotoxigenic spoilage fungi can colonize the crops and be present in all rice food chain supplies, especially Penicillium species, mainly resulting in ochratoxin A (OTA) contamination. In this scenario, the objectives of the present study are evaluating the effect of temperature (20 vs. 25 °C), CO₂ (400 vs. 1000 ppm), and water stress (0.93 vs 0.95 water activity) on growth and OTA production by a Penicillium nordicum strain in vitro on rice-based media and when colonizing layers of raw rice. Results demonstrate the effect of temperature, CO₂ and drought on the OTA production in a rice-based environment, thus contributing to the development of mycotoxins predictive models in climate change scenarios. As a result, improving mycotoxins' surveillance and monitoring systems, whose occurrence can be more frequent due to climatic changes, seems relevant and necessary. The development of prediction models for hazard contaminants presents in foods highly sensitive to climatic changes, such as mycotoxins, in the highly probable new agricultural scenarios is of paramount importance.

Keywords: climate changes, ochratoxin A, penicillium, rice

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Authors: Konrad Steyn, Jacques Laubscher

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South African urban design solutions are mostly aligned with European and North American models that are often not appropriate in addressing some of this country’s challenges such as multiculturalism and decaying urban areas. Sustainable urban redevelopment in South Africa should be comprehensive in nature, sensitive in its manifestation, and should be robust and inclusive in order to achieve social relevance. This paper argues that the success of an urban design intervention is largely dependent on the public’s perceptions and expectations, and the way people participate in shaping their environments. The concept of sustainable urbanism is thus more comprehensive than – yet should undoubtedly include – methods of construction, material usage and climate control principles. The case study is a central element of this research paper. 725 Arcadia Street in Pretoria, was originally commissioned as a food market structure. A starkly contrasting existing modernist adjacent building forms the morphological background. Built in 1969, it is a valuable part of Pretoria’s modernist fabric. It was realised early on that the project should not be a mere localised architectural intervention, but rather an occasion to revitalise the neighbourhood through urban regeneration. Because of the complex and comprehensive nature of the site and rich cultural diversity of the area, a multi-faceted approach seemed the most appropriate response. The methodology for collating data consisted of a combination of literature reviews (regarding the historic original fauna and flora and current plants, observation (frequent site visits) and physical surveying on the neighbourhood level (physical location, connectivity to surrounding landmarks as well as movement systems and pedestrian flows). This was followed by an exploratory design phase, culminating in the present redevelopment proposal. Since built environment interventions are increasingly based on generalised normative guidelines, an approach focusing of urban acupuncture could serve as an alternative. Celebrating the specific urban condition, urban acupuncture offers an opportunity to influence the surrounding urban fabric and achieve urban renewal through physical, social and cultural mediation.

Keywords: neighbourhood, urban renewal, South African urban design solutions, sustainable urban redevelopment

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Authors: Aasaithambi Kalaiselvi, Michael Gabriel Paulraj, Ekambaram Nakkeeran

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Emergences of mosquito vector-borne diseases are considered as a perpetual problem globally in tropical countries. The outbreak of several diseases such as chikungunya, zika virus infection and dengue fever has created a massive threat towards the living population. Frequent usage of synthetic insecticides like Dichloro Diphenyl Trichloroethane (DDT) eventually had its adverse harmful effects on humans as well as the environment. Since there are no perennial vaccines, prevention, treatment or drugs available for these pathogenic vectors, WHO is more concerned in eradicating their breeding sites effectively without any side effects on humans and environment by approaching plant-derived natural eco-friendly bio-insecticides. The aim of this study is to investigate the larvicidal potency of Cinnamomum verum essential oil (CEO) loaded niosomes. Cholesterol and surfactant variants of Span 20, 60 and 80 were used in synthesizing CEO loaded niosomes using Transmembrane pH gradient method. The synthesized CEO loaded niosomes were characterized by Zeta potential, particle size, Fourier Transform Infrared Spectroscopy (FT-IR), GC-MS and SEM analysis to evaluate charge, size, functional properties, the composition of secondary metabolites and morphology. The Z-average size of the formed niosomes was 1870.84 nm and had good stability with zeta potential -85.3 meV. The entrapment efficiency of the CEO loaded niosomes was determined by UV-Visible Spectrophotometry. The bio-potency of CEO loaded niosomes was treated and assessed against gram-positive (Bacillus subtilis) and gram-negative (Escherichia coli) bacteria and fungi (Aspergillus fumigatus and Candida albicans) at various concentrations. The larvicidal activity was evaluated against II to IV instar larvae of Aedes aegypti, Anopheles stephensi and Culex quinquefasciatus at various concentrations for 24 h. The mortality rate of LC₅₀ and LC₉₀ values were calculated. The results exhibited that CEO loaded niosomes have greater efficiency against mosquito larvicidal activity. The results suggest that niosomes could be used in various applications of biotechnology and drug delivery systems with greater stability by altering the drug of interest.

Keywords: Cinnamomum verum, niosomes, entrapment efficiency, bactericidal and fungicidal, mosquito larvicidal activity

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Authors: Ioannis N. Sergentanis, Stavroula Papadodima, Maria Tsellou, Dimitrios Vlachodimitropoulos, Sotirios Athanaselis, Chara Spiliopoulou

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Introduction: The aim of this study is the investigation of characteristics of suicide, as documented in autopsies during a five-year interval in the greater area of Attica, including the city of Athens. This could reveal possible protective or aggravating factors for suicide risk during a period strongly associated with the Greek debt crisis. Materials and Methods: Data was obtained following registration of suicide cases among autopsies performed in the Forensic Medicine and Toxicology Department, School of Medicine, National and Kapodistrian University of Athens, Greece, during the time interval from January 2011 to December 2015. Anonymity and medical secret were respected. A series of demographic and social factors in addition to special characteristics of suicide were entered into a specially established pre-coded database. These factors include social data as well as psychiatric background and certain autopsy characteristics. Data analysis was performed using descriptive statistics and Fisher’s exact test. The software used was STATA/SE 13 (Stata Corp., College Station, TX, USA). Results: A total of 162 cases were studied, 128 men and 34 women. Age ranged from 14 to 97 years old with an average of 53 years, presenting two peaks around 40 and 60 years. A 56% of cases were single/ divorced/ widowed. 25% of cases occurred during the weekend, and 66% of cases occurred in the house. A predominance of hanging as the leading method of suicide (41.4%) followed by jumping from a height (22.8%) and firearms (19.1%) was noted. Statistical analysis showed an association was found between suicide method and gender (P < 0.001, Fisher’s exact test); specifically, no woman used a firearm while only one man used medication overdose (against four women). Discussion: Greece has historically been one of the countries with the lowest suicide rates in Europe. Given a possible change in suicide trends during the financial crisis, further research seems necessary in order to establish risk factors. According to our study, suicide is more frequent in men who are not married, inside their house. Gender seems to be a factor affecting the method of suicide. These results seem in accordance with the international literature. Stronger than expected predominance in male suicide can be associated with failure to live up to social and family expectations for financial reasons.

Keywords: autopsy, Greece, risk factors, suicide

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Authors: Jaleh Mohammad Aliha, Rezvan Razazi, Nasim Naderi

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Introduction: Despite the progress in new effective drugs in the treatment of heart failure, the disease still accompanied with frequent hospitalization, impaired quality of life, early mortality and significant economic burden. Patients with chronic disease and consequently patients with heart failure need the knowledge and optimal health literacy to improve the quality of life and minimize the rate of rehopitalizatio. So, considering to importance of knowledge and health literacy in this patients as well as contradictory literature, this study conducted to investigate the relationship between health literacy and Knowledge of heart failure with rehospitalization in patients with heart failure admitted to heart failure clinic in Rajai Heart center in 1394. Methods: The cross-sectional method with convenience sampling method was used in this study. After obtaining the necessary permissions from the ethics committee and the Shahid Rajai Heart center, 238 patients who were older than 18 years and had ejection fraction 35% or less with the ability to read and write and lack of psychiatric, neurological and cognitive disorders and signed the informed consent were recruited. Data collection were perfomed through demographic data questionnaire, short standard health literacy questionnaire 'Short-TOFHLA-16' and Vanderwall (2005) knowledge of heart failure questionnaire. Reliability was assessed by internal consistency method and Cronbach's alpha for both questionnaires was more than 0.7. Then data were analysed by SPSS-20 with descriptive statistic and analytical statistic such as T-test, Chi-square and ANOVA. Results: The majority of patients were male (66%), married (80%) and had age between 50 to 70 years old (42%). The majority of studied men and women have good health literacy and About half of them have adequate knowledge about heart failure. Fisher's exact test showed that there was a significant statistical correlation between health literacy and knowlegh about heart failure. In other words, higher health literacy associated with more knowledge about their condition. Also findings showed that there was no significant statistical correlation between health literacy and knowledge about heart failure and frequency of CCU and emergency admissions. Conclusion: The study results showed that the higher health literacy, associated with the greater knowledge about heart failure and patients' perception about caring recommendations and disease outcomes. Therefore, the knowledge about heart failure and factors which related to severity of the disease, is the important issue to problem identification and treatment and reduction of rehospitalization.

Keywords: health literacy, heart failure, knowlegde, rehospitalization

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Authors: Petros Gkotsis, Anastasios Zouboulis, Manasis Mitrakas, Dimitrios Zamboulis, E. Peleka

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The most serious drawback in wastewater treatment using membrane bioreactors (MBRs) is membrane fouling which gradually leads to membrane permeability decrease and efficiency deterioration. This work is part of a research project that aims to develop an integrated methodology for membrane fouling control, using specific chemicals which will enhance the coagulation and flocculation of compounds responsible for fouling, hence reducing biofilm formation on the membrane surface and limiting the fouling rate acting as a pre-treatment step. For this purpose, a pilot-scale plant with fully automatic operation achieved by means of programmable logic controller (PLC) has been constructed and tested. The experimental set-up consists of four units: wastewater feed unit, bioreactor, membrane (side-stream) filtration unit and permeate collection unit. Synthetic wastewater was fed as the substrate for the activated sludge. The dissolved oxygen (DO) concentration of the aerobic tank was maintained in the range of 2-3 mg/L during the entire operation by using an aerator below the membrane module. The membranes were operated at a flux of 18 LMH while membrane relaxation steps of 1 min were performed every 10 min. Both commercial and composite coagulants are added in different concentrations in the pilot-scale plant and their effect on the overall performance of the ΜΒR system is presented. Membrane fouling was assessed in terms of TMP, membrane permeability, sludge filterability tests, total resistance and the unified modified fouling index (UMFI). Preliminary tests showed that particular attention should be paid to the addition of the coagulant solution, indicating that pipe flocculation effectively increases hydraulic retention time and leads to voluminous sludge flocs. The most serious drawback in wastewater treatment using MBRs is membrane fouling, which gradually leads to membrane permeability decrease and efficiency deterioration. This results in increased treatment cost, due to high energy consumption and the need for frequent membrane cleaning and replacement. Due to the widespread application of MBR technology over the past few years, it becomes clear that the development of a methodology to mitigate membrane fouling is of paramount importance. The present work aims to develop an integrated technique for membrane fouling control in MBR systems and, thus, contribute to sustainable wastewater treatment.

Keywords: coagulation, membrane bioreactor, membrane fouling, pilot plant

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Authors: Benoît Leclercq, Ilse Depraetere

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The goal of this presentation is to shed new light on the semantics and pragmatics of be able to. It presents the results of a corpus analysis based on data from the BNC (British National Corpus), and discusses these results in light of a specific stance on the semantics-pragmatics interface taking into account recent developments. Be able to is often discussed in relation to can and could, all of which can be used to express ability. Such an onomasiological approach often results in the identification of usage constraints for each expression. In the case of be able to, it is the formal properties of the modal expression (unlike can and could, be able to has non-finite forms) that are in the foreground, and the modal expression is described as the verb that conveys future ability. Be able to is also argued to expressed actualised ability in the past (I was able/could to open the door). This presentation aims to provide a more accurate pragmatic-semantic profile of be able to, based on extensive data analysis and one that is embedded in a very explicit view on the semantics-pragmatics interface. A random sample of 3000 examples (1000 for each modal verb) extracted from the BNC was analysed to account for the following issues. First, the challenge is to identify the exact semantic range of be able to. The results show that, contrary to general assumption, be able to does not only express ability but it shares most of the root meanings usually associated with the possibility modals can and could. The data reveal that what is called opportunity is, in fact, the most frequent meaning of be able to. Second, attention will be given to the notion of actualisation. It is commonly argued that be able to is the preferred form when the residue actualises: (1) The only reason he was able to do that was because of the restriction (BNC, spoken) (2) It is only through my imaginative shuffling of the aces that we are able to stay ahead of the pack. (BNC, written) Although this notion has been studied in detail within formal semantic approaches, empirical data is crucially lacking and it is unclear whether actualisation constitutes a conventional (and distinguishing) property of be able to. The empirical analysis provides solid evidence that actualisation is indeed a conventional feature of the modal. Furthermore, the dataset reveals that be able to expresses actualised 'opportunities' and not actualised 'abilities'. In the final part of this paper, attention will be given to the theoretical implications of the empirical findings, and in particular to the following paradox: how can the same expression encode both modal meaning (non-factual) and actualisation (factual)? It will be argued that this largely depends on one's conception of the semantics-pragmatics interface, and that this need not be an issue when actualisation (unlike modality) is analysed as a generalised conversational implicature and thus is considered part of the conventional pragmatic layer of be able to.

Keywords: Actualisation, Modality, Pragmatics, Semantics

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Authors: Piyush Hajela

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The significance of public spaces is on a rise in Indian cities as a strong interaction space across cultures and community. It is a pertinent gathering space for people across age and gender, where the face keeps changing with time. A public space is directly related to the social dimension, people, comfort, safety, and security, that, it proposes to provide, as inherent qualities. The presence of these and other dimensions of space, together with related equitable environments, impart certain quality to a public space. The higher the optimum contents of these dimensions, the better the quality of public space. Public is represented by PEOPLE through society and community, and space is created by dimensions. Society contains children, women and the elderly, community is composed of social, and religious groups. These behave differently in a different setting and call for varied quality of spaces, created and generated. Public spaces are spread across a city and have more or less established their existence and prominence in a social set up. While few of them are created others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The emergence of public space dates back to the times when people started forming communities, display cultures and traditions publicly, gathered for religious observations and celebrations, and address the society. Traditional cities and societies in India were feudal and orthodox in their nature and yet had public spaces. When the gathering of people at one point in a city became more frequent the point became more accessible and occupied. Baras (large courts, Chowks (public squares) and Maidans (large grounds) became well-known gathering spaces in the towns and cities. As the population grew such points grew in number, each becoming a public space in itself and with a different and definite social character. The author aims at studying the various dimensions of public spaces with which a public space has power to hold people for a significant period of time. The human senses here are note referred to as taste, sight, hearing, touch or smell, but how human senses collectively respond to when stationed in a given public space. The collectives may reflect in dimensions like comfort, safety, environment, freedom etc. Various levels of similar other responses would be studied through interviews, observations and other scientific methods for both qualitative and quantitative analysis.

Keywords: society, interaction, people, accessibility, comfort, enclosure

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Authors: Nji Queenta Ngum, Mwanza Mulunda

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Introduction Most African research reports on the frequent aflatoxin contamination of various foodstuffs, with researchers rarely specifying which of the Aspergillus species are present in these commodities. Numerous research works provide evidence of the ability of fungi to grow, thrive, and interact with other crop species and focus on the fact that these processes are largely affected by climatic variables. South Africa is a water-stressed country with high spatio-temporal rainfall variability; moreover, temperatures have been projected to rise at a rate twice the global rate. This weather pattern change may lead to crop stress encouraging mold contamination with subsequent mycotoxin production. In this study, the biodiversity and distribution of Aspergillus species with their corresponding toxins in maize from six distinct maize producing regions with different weather patterns in South Africa were investigated. Materials And Methods By applying cultural and molecular methods, a total of 1028 maize samples from six distinct agro-climatic regions were examined for contamination by the Aspergillus species while the high performance liquid chromatography (HPLC) method was applied to analyse the level of contamination by aflatoxins. Results About 30% of the overall maize samples were contaminated by at least one Aspergillus species. Less than 30% (28.95%) of the 228 isolates subjected to the aflatoxigenic test was found to possess at least one of the aflatoxin biosynthetic genes. Furthermore, almost 20% were found to be contaminated with aflatoxins, with mean total aflatoxin concentration levels of 64.17 ppb. Amongst the contaminated samples, 59.02% had mean total aflatoxin concentration levels above the SA regulatory limit of 20ppb for animals and 10 for human consumption. Conclusion In this study, climate variables (rainfall reduction) were found to significantly (p<0.001) influence the occurrence of the Aspergillus species (especially Aspergillus fumigatus) and the production of aflatoxin in South Africa commercial maize by maize variety, year of cultivation as well as the agro-climatic region in which the maize is cultivated. This included, amongst others, a reduction in the average annual rainfall of the preceding year to about 21.27 mm, and, as opposed to other regions whose average maximum rainfall ranged between 37.24 – 44.1 mm, resulted in a significant increase in the aflatoxin contamination of maize.

Keywords: aspergillus species, aflatoxins, diversity, drought, food safety, HPLC and PCR techniques

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Authors: Samul Sahile Kebede

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Back ground: -Immune hemolytic anemia commonly affects human immune deficiency, infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to the drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV, which accompanies the greatest percent from acquired hemolytic anemia. Objective: -The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at the university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. Methods: - An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination, and antihuman globulin test were performed to the diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. Result; - The overall prevalence of immune hemolytic anemia was 2.8 % (10 of 358 participants). Of these, 5 were males, and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40 % mild and 60 % moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). Conclusion and recommendation; Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.

Keywords: anemia, hemolytic, immune, auto immune, HIV/AIDS

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Authors: Mokgadi Miranda Hlongwane, Ntebogeng Sharon Mokgalaka, Felix Dapare Dakora

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Lessertia (L.) frutescens (syn. Sutherlandia frutescens) is a leguminous medicinal plant indigenous to South Africa. Traditionally, L. frutescens has been used to treat cancer, diabetes, epilepsy, fever, HIV, stomach problems, wounds and other ailments. This legume is endemic to the Cape fynbos, with large populations occurring wild and cultivated in the Cape Florist Region. Its widespread distribution in the Western Cape, Northern Cape, Eastern Cape and Kwazulu-Natal is linked to its increased use as a phytomedicine in the treatment of various diseases by traditional healers. The frequent harvesting of field plants for use as a medicine has made it necessary to undertake studies towards the conservation of Lessertia frutescens. As a legume, this species can form root nodules and fix atmospheric N₂ when in symbiosis with soil bacteria called rhizobia. So far, however, few studies (if any) have been done on the efficacy and diversity of native bacterial symbionts nodulating L. frutescens in South Africa. The aim of this project was to isolate and characterize L. frutescens-nodulating bacteria from five different locations in the Western Cape Province. This was done by trapping soil rhizobia using rhizosphere soil suspension to inoculate L. frutescens seedlings growing in sterilized sand and receiving sterile N-free Hoagland nutrient solution under glasshouse conditions. At 60 days after planting, root nodules were harvested from L. frutescens plants, surface-sterilized, macerated, and streaked on yeast mannitol agar (YMA) plates and incubated at 28 ˚C for observation of bacterial growth. The majority of isolates were slow-growers that took 6-14 days to appear on YMA plates. However, seven isolates were fast-growers, taking 2-4 days to appear on YMA plates. Single-colony cultures of the isolates were assessed for their ability to nodulate L. frutescens as a homologous host under glasshouse conditions. Of the 92 bacterial isolates tested, 63 elicited nodule formation on L. frutescens. Symbiotic effectiveness varied markedly between and among test isolates. There were also significant (p≤0.005) differences in nodulation, shoot biomass, photosynthetic rates, leaf transpiration and stomatal conductance of L. frutescens plants inoculated with the test isolates, which is an indication of their functional diversity.

Keywords: lessertia frutescens, nodulating, rhizobia, symbiotic effectiveness

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Authors: Donghee Kang

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Background: Cancer pain is very difficult to control as the mechanism of pain is varied, and the patient has several co-morbidities. The use of Intravenous Patient-Controlled Analgesia (IV-PCA) can effectively control underlying pain and breakthrough pain. Ketamine is used in many pain patients due to its unique analgesic effect. In this study, it was checked whether there was a difference in the amount of analgesic usage, pain control degree, and side effects between patients who controlled pain with fentanyl-based IV-PCA and those who added Ketamine for pain control. Methods: Among the patients referred to this department for cancer pain, IV-PCA was applied to patients who were taking sufficient oral analgesics but could not control them or had blood clotting disorders that made the procedure difficult, and this patient group was targeted. In IV-PCA, 3000 mcg of Fentanyl, 160 mg of Nefopam, and 0.3 mg of Ramosetrone were mixed with normal saline to make a total volume of 100 ml. Group F used this IV-PCA as it is, and group K mixed 250 mg of Ketamine with normal saline to make a total volume of 100 ml. For IV-PCA, the basal rate was 0.5ml/h, the bolus was set to 1ml when pressed once, and the lockout time was set to 15 minutes. If pain was not controlled after IV-PCA application, 500 mcg of Fentanyl was added, and if excessive sedation or breathing difficulties occurred, the use was stopped for one hour. After that, the degree of daily pain control, analgesic usage, and side effects were investigated for seven days using this IV-PCA. Results: There was no difference between the two groups in the demographic data. Both groups had adequate pain control. Initial morphine milligram equivalents did not differ between the two groups, but the total amount of Fentanyl used for seven days was significantly different between the two groups [p=0.014], and group F used more Fentanyl through IV-PCA. In addition, the amount of sleeping pills used during the seven days was higher in Group F [p<0.01]. Overall, there was no difference in the frequency of side effects between the two groups, but the nausea was more frequent in Group F [p=0.031]. Discussion: When the two groups were compared, pain control was good in both groups. This seems to be because Fentanyl-based IV-PCA showed an adequate pain control effect. However, there was a significant difference in the total amount of opioid (Fentanyl) used, which is thought to be the opioid-sparing effect of Ketamine. Also, among the side effects, nausea was significantly less, which is thought to be possible because the amount of opioids used in the Ketamine group was small. The frequency of requesting sleeping pills was significantly less in the group using Ketamine, and it seems that Ketamine also helped improve sleep quality. In conclusion, using Ketamine with an opioid to control pain seems to have advantages. IV-PCA, which can be used effectively when other procedures are difficult, is more effective and safer when used together with Ketamine than opioids alone.

Keywords: cancer pain, intravenous patient-controlled analgesia, Ketamine, opioid

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Authors: Olga Mironiuk, Małgorzata Kossowska

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The aim of the present study was to investigate the influence of Situational Attribution Training on reducing automatic in-group stereotyping in females. The experiment was conducted with the control of age and level of prejudice. 90 female participants were randomly assigned to two conditions: experimental and control group (each group was also divided into younger- and older-aged condition). Participants from the experimental condition were subjected to more extensive training. In the first part of the experiment, the experimental group took part in the first session of Situational Attribution Training while the control group participated in the Grammatical Training Control. In the second part of the research both groups took part in the Situational Attribution Training (which was considered as the second training session for the experimental group and the first one for the control condition). The training procedure was based on the descriptions of ambiguous situations which could be explained using situational or dispositional attributions. The participant’s task was to choose the situational explanation from two alternatives, out of which the second one presented the explanation based on neutral or stereotypically associated with women traits. Moreover, the experimental group took part in the third training session after two- day time delay, in order to check the persistence of the training effect. The main hypothesis stated that among participants taking part in the more extensive training, the automatic in-group stereotyping would be less frequent after having finished training sessions. The effectiveness of the training was tested by measuring the response time and the correctness of answers: the longer response time for the examples where one of two possible answers was based on the stereotype trait and higher correctness of answers was considered to be a proof of the training effectiveness. As the participants’ level of prejudice was controlled (using the Ambivalent Sexism Inventory), it was also assumed that the training effect would be weaker for participants revealing a higher level of prejudice. The obtained results did not confirm the hypothesis based on the response time: participants from the experimental group responded faster in case of situations where one of the possible explanations was based on stereotype trait. However, an interesting observation was made during the analysis of the answers’ correctness: regardless the condition and age group affiliation, participants made more mistakes while choosing the situational explanations when the alternative was based on stereotypical trait associated with the dimension of warmth. What is more, the correctness of answers was higher in the third training session for the experimental group in case when the alternative of situational explanation was based on the stereotype trait associated with the dimension of competence. The obtained results partially confirm the effectiveness of the training.

Keywords: female, in-group stereotyping, prejudice, situational attribution training

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Authors: S. Surapa Raju

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In Andhra Pradesh, the symptoms of climate variations in coastal villages can be observed from various studies. The Andhra Pradesh coast is known its frequent tropical cyclones and associated floods and tidal surges causing loss of life and property in the region. In the last decade alone, the state experienced 18 devastating storms causing huge loss to coastal people. The year 2007 was the fourth warmest year on record since 1901 and 2009 witnessed the heat wave conditions prevailing over the coastal Andhra Pradesh. With regarding to sea level rise (SLR), 43 percent of the coastal areas considered to be at high risk. The main objectives of the study are: to know the perceptions of fisher people on climate variations and to find out the awareness of the fisher people on climate variations and its effects at village and on fishing households. Altogether 150 households were chosen purposively for this study and collected information from the households based on semi-structured schedule. The present field-based study observed that most of the fisher people are experienced about the changes in climate variations in their villages. The first generation fisher people expressed that the at least 1/2km of sea erosion taken place from the last 20 years and most of them displaced. With regard to fishing activities, first generation fisher people revealed that 20 years back they were fishing in near-shore areas, but now availability of near shore is decreased at a large extent. The present study observed the lot of variations in growth of species in marine districts of Andhra Pradesh from the year 2005-2010. Some species like Silver pomfret, Sole (flat fish), Chriocentrus, Thrisocies, Stakes, Rays etc. are in decaling. The results of the study indicate that huge variation observed in growth rates of fish species. Small and traditional fishers have drastically effected in El NiNo years than the normal years as they have not own suitable equipment such as crafts and nets. The study discovered that many changes taken place in the fishing activities and they are: go for long distance for fishing which increases the cost of fishing operations; decrease in fish catches. Need to take up in-depth studies in the marine villages and tackle the situation by creating more awareness about the negative effects of climate variations among fishing households. Suitable fish craft technology is to be supplied and create more employment opportunities for the fishers in other than fishery.

Keywords: climate, Andhra Pradesh, El nino years, India

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Authors: Nemat Mohammadi, Yuki Nakayama

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After occurring Great East Japan earthquake and as a consequence the invasion of an extremely large Tsunami to the city, obligated many local governments to take into account certainly these kinds of issues. Poor preparation of local governments to deal with such kinds of disasters at that time and consequently lack of assistance delivery for local residents caused thousands of civilian casualties as well as billion dollars of economic damages. Those local governments who are responsible for governing such coastal areas, have to consider some countermeasures to deal with these natural disasters, prepare a comprehensive evacuation plan and contrive some feasible emergency plans for the purpose of victims’ reduction as much as possible. Under this evacuation plan, the local government should contemplate more about the traffic congestion during wide-area evacuation operation and estimate the minimum essential time to evacuate the whole city completely. This challenge will become more complicated for the government when the people who are affected by disasters are not only limited to the normal informed citizens but also some pregnant women, physically handicapped persons, old age citizens and foreigners or tourists who are not familiar with that conditions as well as local language are involved. The important issue to deal with this challenge is that how to inform these people to take a proper action right away noticing the Tsunami is coming. After overcoming this problem, next significant challenge is even more considerable. Next challenge is to evacuate the whole residents in a short period of time from the threated area to the safer shelters. In fact, most of the citizens will use their own vehicles to evacuate to the designed shelters and some of them will use the shuttle buses which are provided by local governments. The problem will arise when all residents want to escape from the threated area simultaneously and consequently creating a traffic jam on evacuation routes which will cause to prolong the evacuation time. Hence, this research mostly aims to calculate the minimum essential time to evacuate each region inside the threated area and find the evacuation start point for each region separately. This result will help the local government to visualize the situations and conditions during disasters and assist them to reduce the possible traffic jam on evacuation routes and consequently suggesting a comprehensive wide-area evacuation plan during natural disasters.

Keywords: BPR formula, disaster scenarios, evacuation completion time, wide-area evacuation

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Authors: Aisyiyah Fauziah Rahmah

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Generally, an urban city has a rapid growth, it has frequent a variety of problems, especially of convenience in public space usage. The density of population in urban areas and the high activity is also indicated as a cause of urban resident lifestyle for the worse in social relationships and allow for the stress. Streets and green space (parks) are the only public space in a residential area which is used as a place to build social activity, to meet and interact with the other housing dweller. The high level of activity and social interaction that occurs will affect the spatial arrangement. It can be effected the space structures in housing more complex. Ease in access to public space is the reason many dweller prefer doing social activities there. Hillier in Carmona et al (2003) explains that the pattern and intensity of movement of individuals is influenced by the configuration of space, even the space structure can be regarded as the single most influential determinant of movements in the space. Whyte in Zhang and Lawson (2009) also suggest some factors such as seats, trees, water and legibility of space encourage people to stay in public outdoor space. Furthermore this activities can attract more activities. Villa Bukit Tidar is a housing in Lowokwaru District which highest number of people in Malang City, so social activity is also high there. It has natural and recreational concept and provided with view of Malang City from heights. This potential is able to attract the people who live there to stay in public outdoor space and doing activities there. From this study we can find whether the ease of access to public space and visual satisfaction of Villa Bukit Tidar housing affect the usage of public space. This study was carried out by observing the streets pattern and plot pattern to know the configuration space of Villa Bukit Tidar housing through values of connectivity and integrity by resulting from space sintax analysis. Distributing questionnaires also carried out to determine the level of satisfaction and importance perception of visual condition in the public space in Villa Bukit Tidar housing through Important Performance Analysis (IPA). Results of this research indicated that the public spaces in Villa Bukit Tidar housing who has high connectivity and integrity is considered to be visually satisfied and it has a higher public space usage than has low connectivity and integrity are considered to be visually dissatisfied.

Keywords: configuration space, visual perception, social activities, public space usage

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Authors: Marta Fernández Batalla, José María Santamaría García, Maria Lourdes Jiménez Rodríguez, Roberto Barchino Plata, Adriana Cercas Duque, Enrique Monsalvo San Macario

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Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.

Keywords: feeding behavior health, nutrition therapy, primary care nursing, technology assessment

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Authors: Gwendolyn Royal-Smith

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Cocaine ranks as one of the world’s most addictive and commonly abused stimulant drugs. Recent evidence indicates that the abuse of cocaine has risen so quickly among females that this group now accounts for about 40 percent of all users in the United States. Neuropsychological studies have demonstrated that specific neural activation patterns carry higher risks for neurocognitive and executive function in cocaine addicted females thereby increasing their vulnerability for poorer treatment outcomes and more frequent post-treatment relapse when compared to males. This study examined secondary data with a convenience sample of 164 cocaine addicted male and females to assess neurocognitive and executive function. The principal objective of this study was to assess whether individual performance on the Stroop Word Color Task is predictive of treatment success by gender. A second objective of the study evaluated whether individual performance employing neurocognitive measures including the Stroop Word-Color task, the Rey Auditory Verbal Learning Test (RALVT), the Iowa Gambling Task, the Wisconsin Card Sorting Task (WISCT), the total score from the Barratte Impulsiveness Scale (Version 11) (BIS-11) and the total score from the Frontal Systems Behavioral Scale (FrSBE) test demonstrated differences in neurocognitive and executive function performance by gender. Logistic regression models were employed utilizing a covariate adjusted model application. Initial analyses of the Stroop Word color tasks indicated significant differences in the performance of males and females, with females experiencing more challenges in derived interference reaction time and associate recall ability. In early testing including the Rey Auditory Verbal Learning Test (RALVT), the number of advantageous vs disadvantageous cards from the Iowa Gambling Task, the number of perseverance errors from the Wisconsin Card Sorting Task (WISCT), the total score from the Barratte Impulsiveness Scale (Version 11) (BIS-11) and the total score from the Frontal Systems Behavioral Scale, results were mixed with women scoring lower in multiple indicators in both neurocognitive and executive function.

Keywords: cocaine addiction, gender, neuropsychology, neurocognitive, executive function

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Authors: Nina Ponikvar, Katja Zajc Kejžar

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While the positive impacts of heritage on a broad societal spectrum have long been recognized and measured, the economic effects of the heritage sector are often less visible and frequently underestimated. At macro level, economic effects are usually studied based on one of the two mainstream approach, i.e. either the multiplier approach or the value chain approach. Consequently, there is limited comparability of the empirical results due to the use of different methodological approach in the literature. Furthermore, it is also not clear on which criteria the used approach was selected. Our aim is to bring the attention to the difference in the scope of effects that are encompassed by the two most frequent methodological approaches to valuation of economic effects of cultural heritage on macroeconomic level, i.e. the multiplier approach and the value chain approach. We show that while the multiplier approach provides a systematic, theory-based view of economic impacts but requires more data and analysis, the value chain approach has less solid theoretical foundations and depends on the availability of appropriate data to identify the contribution of cultural heritage to other sectors. We conclude that the multiplier approach underestimates the economic impact of cultural heritage, mainly due to the narrow definition of cultural heritage in the statistical classification and the inability to identify part of the contribution of cultural heritage that is hidden in other sectors. Yet it is not possible to clearly determine whether the value chain method overestimates or underestimates the actual economic impact of cultural heritage since there is a risk that the direct effects are overestimated and double counted, but not all indirect and induced effects are considered. Accordingly, these two approaches are not substitutes but rather complementary. Consequently, a direct comparison of the estimated impacts is not possible and should not be done due to the different scope. To illustrate the difference of the impact assessment of the cultural heritage, we apply both approaches to the case of Slovenia in the 2015-2022 period and measure the economic impact of cultural heritage sector in terms of turnover, gross value added and employment. The empirical results clearly show that the estimation of the economic impact of a sector using the multiplier approach is more conservative, while the estimates based on value added capture a much broader range of impacts. According to the multiplier approach, each euro in cultural heritage sector generates an additional 0.14 euros in indirect effects and an additional 0.44 euros in induced effects. Based on the value-added approach, the indirect economic effect of the “narrow” heritage sectors is amplified by the impact of cultural heritage activities on other sectors. Accordingly, every euro of sales and every euro of gross value added in the cultural heritage sector generates approximately 6 euros of sales and 4 to 5 euros of value added in other sectors. In addition, each employee in the cultural heritage sector is linked to 4 to 5 jobs in other sectors.

Keywords: economic value of cultural heritage, multiplier approach, value chain approach, indirect effects, slovenia

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Authors: Liza Ireni-Saban

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The 6.6 magnitude quake event that occurred in 2003 (Bam, Iran) made it impossible for the Iranian government to handle disaster relief efforts domestically. In this extreme event, the Iranian government reached out to the international community, and this created a momentum that had to be carried out by trust-building efforts on all sides, often termed ‘Disaster Diplomacy’. Indeed, the circumstances were even more critical when one considers the increasing political and economic isolation of Iran within the international community. The potential for transformative political space to be opened by disaster has been recognized by dominant international political actors. Despite the fact that Bam 2003 post-disaster relief efforts did not catalyze any diplomatic activities on all sides, it is suggested that few international aid agencies have successfully used disaster recovery to enhance their popular legitimacy and reputation among the international community. In terms of disaster diplomacy, an actor’s reputational capital may affect his ability to build coalitions and alliances to achieve international political ends, to negotiate and build understanding and trust with foreign publics. This study suggests that the post-disaster setting may benefit from using the ecology of games framework to evaluate the role of bridging actors and mediators in facilitating collaborative governance networks. Recent developments in network theory and analysis provide means of structural embeddedness to explore how reputational capital can be built through brokerage roles of actors engaged in a disaster management network. This paper then aims to structure the relations among actors that participated in the post-disaster relief efforts in the 2003 Bam earthquake (Iran) in order to assess under which conditions actors may be strategically utilized to serve as mediating organizations for future disaster events experienced by isolated nations or nations in conflict. The results indicate the strategic use of reputational capital by the Iranian Ministry of Foreign Affairs as key broker to build a successful coordinative system for reducing disaster vulnerabilities. International aid agencies rarely played brokerage roles to coordinate peripheral actors. U.S. foreign assistance (USAID), despite coordination capacities, was prevented from serving brokerage roles in the system.

Keywords: coordination, disaster diplomacy, international aid organizations, Iran

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Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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Authors: A. G. Back

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In the context of global climate change, extreme weather events are increasingly intense and frequent, challenging the adaptability of urban space. In this sense, urban planning is a relevant instrument for addressing, in a systemic manner, various sectoral policies capable of linking the urban agenda to the reduction of social and environmental risks. The Master Plan of the Municipality of Sao Paulo, 2014, presents innovations capable of promoting the transition to sustainability in the urban space. Among such innovations, the following stand out: i) promotion of density in the axes of mass transport involving mixture of commercial, residential, services, and leisure uses (principles related to the compact city); ii) vulnerabilities reduction based on housing policies, including regular sources of funds for social housing and land reservation in urbanized areas; iii) reserve of green areas in the city to create parks and environmental regulations for new buildings focused on reducing the effects of heat island and improving urban drainage. However, long-term implementation involves distributive conflicts and may change in different political, economic, and social contexts over time. Thus, the central objective of this paper is to identify which factors limit or support the implementation of these policies. That is, to map the challenges and interests of converging and/or divergent urban actors in the sustainable urban development agenda and what resources they mobilize to support or limit these actions in the city of Sao Paulo. Recent proposals to amend the urban zoning law undermine the implementation of the Master Plan guidelines. In this context, three interest groups with different views of the city come into dispute: the real estate market, upper middle class neighborhood associations ('not in my backyard' movements), and social housing rights movements. This paper surveys the different interests and visions of these groups taking into account their convergences, or not, with the principles of sustainable urban development. This approach seeks to fill a gap in the international literature on the causes that underpin or hinder the continued implementation of policies aimed at the transition to urban sustainability in the medium and long term.

Keywords: adaptation, ecosystem-based adaptation, interest groups, urban planning, urban transition to sustainability

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