Search results for: post facial syndrome

Authors: L. Matthewman, J. Nowlan

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Background: Holistic or Integrative Psychology emphasizes the interdependence of physiological, spiritual and psychological dynamics. Studying “wholeness and well-being” from a systems perspective combines innovative psychological science interventions with Eastern orientated healing wisdoms and therapies. The literature surrounding holistic/integrative psychology focuses on multi-stage interventions in attempts to enhance the mind-body experiences of well-being for participants. This study proposes a new single stage model as an intervention for UG/PG students, time-constrained workplace employees and managers/leaders for improved well-being and life enhancement. The main research objective was to investigate participants’ experiences of holistic and mindfulness interventions for impact on emotional well-being. The main research question asked was if single stage holistic interventions could impact on psychological well-being. This is of consequence because many people report that a reason for not taking part in mind-body or wellness programmes is that they believe that they do not have sufficient time to engage in such pursuits. Experimental Approach: The study employed a mixed methods pre-test/post-test research design. Data was analyzed using descriptive statistics and interpretative phenomenological analysis. Purposive sampling methods were employed. An adapted mindfulness measurement questionnaire (MAAS) was administered to 20 volunteer final year UG student participants prior to the single stage intervention and following the intervention. A further post-test longitudinal follow-up took place one week later. Intervention: The single stage model intervention consisted of a half hour session of mindfulness, yoga stretches and head and neck massage in the following sequence: Mindful awareness of the breath, yoga stretches 1, mindfulness of the body, head and neck massage, mindfulness of sounds, yoga stretches 2 and finished with pure awareness mindfulness. Results: The findings on the pre-test indicated key themes concerning: “being largely unaware of feelings”, “overwhelmed with final year exams”, “juggling other priorities” , “not feeling in control”, “stress” and “negative emotional display episodes”. Themes indicated on the post-test included: ‘more aware of self’, ‘in more control’, ‘immediately more alive’ and ‘just happier’ compared to the pre-test. Themes from post-test 2 indicated similar findings to post-test 1 in terms of themes. but on a lesser scale when scored for intensity. Interestingly, the majority of participants reported that they would now seek other similar interventions in the future and would be likely to engage with a multi-stage intervention type on a longer-term basis. Overall, participants reported increased psychological well-being after the single stage intervention. Conclusion: A single stage one-off intervention model can be effective to help towards the wellbeing of final year UG students. There is little indication to suggest that this would not be generalizable to others in different areas of life and business. However this study must be taken with caution due to low participant numbers. Implications: Single stage one-off interventions can be used to enhance peoples’ lives who might not otherwise sign up for a longer multi-stage intervention. In addition, single stage interventions can be utilized to help participants progress onto longer multiple stage interventions. Finally, further research into one stage well-being interventions is encouraged.

Keywords: holistic/integrative psychology, mindfulness, well-being, yoga

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Authors: Sergei Kosarev

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Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

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Authors: Pavel Bulai, Taras Pitlik, Tatsiana Kulahava, Timofei Lipski

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The method of Electrocardiography (ECG) interpretation for post-exercise recovery tracking was developed. Metabolic indices (aerobic and anaerobic) were designed using ECG-derived features. This study reports the associations between aerobic and anaerobic indices and classical parameters of the person’s physiological state, including blood biochemistry, glycogen concentration and VO2max changes. During the study 9 participants, healthy, physically active medium trained men and women, which trained 2-4 times per week for at least 9 weeks, fulfilled (i) ECG monitoring using Apple Watch Series 4 (AWS4); (ii) blood biochemical analysis; (iii) maximal oxygen consumption (VO2max) test, (iv) bioimpedance analysis (BIA). ECG signals from a single-lead wrist-wearable device were processed with detection of QRS-complex. Aerobic index (AI) was derived as the normalized slope of QR segment. Anaerobic index (ANI) was derived as the normalized slope of SJ segment. Biochemical parameters, glycogen content and VO2max were evaluated eight times within 3-60 hours after training. ECGs were recorded 5 times per day, plus before and after training, cycloergometry and BIA. The negative correlation between AI and blood markers of the muscles functional status including creatine phosphokinase (r=-0.238, p < 0.008), aspartate aminotransferase (r=-0.249, p < 0.004) and uric acid (r = -0.293, p<0.004) were observed. ANI was also correlated with creatine phosphokinase (r= -0.265, p < 0.003), aspartate aminotransferase (r = -0.292, p < 0.001), lactate dehydrogenase (LDH) (r = -0.190, p < 0.050). So, when the level of muscular enzymes increases during post-exercise fatigue, AI and ANI decrease. During recovery, the level of metabolites is restored, and metabolic indices rising is registered. It can be concluded that AI and ANI adequately reflect the physiology of the muscles during recovery. One of the markers of an athlete’s physiological state is the ratio between testosterone and cortisol (TCR). TCR provides a relative indication of anabolic-catabolic balance and is considered to be more sensitive to training stress than measuring testosterone and cortisol separately. AI shows a strong negative correlation with TCR (r=-0.437, p < 0.001) and correctly represents post-exercise physiology. In order to reveal the relation between the ECG-derived metabolic indices and the state of the cardiorespiratory system, direct measurements of VO2max were carried out at various time points after training sessions. The negative correlation between AI and VO2max (r = -0.342, p < 0.001) was obtained. These data testifying VO2max rising during fatigue are controversial. However, some studies have revealed increased stroke volume after training, that agrees with findings. It is important to note that post-exercise increase in VO2max does not mean an athlete’s readiness for the next training session, because the recovery of the cardiovascular system occurs over a substantially longer period. Negative correlations registered for ANI with glycogen (r = -0.303, p < 0.001), albumin (r = -0.205, p < 0.021) and creatinine (r = -0.268, p < 0.002) reflect the dehydration status of participants after training. Correlations between designed metabolic indices and physiological parameters revealed in this study can be considered as the sufficient evidence to use these indices for assessing the state of person’s aerobic and anaerobic metabolic systems after training during fatigue, recovery and supercompensation.

Keywords: aerobic index, anaerobic index, electrocardiography, supercompensation

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Authors: Nguyen Quynh Trang, Nguyễn Thị Hông Nhung

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The study aimed to identify the effectiveness of using the mind map technique to enhance students’ medical vocabulary retention among a group of students at a higher education institution - Thai Nguyen University of Medicine and Pharmacy during the first semester of the school year 2022-2023. The research employed a quasi-experimental method, exploring primary sources such as questionnaires and the analyzed results of pre-and-post tests. Almost teachers and students showed high preferences for the implementation of the mind map technique in language teaching and learning. Furthermore, results from the pre-and-post tests between the experimental group and control one pointed out that this technique brought back positive academic performance in teaching and learning English. The research findings revealed that there should be more supportive policies to evoke the use of the mind map technique in a pedagogical context. Aim of the Study: The purpose of this research was to investigate whether using mind mapping can help students to enhance nursing students’ medical vocabulary retention and to assess the students’ attitudes toward using mind mapping as a tool to improve their vocabulary. The methodology of the study: The research employed a quasi-experimental method, exploring primary sources such as questionnaires and the analyzed results of pre-and-post tests. The contribution of the study: The research contributed to the innovation of teaching vocabulary methods for English teachers at a higher education institution. Moreover, the research helped the English teachers and the administrators at a university evoke and maintain the motivation of students not only in English classes but also in other subjects. The findings of this research were beneficial to teachers, students, and researchers interested in using mind mapping to teach and learn English vocabulary. The research explored and proved the effectiveness of applying mind mapping in teaching and learning English vocabulary. Therefore, teaching and learning activities were conducted more and more effectively and helped students overcome challenges in remembering vocabulary and creating motivation to learn English vocabulary.

Keywords: medical vocabulary retention, mind map technique, nursing students, medical vocabulary

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: A. Flora, A. Di Lascio, D. Cardone, G. Gesualdi, G. Perrone

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This paper considers the seismic assessment and retrofit of a pilotis-type RC frame building, which was designed for gravity loads only, prior to the introduction of seismic design provisions. Pilotis-type RC frame buildings, featuring an uniform infill throughout the height and an open ground floor, were, and still are, quite popular all over the world, as they offer large open areas very suitable for retail space at the ground floor. These architectural advantages, however, are of detriment to the building seismic behavior, as they can determine a soft-storey collapse mechanism. Extensive numerical analyses are carried out to quantify and benchmark the performance of the selected building, both in terms of overall collapse capacity and expected losses. Alternative retrofit strategies are then examined, including: (i) steel jacketing of RC columns and beam-column joints, (ii) steel bracing and (iv) seismic isolation. The Expected Annual Loss (EAL) of the selected case-study building, pre- and post-rehabilitation, is evaluated, following a probabilistic approach. The breakeven time of each solution is computed, comparing the initial cost of the retrofit intervention with expected benefit in terms of EAL reduction.

Keywords: expected annual loss, reinforced concrete buildings, seismic loss assessment, seismic retrofit

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Authors: Saeed Dehnavi, Zahra Dehnavi

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Background: Psychodrama, as a form of art therapy, helps people to enact and use role-plays for a specific problem, rather than just talking about it, in an effort to review the problem, gain feedback from group members, find appropriate solutions, and practice them for their life. This paper evaluated the effectiveness of psychodrama on enhancing self-esteem of young adolescent boys. Methodology: This is aquasi-experimental research study, using a pre-post testing plan with control group.From four secondary schools in Kermanshah – Iran, 210 adolescent boys (aged 13 and 14 years) were asked to complete Koper Smith's self-esteem measure scale. Given the low self-esteem scores (less than the cut-off of 23), a number of 20 individuals were selected and randomly placed into two control and experimental groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. Data analysis was carried out by the analysis of covariance (ANCOVA). Results: The results of ANCOVA analysis showed an increase in the post-test scores for self-esteem, and such increase was statistically significant. Conclusion: The findings indicated the effectiveness of psychodrama on self-esteem enhancement of young boys. During psychodrama sessions, the adolescents learned to take the initiative, communicate with others in an excited state, and improve their self-esteem with positive and constructive experiences.

Keywords: psychodrama, self-esteem, young adolescents, boys

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Authors: Nurul Z. Sani, Amalina N. Ghazali, Azree Elmy, Lee C. Yuen, Zar C. Thent

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Piper betel (P. betel) leaves is widely used in Asian countries for treating diabetes mellitus and its complication. In our previous study, we observed the positive effect of P.betel extract on diabetic wounds following 3 and 7 days of treatment. The aim of the present study was to determine the effect of P.betel leaves extract in the diabetic rats was observed in terms of body weight and wound contraction rates following 5 days of the treatment. Total 64 male Sprague-Dawley rats were used and the experimental rats received a single dose of 60mg/kg of Streptozotocin (STZ) injection, intraperitoneally. Four full thickness (6mm) cutaneous wounds were created on dorsum of each rat. The rats were divideid into (n=8): Non-treated Control (NC), Non-treated Diabetic (ND), diabetic treated with commercial cream (SN) and diabetic treated with 50mg/kg of P.betel extract (PB). The rats were sacrificed on day 0 and 5 post wounding. Significant increased in wound closure rate, body weight was observed in PB group compared to ND. Histological deterioration was restored in the P. betel extract treated wounds. It is concluded that topical application with P.betel extract for 5 days of post wounding offers positive scientific value in diabetic rats.

Keywords: diabetes, piper betel, wound healing, body weight, morphology

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Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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Authors: Manana Kvetenadze, Dali Nikolaishvili

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The study revealed the territorial changes of Georgia before the Soviet and Post-Soviet periods. This includes the estimation of the country's borders, its administrative-territorial arrangement change as well as the establishment of territorial losses. Georgia’s old and new borders marked on the map are of great interest. The new boundary shows the condition of 1922 year, following the Soviet period. Neither on this map nor in other works Ivane Javakhishvili talks about what he implies in the old borders, though it is evident that this is the Pre-Soviet boundary until 1921 – i.e., before the period when historical Tao, Zaqatala, Lore, Karaia represented the parts of Georgia. According to cartometric-geographical terms, the work presents detailed analysis of Georgia’s borders, along with this the comparison of research results has been carried out: 1) At the boundary line on Soviet topographic maps, the maps of 100,000; 50,000 and 25,000 scales are used; 2) According to Ivane Javakhishvili’s work ('The borders of Georgia in terms of historical and contemporary issues'). During that research, we used multi-disciplined methodology and software. We used Arc GIS for Georeferencing maps, and after that, we compare all post-Soviet Union maps, in order to determine how the borders have changed. During this work, we also use many historical data. The features of the spatial distribution of the territorial administrative units of Georgia, as well as the distribution of administrative-territorial units of the objects depicted on the map, have been established. The results obtained are presented in the forms of thematic maps and diagrams.

Keywords: border, GIS, georgia, historical cartography, old maps

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Authors: Liberty Takudzwa Nyete

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This paper examines the feminine representation of women’s experiences in relation to womanhood as depicted by selected three South African female authors:. The study examines the challenges, difficulties and strategies used by various female characters’ to deal with situations in a typical apartheid and post-apartheid society. It also explores the way in which gender, race and class discourses are treated in the selected texts. The three authors, born and bred at the peak of the anti-apartheid movement and women’s protest against patriarchy, witnessed the effects of apartheid on both their families and societies at large which could perhaps have influenced their writing. The study is informed by both the feminist and womanist ideologies postulated by different theorists. In particular, the study of Not Woman Enough considers issues of motherhood, womanhood and racism; while that of Shameless focuses on the importance of women’s narration of their own stories, sexuality and racism; and the depiction of sexual violence, class, and women’s roles in the fight against oppression is explored with regard to This Book Betrays My Brother. Thus, the study concludes on the social makeovers that include women in all the spheres of life, such as education and the economy, which were largely dominated by men but are no longer defined by economic status, physical attributes, class nor sexuality.

Keywords: apartheid, feminism, prostitution, sexual violence, womanism, womanhood

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Authors: Mustafa M. Donma, Orkide Donma

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Cardiovascular pathology is one of the expected consequences of excessive fat gain. The role of zinc in thyroid hormone metabolism is an important matter. The concentrations of both thyroid stimulating hormone (TSH) and zinc are subject to variation in obese individuals. Zinc exhibits protective effects on cardiovascular health and is inversely correlated with cardiovascular markers in childhood obesity. The association between subclinical hypothyroidism (SCHT) and metabolic disorders is under investigation due to its clinical importance. Underactive thyroid gland causes high TSH levels. Subclinical hypothyroidism is defined as the elevated serum TSH levels in the presence of normal free thyroxin (T4) concentrations. The aim of this study was to evaluate the associations between TSH levels and zinc concentrations in morbid obese (MO) children exhibiting SCHT. The possibility of using the probable association between these parameters was also evaluated for the discrimination of metabolic syndrome positive (MetS+) and metabolic syndrome negative (MetS-) groups. Forty-two children were present in each group. Informed consent forms were obtained. Institutional Ethics Committee approved the study protocol. Tables prepared by World Health Organization were used for the definition of MO children. Children, whose age- and sex-dependent body mass index percentile values were above 99, were defined as MO. Children with at least two MetS components were included in MOMetS+ group. Elevated systolic/diastolic blood pressure values, increased fasting blood glucose, triglycerides (TRG)/decreased high density lipoprotein-cholesterol (HDL-C) concentrations in addition to central obesity were listed as MetS components. Anthropometric measures were recorded. Routine biochemical analyses were performed. Thirteen and fifteen children had SCHT in MOMetS- and MOMetS+ groups, respectively. Statistical analyses were performed. p<0.05 was accepted as statistically significant. In MOMetS- and MOMetS+ groups, TSH levels were 4.1±2.9 mU/L and 4.6±3.1 mU/L, respectively. Corresponding values for SCHT cases in these groups were 7.3±3.1 mU/L and 8.0±2.7 mU/L. Free T4 levels were within normal limits. Zinc concentrations were negatively correlated with TSH levels in both groups. The significant negative correlation calculated in MOMetS+ group (r= -0.909; p<0.001) was much stronger than that found in MOMetS- group (r= -0.706; p<0.05). This strong correlation (r= -0.909; p<0.001) calculated for cases with SCHT in MOMetS+ group was much lower (r= -0.793; p<0.001) when all MOMetS+ cases were considered. Zinc is closely related to T4 and TSH therefore, it participates in thyroid hormone metabolism. Since thyroid hormones are required for zinc absorption, hypothyroidism can lead to zinc deficiency. The presence of strong correlations between TSH and zinc in SCHT cases found in both MOMetS- and MOMetS+ groups pointed out that MO children were under the threat of cardiovascular pathologies. The detection of the much stronger correlation in MOMetS+ group in comparison with the correlation found in MOMetS- group was the indicator of greater cardiovascular risk due to the presence of MetS. In MOMetS+ group, correlation in SCHT cases found higher than correlation calculated for all cases confirmed much higher cardiovascular risk due to the contribution of SCHT.

Keywords: cardiovascular risk, children, morbid obesity, subclinical hypothyroidism, zinc

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Authors: Imran Khan Swati, Mohammad Younas

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This work aims to explore the potential applications of polymeric hydrophobic membranes and green ionic liquids (ILs). Protic and aprotic ILs were synthesized in the lab., characterized, and tested for CO₂/N₂ and CO₂/CH₄ separation using hydrophobic polymeric membranes via supported ionic liquid membrane (SILM). ILs were verified by FTIR spectroscopy. The SILMs were stable at room temperature up to 0.5 MPa. For CO₂, [BSmim][tos] had the greatest coefficient of solubility and permeability, along with all ILs. At 0.5 MPa, IL [BSmim][tos] was found with a selectivity of 56.2 and 47.5 for pure CO₂/N₂ and CO₂/CH₄, respectively. The ILs synthesized for this study are rated as [BSmim][tos]>[BSmpy][tos]>[Bmim][Cl]>[Bpy][Cl] based on their SILM separation performance. Furthermore, high values of selectivity of [BSmim][tos] and [BSmpy][tos] support the use of ILs for CO₂ separation using SILMs. The study was extended to synthesize and test the ammonium-based ILs, [2-HEA][f] and [2-HEA][Hs]. These ILs achieved 50 % less selectivity for CO₂/N₂ as compared to [BSmim][tos] and [BSmpy][tos]. Nevertheless, the permeability of CO₂ achieved with [2-HEA][f] and [2-HEA][Hs] is more than 20 times higher than the [BSmim][tos] and [BSmpy][tos]. Later, the CO₂/N₂ permeability and selectivity study was extended using a flat sheet membrane contactor with recirculated IL. The contact angle effects, liquid entry pressure (LEP), initial CO₂ concentration, and type of solvents and membrane material on the CO₂ capture efficiency and membrane wetting in the post-combustion capture (PCC) process have been experimentally investigated and evaluated. Polytetrafluoroethylene (PTFE) has shown the most hydrophobic property with 6-170 loss in the contact angle. Furthermore, [Omim][BF4] and [Bmim][BF6] have exhibited only 5-8 % loss in LEP using PTFE membrane support. The CO₂ capture efficiency has been achieved as 80.8-99.8 % in different combinations of ILs and membrane support, keeping all other variables constant. While increasing CO₂ concentration from 15 to 45 % vol., an increase of nearly three folds in the CO₂ mass transfer flux was observed. The combination of [Omim][BF4] and PTFE membrane witnessed good long-term stability with only a 20 % loss in CO₂ capture efficiency in 480 min of continuous operation. A 3- D simulation model for non-dispersive solvent absorption in membrane contactors provides insight into the optimum design of a separation system for a specific application minimizing the overall cost and making the process environment-friendly.

Keywords: Post-combustion CO2 capture, membrane synthesis, process development, permeability and selectivity, ionic liquids

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Authors: Alonge Isaac Olusola

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This paper focuses on the evolution and development of Yoruba theatre during the pre-colonial, colonial and post-colonial years and how Yoruba crime films have been influenced by foreign culture. It emphasizes on the transition of theatre from the ground to the stage and from the stage to the screen with emphasis on the contribution of late Chief Hubert Ogunde who is regarded as the doyen of Yoruba and the entire Nigerian theatre. Using the Theory of Post-colonialism, two modern Yoruba crime films are carefully selected from the numerous available ones to highlight and explain the various aspects of Yoruba films that have been greatly influenced by the foreign cultural practices. The questions to be answered here include 'Which attitudes or cultural practices are widely believed to be that of Yoruba?', 'To what extent are they projected in the selected Yoruba crime films?', 'Which attitudes or cultural practices are widely believed to be foreign among the Yoruba people?', 'To what extent are they projected in the selected Yoruba crime films?'. Although, the British colonial masters granted political independence to Nigeria on October 1, 1960, but a seed of multi-culture and counterculture had been sown into the lives of the Yoruba people. Under the literature review, there is an intensive illumination on some scholars’ ideas and views on what constitutes Yoruba culture, the evolution and development of drama, theatre and films in the Yoruba society and the nature of criminals and criminalities in the Yoruba society and the western world in the pre-colonial and post-colonial times. Furthermore, the processes of interaction between man, his values and his thoughts are also highlighted – a situation that procreates criminal or benevolent acts. Consequently, the paper dwells on how colonialism, despite its so-called merits put the gradual process of urbanization and civilization among the originally rustic, cohesive and moralistic Yoruba society on a supersonic speed that culminated in acquisition of attitudes that are alien to the Yoruba culture. Since a drama is nothing but the theatrical replication of what occurs in the real life, the paper then focuses on the submission that Yoruba crime films have experienced a serious foreign influence in form and content as a result of this encounter. In conclusion, the findings of the impact of foreign cultural practices on Yoruba crime films are highlighted and expatiated with a view to recommending a few steps that could be taken to retain the projection of the original Yoruba cultural practices in Yoruba films, especially the ones that have crime as a theme.

Keywords: culture, films, theatre, Yoruba

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Authors: Andrée-Anne Parent, Alain-Steve Comtois

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The Antarctica environment can be a great challenge for human exploration. Explorers need to be focused on the task and require the physical abilities to succeed and survive in complete autonomy in this hostile environment. The aim of this study was to observe cognitive performance and physiological stress with a biomarker (cortisol) and hand grip strength during an expedition in Antarctica. A total of 6 explorers were in complete autonomous exploration on the Forbidden Plateau in Antarctica to reach unknown summits during a 30 day period. The Stroop Test, a simple reaction time, and mood scale (PANAS) tests were performed every week during the expedition. Saliva samples were taken before sailing to Antarctica, the first day on the continent, after the mission on the continent and on the boat return trip. Furthermore, hair samples were taken before and after the expedition. The results were analyzed with SPSS using ANOVA repeated measures. The Stroop and mood scale results are presented in the following order: 1) before sailing to Antarctica, 2) the first day on the continent, 3) after the mission on the continent and 4) on the boat return trip. No significant difference was observed with the Stroop (759±166 ms, 850±114 ms, 772±179 ms and 833±105 ms, respectively) and the PANAS (39.5 ±5.7, 40.5±5, 41.8±6.9, 37.3±5.8 positive emotions, and 17.5±2.3, 18.2±5, 18.3±8.6, 15.8±5.4 negative emotions, respectively) (p>0.05). However, there appears to be an improvement at the end of the second week. Furthermore, the simple reaction time was significantly lower at the end of the second week, a moment where important decisions were taken about the mission, vs the week before (416±39 ms vs 459.8±39 ms respectively; p=0.030). Furthermore, the saliva cortisol was not significantly different (p>0.05) possibly due to important variations and seemed to reach a peak on the first day on the continent. However, the cortisol from the hair pre and post expedition increased significantly (2.4±0.5 pg/mg pre-expedition and 16.7±9.2 pg/mg post-expedition, p=0.013) showing important stress during the expedition. Moreover, no significant difference was observed on the grip strength except between after the mission on the continent and after the boat return trip (91.5±21 kg vs 85±19 kg, p=0.20). In conclusion, the cognitive performance does not seem to be affected during the expedition. Furthermore, it seems to increase for specific important events where the crew seemed to focus on the present task. The physiological stress does not seem to change significantly at specific moments, however, a global pre-post mission measure can be important and for this reason, for long-term missions, a pre-expedition baseline measure is important for crewmembers.

Keywords: Antarctica, cognitive performance, expedition, physiological adaptation, reaction time

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Authors: Aicha Majda, Abdelhamid El Hassani

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Lung CT image segmentation is a prerequisite in lung CT image analysis. Most of the conventional methods need a post-processing to deal with the abnormal lung CT scans such as lung nodules or other lesions. The simplest similarity measure in the standard Graph Cuts Algorithm consists of directly comparing the pixel values of the two neighboring regions, which is not accurate because this kind of metrics is extremely sensitive to minor transformations such as noise or other artifacts problems. In this work, we propose an improved version of the standard graph cuts algorithm based on the Patch-Based similarity metric. The boundary penalty term in the graph cut algorithm is defined Based on Patch-Based similarity measurement instead of the simple intensity measurement in the standard method. The weights between each pixel and its neighboring pixels are Based on the obtained new term. The graph is then created using theses weights between its nodes. Finally, the segmentation is completed with the minimum cut/Max-Flow algorithm. Experimental results show that the proposed method is very accurate and efficient, and can directly provide explicit lung regions without any post-processing operations compared to the standard method.

Keywords: graph cuts, lung CT scan, lung parenchyma segmentation, patch-based similarity metric

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Authors: Ali Shah

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This paper outlines the case study experience of using a variety of online strategies in an Australian music academy context during covid times. The study aimed at exploring how online applications help students to learn music, specifically playing musical instruments, composing songs, and performing virtually. To explore this, music teachers’ perceptions and experiences regarding online learning, the teaching strategies they implemented, and the challenges they faced were examined. For the purpose of this study, a qualitative research structure was adopted through the use of three data collection tools. These methods included pre- and post-research individual interviews of teachers and students, analysis of their lesson plans, virtual classroom observations of the teachers followed by the researcher’sown reflections, post-observation discussions, and teachers’ reflective journals. The findings revealed that teachers had a theoretical understanding of virtual learning and recent musical application such as Flowkey, Skoove, and Piano marvel, which are benefits of e-learning. While teachers faced challenges in implementing strategies to teach keyboard/piano online, overall, both students and teachers felt the positive impact of online applications and strategies on their learning and felt that modern technology made it possible for anyone to take music lessons at home.

Keywords: music, keyboard, piano, online learning, virtual learning

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Authors: Hanifa Maryani Ahmad, Muslim Yusuf

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Background: Unilateral crossbite can be defined as an abnormal transverse relationship between the upper and lower teeth where the mandibular buccal cusp occluding to the maxillary buccal cusp and which involves only one side of the arch. This report describes the treatment of an adolescent female with Class III malocclussion unilateral crossbite resulting from a mildly constricted maxillary arch. The patient had a Class III skeletal relationship, Class III molar relationships, unilateral crossbite on the left side, and deviated midlines. Objectives: The treatment objectives were to correct the abnormal transverse relationship, achieve proper dental inclination, and correct the unilateral crossbites to improve the facial profile. Case management: The treatment protocol was using transpalatal arch with extension arm modification to expand the maxillary arch. Following the levelling and aligning stage of treatment, using a vertical loop while mandibular arch was expanded after getting an end to end relationship on the anterior side. Results: Corrections of the unilateral crossbite were achieved in 4 months. The treatment is still on process because the canines relationship were not corrected. Conclusions: This report highlights a treatment using transpalatal arch with extension arm modification that can be used to expand the transverse width of an arch to correct the discrepancy. Even though the treatment processes were still ongoing, the correction of the unilateral crossbite have been achieved in 4 months by only using the transpalatal arch.

Keywords: crossbite unilateral, late growing, non-extraction, transpalatal arch

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Authors: Abdmohammad Mousavi, Mohsen Shams, Mehdi Akbartabar Toori, Ali Mousavizadeh, Mohammad Ali Morowatisharifabad

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The effectiveness of Transtheoretical Model (TTM) on nutritional behavior change and lose weight has been subject to questions by some studies. The objective of this study was to determine the effect of nutritional behavior change and lose weight interventions based on TTM in obese and overweight women. This experimental study that was a 8 months trial nutritional behavior change and weight loss program based on TTM with two conditions and pre–post intervention measurements weight mean. 299 obese and overweight 20-44 years old women were selected from two health centers include training (142) and control (157) groups in Yasuj, a city in south west of Iran. Data were analyzed using paired T-test and One–Way ANOVA tests. In baseline, adherence with nutritional healthy behavior in training group(9.4%) compare with control(38.8%) were different significantly(p=.003), weight mean of training(Mean=78.02 kg, SD=11.67) compared with control group(Mean=77.23 kg, SD=10.25) were not (P=.66). In post test, adherence with nutritional healthy behavior in training group(70.1%) compare with control (37.4%) were different significantly (p=.000), weight mean of training (Mean=74.65 kg, SD=10.93, p=.000) compare with pre test were different significantly and control (Mean=77.43 kg, SD=10.43, p=.411) were not. The training group has lost 3.37 kg weight, whereas the control group has increased .2 kg weight. These results supported the applicability of the TTM for women weight lose intervention.

Keywords: nutritional behavior, Transtheoretical Model, weight lose, women

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Authors: Amin Asgarian, Ghyslaine McClure

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Experiences in the past earthquakes have clearly demonstrated the necessity of seismic design and assessment of Non-Structural Components (NSCs) particularly in post-disaster structures such as hospitals, power plants, etc. as they have to be permanently functional and operational. Meeting this objective is contingent upon having proper seismic performance of both structural and non-structural components. Proper seismic design, analysis, and assessment of NSCs can be attained through generation of Floor Design Spectrum (FDS) in a similar fashion as target spectrum for structural components. This paper presents the developed methodology to generate FDS directly from corresponding Uniform Hazard Spectrum (UHS) (i.e. design spectra for structural components). The methodology is based on the experimental and numerical analysis of a database of 27 real Reinforced Concrete (RC) buildings which are located in Montreal, Canada. The buildings were tested by Ambient Vibration Measurements (AVM) and their dynamic properties have been extracted and used as part of the approach. Database comprises 12 low-rises, 10 medium-rises, and 5 high-rises and they are mostly designated as post-disaster\emergency shelters by the city of Montreal. The buildings are subjected to 20 compatible seismic records to UHS of Montreal and Floor Response Spectra (FRS) are developed for every floors in two horizontal direction considering four different damping ratios of NSCs (i.e. 2, 5, 10, and 20 % viscous damping). Generated FRS (approximately 132’000 curves) are statistically studied and the methodology is proposed to generate the FDS directly from corresponding UHS. The approach is capable of generating the FDS for any selection of floor level and damping ratio of NSCs. It captures the effect of: dynamic interaction between primary (structural) and secondary (NSCs) systems, higher and torsional modes of primary structure. These are important improvements of this approach compared to conventional methods and code recommendations. Application of the proposed approach are represented here through two real case-study buildings: one low-rise building and one medium-rise. The proposed approach can be used as practical and robust tool for seismic assessment and design of NSCs especially in existing post-disaster structures.

Keywords: earthquake engineering, operational and functional components, operational modal analysis, seismic assessment and design

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Authors: Ehsan Atefi, Michael Grigware

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Respiratory failure secondary to surfactant deficiency resulting from respiratory distress syndrome is considered one major cause of morbidity in preterm infants. Surfactant replacement treatment (SRT) is considered an effective treatment for this disease. Here, we introduce an AI-mediated approach for estimating the distribution of surfactant in the lung airway of a newborn infant during SRT. Our approach implements machine learning to precisely estimate the splitting ratio of a liquid drop during bifurcation at different injection velocities and patient orientations. This technique can be used to calculate the surfactant residue remaining on the airway wall during the surfactant injection process. Our model works by minimizing the pressure drop difference between the two airway branches at each generation, subject to mass and momentum conservation. Our platform can be used to generate feedback for immediately adjusting the velocity of injection and patient orientation during SRT.

Keywords: respiratory failure, surfactant deficiency, surfactant replacement, machine learning

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Authors: Inigo Sanz-Pena, Shanika Arachchi, Dilani Dhammika, Sanjaya Mallikarachchi, Jeewantha S. Bandula, Alison H. McGregor, Nicolas Newell

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The use of orthotic braces for adolescent idiopathic scoliosis (AIS) patients is the most common non-surgical treatment to prevent deformity progression. The traditional method to create an orthotic brace involves casting the patient’s torso to obtain a representative geometry, which is then rectified by an orthotist to the desired geometry of the brace. Recent improvements in 3D scanning technologies, rectification software, CNC, and additive manufacturing processes have given the possibility to compliment, or in some cases, replace manual methods with digital approaches. However, the rectification process remains dependent on the orthotist’s skills. Therefore, the rectification process needs to be carefully characterized to ensure that braces designed through a digital workflow are as efficient as those created using a manual process. The aim of this study is to compare 3D scans of patients with AIS against 3D scans of both pre- and post-rectified casts that have been manually shaped by an orthotist. Six AIS patients were recruited from the Ragama Rehabilitation Clinic, Colombo, Sri Lanka. All patients were between 10 and 15 years old, were skeletally immature (Risser grade 0-3), and had Cobb angles between 20-45°. Seven spherical markers were placed at key anatomical locations on each patient’s torso and on the pre- and post-rectified molds so that distances could be reliably measured. 3D scans were obtained of 1) the patient’s torso and pelvis, 2) the patient’s pre-rectification plaster mold, and 3) the patient’s post-rectification plaster mold using a Structure Sensor Mark II 3D scanner (Occipital Inc., USA). 3D stick body models were created for each scan to represent the distances between anatomical landmarks. The 3D stick models were used to analyze the changes in position and orientation of the anatomical landmarks between scans using Blender open-source software. 3D Surface deviation maps represented volume differences between the scans using CloudCompare open-source software. The 3D stick body models showed changes in the position and orientation of thorax anatomical landmarks between the patient and the post-rectification scans for all patients. Anatomical landmark position and volume differences were seen between 3D scans of the patient’s torsos and the pre-rectified molds. Between the pre- and post-rectified molds, material removal was consistently seen on the anterior side of the thorax and the lateral areas below the ribcage. Volume differences were seen in areas where the orthotist planned to place pressure pads (usually at the trochanter on the side to which the lumbar curve was tilted (trochanter pad), at the lumbar apical vertebra (lumbar pad), on the rib connected to the apical vertebrae at the mid-axillary line (thoracic pad), and on the ribs corresponding to the upper thoracic vertebra (axillary extension pad)). The rectification process requires the skill and experience of an orthotist; however, this study demonstrates that the brace shape, location, and volume of material removed from the pre-rectification mold can be characterized and quantified. Results from this study can be fed into software that can accelerate the brace design process and make steps towards the automated digital rectification process.

Keywords: additive manufacturing, orthotics, scoliosis brace design, sculpting software, spinal deformity

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Authors: Hui Fang Huang Su, Jia Borror

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This study compared two interventions for teaching math to preschool-aged students with autism spectrum disorder (ASD). The first is considered the business as usual (BAU) intervention, which uses the Strategies for Teaching Based on Autism Research (STAR) curriculum and discrete trial teaching as the instructional methodology. The second is the Math is Not Difficult (Project MIND) activity-embedded, naturalistic intervention. These interventions were randomly assigned to four preschool students with ASD classrooms and implemented over three months for Project Mind. We used measurement gained during the same three months for the STAR intervention. In addition, we used A quasi-experimental, pre-test/post-test design to compare the effectiveness of these two interventions in building mathematical knowledge and skills. The pre-post measures include three standardized instruments: the Test of Early Math Ability-3, the Problem Solving and Calculation subtests of the Woodcock-Johnson Test of Achievement IV, and the Bracken Test of Basic Concepts-3 Receptive. The STAR curriculum-based assessment is administered to all Baudhuin students three times per year, and we used the results in this study. We anticipated that implementing these two approaches would improve the mathematical knowledge and skills of children with ASD. Still, it is crucial to see whether a behavioral or naturalistic teaching approach leads to more significant results.

Keywords: early learning, autism, math for pre-schoolers, special education, teaching strategies

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Authors: K. Kalieva, G. Ibraimova

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In literature, poetry stands as a profound genre that bridges the life experiences of everyday people, transcending language and culture to unite people through the universal language of emotion and human connection. This paper explores the collaborative efforts of translators in creating the anthology of post-Soviet Kyrgyz women’s poetry, a project spanning over ten years. This compelling anthology brings together the works of fifty prominent female poets from Kyrgyzstan during the post-Soviet era. It includes the original poems in Kyrgyz and provide English translations, sharing the rich and diverse voices of Kyrgyz women with a global audience and fostering a deep appreciation for the beauty of their words. The paper highlights the unique perspectives on life, love, and identity offered by each poet, and emphasizes the role of translation in making these voices accessible worldwide. Each poet's unique voice offers a glimpse into the rich cultural and literary landscape of Kyrgyzstan, highlighting themes that resonate universally. Methodology of the paper employs a combination of qualitative content analysis, semiotic analysis, and quantitative thematic analysis to examine the translation strategies, and the cultural and emotional peculiarities captured in the translations, as well as the themes explored by the poets in their poems. Through the art of translation, the paper explores the lyrical world of Kyrgyz women poets. Although Kyrgyz poets’ names and poems are unfamiliar to many, their words resonate with an emotional depth that is sure to leave a lasting impression. Kyrgyz women's poetry translated into English celebrates the distinctive voices of women in the contemporary world. It serves as a reminder that poetry possesses the power to transcend life's obstacles, foster mutual understanding, and inspire positive change. The poems created by Kyrgyz women are envisioned to serve as a source of inspiration for readers. The paper proposes a poetic journey created by Kyrgyz women, offering readers an opportunity to experience Kyrgyz landscapes, traditions, and universal human themes through their verses. The paper provides an in-depth analysis of the poem translations, exploring the beauty and depth of the poets' thoughts and feelings. Through these translations, readers are invited to explore the world of Kyrgyz women poets, enriching their understanding of the language, culture, and the profound human experiences conveyed in the poetry. The hypotheses of the paper is that analyzing these translations through translation studies theories and linguistic and semiotic frameworks will reveal the complexities and challenges involved in translating poetry across languages and cultures.

Keywords: Kyrgyz poetry, post-soviet literature, translation, women poets.

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Authors: Narjes Azimi

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It has been a while that narrative and storytelling turned to be the inevitable part of media. The narrative has so many aspects and among those entire aspects, the fantasy genre is consciously challenging one as fantasy readers are used to reading narratives like good versus evil plot. This paper will analyze the ASOIF TV series as a Meta narrative cultural production that deconstructs the elements of a traditional narrative. This study will shade on a grand narrative perspective from poststructuralism point of view. The theoretical framework is structuralism and post structuralism. Lyotard and Barthes are two main poststructuralists and focus of the study. Lyotard grand narrative elements will analyze in this research study. Fantasy genre generated a number of outstanding authors that explore innovative perspectives. Among all these leading authors George R.R Martin is one of the best. George R. R. Martin’s Fantasy a Song of Ice and Fire picturized the brutal world that seven kingdoms struggling for the power. Since 2011 this production has been followed and watched by millions of audiences all around the world. The methodology is the textual analysis of selected scenes. Martin’s distinctive fantasy style which makes it different from other fantasies, yet this shift does not negate how the previous fantasy writers represent the mentioned concepts of war, and etc., but Martin’ fantasy and left the mature audiences full of uncertainty.

Keywords: narrative theory, metanarrative, deconstruction, post-structuralism, Lyotard, Barthes

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Authors: Mohsen Goodarzi, George Berghorn

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Despite the rapid growth in the number of green building and community development projects, the long-term performance of these projects has not yet been sufficiently evaluated from the users’ points of view. This is partially due to the lack of post-occupancy evaluation tools available for this type of project. In this study, a post-construction evaluation model is developed to evaluate the relationship between the perceived performance and satisfaction of residents in LEED-certified residential buildings and communities. To develop this evaluation model, a primary five-factor model was developed based on the existing models and residential satisfaction theories. Each factor of the model included several measures that were adopted from LEED certification systems such as LEED-BD+C New Construction, LEED-BD+C Multifamily Midrise, LEED-ND, as well as the UC Berkeley’s Center for the Built Environment survey tool. The model included four predictor variables (factors), including perceived building performance (8 measures), perceived infrastructure performance (9 measures), perceived neighborhood design (6 measures), and perceived economic performance (4 measures), and one dependent variable (factor), which was residential satisfaction (6 measures). An online survey was then conducted to collect the data from the residents of LEED-certified residential communities (n=192) and the validity of the model was tested through Confirmatory Factor Analysis (CFA). After modifying the CFA model, 26 measures, out of the initial 33 measures, were retained to enter into a Structural Equation Model (SEM) and to find the relationships between the perceived buildings performance, infrastructure performance, neighborhood design, economic performance and residential Satisfaction. The results of the SEM showed that the perceived building performance was the most influential factor in determining residential satisfaction in LEED-certified communities, followed by the perceived neighborhood design. On the other hand, perceived infrastructure performance and perceived economic performance did not show any significant relationship with residential satisfaction in these communities. This study can benefit green building researchers by providing a model for the evaluation of the long-term performance of these projects. It can also provide opportunities for green building practitioners to determine priorities for future residential development projects.

Keywords: green building, residential satisfaction, perceived performance, confirmatory factor analysis, structural equation modeling

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Authors: Neha Tiwari

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Rights are prerequisite for individuals to pursue their aims and enrich themselves. Laski has said rights are, ‘conditions of social life without which no man can seek himself at his best.’ However with superior technology, rights of many individuals are at stake as well. One such sufferer is the babies born out of the practice of commercial surrogacy. Commercial surrogacy has emerged as the most viable option for the childless couples. The practice has garnered lot of debate in both academia and media. Some argue for a complete ban and some for strict rules and regulation. Most of the time the debate is regarding the rights of the surrogate, something which we cannot ignore. Equally important are the rights of the children born out of such arrangements. However, not much attention is being paid to them. Recently, a controversy emerged when a surrogate gave birth to twins. One of the babies, Gammy born with down syndrome was left behind by the couple. Gammy could die because his poor Thai surrogate mother may not be able to pay for his treatment. Even if he survives, he will never know his twin sister as her identity would never be disclosed. This is just one of many such cases where the future of such babies is being played with. If the rights of these children are not taken care of many of them will have to bear the brunt of society's ignorance and perhaps live with a scar which won't heal in their lifetime.

Keywords: babies, commercial surrogacy, rights, technology

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Authors: Mariia A. Parfenenko, Ilya S. Dantsev, Sergei V. Bochenkov, Natalia V. Vinogradova, Olga S. Groznova, Victoria Yu. Voinova

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Introduction: Autism is the most common neurodevelopmental disorder. Autism is characterized by difficulties in social interaction and adherence to stereotypic behavioral patterns and frequently co-occurs with epilepsy, intellectual disabilities, connective tissue disorders, and other conditions. CHD8 codes for chromodomain-helicase-DNA-binding protein 8 - a chromatin remodeler that regulates cellular proliferation and neurodevelopment in embryogenesis. CHD8 is one of the genes most frequently involved in autism. Patients and methods: 2 unrelated male patients, P3 and P12, aged 3 and 12 years old, underwent whole genome sequencing, which determined that they both had different likely pathogenic variants, both previously undescribed in literature. Sanger sequencing later determined that P12 inherited the variant from his affected mother. Results: P3 and P12 presented with autism, a developmental delay, ataxia, sleep disorders, overgrowth, and macrocephaly, as well as other clinical features typically present in patients with causative variants in CHD8. The mother of P12 also has autistic traits, as well as ataxia, hypotonia, sleep disorders, and other symptoms. However, P3 and P12 also have different cardiac abnormalities. P3 had signs of a repolarization disorder: a flattened T wave in the III and aVF derivations and a negative T wave in the V1-V2 derivations. He also had structural valve anomalies with associated regurgitation, local contractility impairment of the left ventricular, and diastolic dysfunction of the right ventricle. Meanwhile, P12 had Wolff-Parkinson-White syndrome and underwent radiofrequency ablation at the age of 2 years. At the time of observation, P12 had mild sinus arrhythmia and an incomplete right bundle branch block, as well as arterial hypertension. Discussion: Cardiac abnormalities were not previously reported in patients with causative variants in CHD8. The underlying mechanism for the formation of those abnormalities is currently unknown. However, the two hypotheses are either a disordered interaction with CHD7 – another chromodomain remodeler known to be directly involved in the cardiophenotype of CHARGE syndrome – a rare condition characterized by coloboma, heart defects and growth abnormalities, or the disrupted functioning of CHD8 as an A-Kinase Anchoring Protein, which are known to modulate cardiac function. Conclusion: We observed 2 unrelated autistic males with likely pathogenic variants in CHD8 that presented with typical symptoms of CHD8-related neurodevelopmental disorder, as well as cardiac abnormalities. Cardiac abnormalities have, until now, been considered uncharacteristic for patients with causative variants in CHD8. Further accumulation of data, including experimental evidence of the involvement of CHD8 in heart formation, will elucidate the mechanism underlying the cardiophenotype of those patients. Acknowledgements: Molecular genetic testing of the patients was made possible by the Charity Fund for medical and social genetic aid projects «Life Genome.»

Keywords: autism spectrum disorders, chromodomain-helicase-DNA-binding protein 8, neurodevelopmental disorder, cardio phenotype

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Authors: Jason M. Hegenauer, Nicholas Fucci

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In the late 1990s, a major deinstitutionalization movement of elderly patients took place, since which, the design of long-term care facilities has not been adequately analyzed in the United States. Over the course of the last 25 years, major innovations in construction methods, technology, and medicine have been developed, drastically changing the landscape of healthcare architecture. In light of recent events, and the expected increase in elderly populations with the aging of the baby-boomer generation, it is evident that reconsideration of these facilities is essential for the proper care of aging populations. The global response has been effective in stifling this pandemic; however, widespread disease still poses an imminent threat to the human race. Having witnessed the devastation Covid-19 has reaped throughout nursing homes and long-term care facilities, it is evident that the current strategies for protecting our most vulnerable populations are not enough. Light renovation of existing facilities and previously overlooked considerations for new construction projects can drastically lower the risk at nursing homes and long-term care facilities. A reconfigured entry sequence supplements several of the features which have been long-standing essentials of the design of these facilities. This research focuses on several aspects identified as needing improvement, including indoor environment quality, security measures incorporated into healthcare architecture and design, and architectural mitigation strategies for sick building syndrome. The results of this study have been compiled as 'best practices' for the design of future healthcare construction projects focused on the health, safety, and quality of life of the residents of these facilities. These design strategies, which can easily be implemented through renovation of existing facilities and new construction projects, minimize risk of infection and spread of disease while allowing routine functions to continue with minimal impact, should the need for future lockdowns arise. Through the current lockdown procedures, which were implemented during the Covid-19 pandemic, isolation of residents has caused great unrest and worry for family members and friends as they are cut off from their loved ones. At this time, data is still being reported, leaving infection and death rates inconclusive; however, recent projections in some states list long-term care facility deaths as high as 60% of all deaths in the state. The population of these facilities consists of residents who are elderly, immunocompromised, and have underlying chronic medical conditions. According to the Centers for Disease Control, these populations are particularly susceptible to infection and serious illness. The obligation to protect our most vulnerable population cannot be overlooked, and the harsh measures recently taken as a response to the Covid-19 pandemic prove that the design strategies currently utilized for doing so are inadequate.

Keywords: building security, healthcare architecture and design, indoor environment quality, new construction, sick building syndrome, renovation

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