Search results for: life cycle management

Authors: Lukas Kober, Vladimir Littva, Vladimir Siska

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The pandemic has had a significant impact on our lives. One of the most affected professions is the nursing profession. Nurses are closest to the patient, spend the most time with him, support him, often replace the closest family members, and of course, are part of the whole treatment process. Current nurses have more competencies and roles than in the past. The healthcare system has reached a turning point, also in connection with the spreading Delta variant and the risk of the arrival of the third wave. The lack of nurses is a long-term problem, but it did not arise by itself. The reasons for the departure of nurses from the health care system are not only due to the increasing average age of nurses and midwives in Slovakia and their retirement. Thousands of nurses are leaving due to poor working conditions, low wages, and poor management of individual workplaces. We need to keep older nurses in the health care system, otherwise, we risk their early departure. The pandemic only exacerbates this situation, and the associated risks, such as occupational infections or enormous overload and exhaustion, only accelerate the exit from the profession. According to current data from the register of nurses and midwives, we canceled 772 registrations from January to September 2021, and 584 nurses requested the suspension of registration due to non-performance of the profession. During the same period, we registered only 240 new nurses graduate. We have had this significant disparity here for a long time. For the whole of 2020, we canceled 911 registrations and suspended 973 registrations. We registered a total of 389 graduates. Our system loses hundreds of graduates a year and loses experienced nurses with decades of experience who leave due to poor working conditions, wages and suffer from burnout. Such compensation should also be awarded to the families of health professionals who have lost their lives due to work and to COVID-19. These options can also be motivating for promising people interested in studying nursing, who can gradually replace the missing workforce. This purchase is supported by the KEGA project no. 015KU-4/2019.

Keywords: pandemic, COVID-19, nursing, nursing workforce, lack of nurses

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Atefeh Abedini, Pegah Soltani, Arda Kiani

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Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association.

Keywords: mycobacterium tuberculosis, sarcoidosis, genome, DNA, trans-bronchial needle aspiration

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Authors: Husain Rajib, T. H. Sheikh, D. G. Jewel

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Background: Amblyopia is a frequent cause of monocular blindness in children. It can be unilateral or bilateral reduction of best corrected visual acuity associated with decrement in visual processing, accomodation, motility, spatial perception or spatial projection. Anisometropia is an important risk factor for amblyopia that develops when unequal refractive error causes the image to be blurred in the critical developmental period and central inhibition of the visual signal originating from the affected eye associated with significant visual problems including anisokonia, strabismus, and reduced stereopsis. Methods: It is a prospective hospital based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 50 anisometropic amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 3 to 13 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over month, then occlusion treatment was started. Occlusion was done daily for 6-8 hours (full time) together with vision therapy. The occlusion was carried out for 3 months. Results: In this study about 8% subjects had anisometropia from myopia, 18% from hyperopia, 74% from astigmatism. The initial mean visual acuity was 0.74 ± 0.39 Log MAR and after intervention of amblyopia therapy with active vision therapy mean visual acuity was 0.34 ± 0.26 Log MAR. About 94% of subjects were improving at least two lines. The depth of amblyopia associated with type of anisometropic refractive error and magnitude of Anisometropia (p<0.005). By doing this study 10% mild amblyopia, 64% moderate and 26% severe amblyopia were found. Binocular function also decreases with magnitude of Anisometropia. Conclusion: Anisometropic amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Occlusion therapy with at least one instructed hour of active visual activity practiced out of school hours was effective in anisometropic amblyopes who were diagnosed at the age of 8 years and older, and the patients complied well with the treatment.

Keywords: refractive error, anisometropia, amblyopia, strabismic amblyopia

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Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

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Authors: Abanda Wilfred Chick

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Background: According to World Health Organization (WHO), the role of Information and Communication Technologies (ICT) in health sectors of developing nations has been demonstrated to have had a great improvement of fifty percent reduction in mortality and or twenty-five-fifty percent increase in productivity. The objective of this study was to assess the use of information and communication technologies in enhancing health care delivery for Human Immunodeficiency Virus (HIV) patients in Bamenda Health District. Methods: This was a descriptive-analytical cross-sectional study in which 388 participants were consecutively selected amongst health personnel and HIV patients from public and private health institutions involved in Human Immunodeficiency Virus management. Data on socio-demographic variables, the use of information and communication technologies tools, and associated challenges were collected using structured questionnaires. Descriptive statistics with a ninety-five percent confidence interval were used to summarize findings, while Cramer’s V test, logistic regression, and Chi-square test were used to measure the association between variables, Epi info version7.2, MS Excel, and SPSS version 25.0 were utilized for data entry and statistical analysis respectively. Results: Of the participants, one-quarter were health personnel, and three-quarters were HIV patients. For both groups of participants, there was a significant relationship between the use of ICT and demographic information such as level of education, marital status, and age (p<0.05). For the impediments to using ICT tools, a greater proportion identified the high cost of airtime or internet bundles, followed by an average proportion that indicated inadequate training on ICT tools; for health personnel, the majority said inadequate training on ICT tools/applications and half said unavailability of electricity. Conclusion: Not up to half of the HIV patients effectively make use of ICT tools/applications to receive health care. Of health personnel, three quarters use ICTs, and only one quarter effectively use mobile phones and one-third of computers, respectively, to render care to HIV patients.

Keywords: ICT tools, HIV patients, health personnel, health care delivery

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Authors: Juliana Shimara Pires Ferrão, Letícia Palmeira Pinto, Francisco Palma Rennó, Francisco Javier Hernandez Blazquez

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The ruminant stomach is a complex and multi-chambered organ. Although the true stomach (abomasum) is fully differentiated and functional at birth, the same does not occur with the rumen chamber. At this moment, rumen papillae are small or nonexistent. The papillae only fully develop after weaning and during calf growth. Papillae development and ruminal epithelium specialization during the fetus growth and at birth must be two interdependent processes that will prepare the rumen to adapt to ruminant adult feeding. The microscopic study of rumen epithelium at these early phases of life is important to understand how this structure prepares the rumen to deal with the following weaning processes and its functional activation. Samples of ruminal mucosa of bovine fetuses (110- and 150 day-old) and newborn calves were collected (dorsal and ventral portions) and processed for light and electron microscopy and immunohistochemistry. The basal cell layer of the stratified pavimentous epithelium present in different ruminal portions of the fetuses was thicker than the same portions of newborn calves. The superficial and intermediate epithelial layers of 150 day-old fetuses were thicker than those found in the other 2 studied ages. At this age (150 days), dermal papillae begin to invade the intermediate epithelial layer which gradually disappears in newborn calves. At birth, the ruminal papillae project from the epithelial surface, probably by regression of the epithelial cells (transitory cells) surrounding the dermal papillae. The PCNA cell proliferation index (%) was calculated for all epithelial samples. Fetuses 150 day-old showed increased cell proliferation in basal cell layer (Dorsal Portion: 84.2%; Ventral Portion: 89.8%) compared to other ages studied. Newborn calves showed an intermediate index (Dorsal Portion: 65.1%; Ventral Portion: 48.9%), whereas 110 day-old fetuses had the lowest proliferation index (Dorsal Portion: 57.2%; Ventral Portion: 20.6%). Regarding the transitory epithelium, 110 day-old fetuses showed the lowest proliferation index (Dorsal Portion: 44.6%; Ventral Portion: 20.1%), 150 day-old fetuses showed an intermediate proliferation index (Dorsal Portion: 57.5%; Ventral Portion: 71.1%) and newborn calves presented a higher proliferation index (Dorsal Portion: 75.1%; Ventral Portion: 19.6%). Under TEM, the 110- and 150 day-old fetuses presented thicker and poorly organized basal cell layer, with large nuclei and dense cytoplasm. In newborn calves, the basal cell layer was more organized and with fewer layers, but typically similar in both regions of the rumen. For the transitory epithelium, fetuses displayed larger cells than those found in newborn calves with less electrondense cytoplasm than that found in the basal cells. The ruminal dorsal portion has an overall higher cell proliferation rate than the ventral portion. Thus we can infer that the dorsal portion may have a higher cell activity than the ventral portion during ruminal development. Moreover, the basal cell layer is thicker in the 110- and 150 day-old fetuses than in the newborn calves. The transitory epithelium, which is much reduced, at birth may have a structural support function of the developing dermal papillae. When it regresses or is sheared off, the papillae are “carved out” from the surrounding epithelial layer.

Keywords: bovine, calf, epithelium, fetus, hematoxylin-eosin, immunohistochemistry, TEM, Rumen

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Authors: Emir Sunguroglu, Merve Sunguroglu, Yesim Aliefendioglu, Harun Tanrivermis

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Basic human needs range from physiological needs such as food, water and shelter to safety needs such as security, protection from natural disasters and even urban terrorism which are extant and not fulfilled even in urban areas where people live civilly in large communities. These basic needs when arose in urban life lead to a different kind of crime set defined as urban crimes. Urban crimes mostly result from differences between socioeconomic conditions in society. Income inequality increases tendency towards urban crimes. Especially in slum areas and suburbs, urban crimes not only threaten public security but they also affect deliverance of public services. It is highlighted that, construction of urban security against problems caused by urban crimes is not only achieved by involvement of urban security in security of the community but also comprises juridical development and staying above a level of legal standards concurrently. The idea of urban transformation emerged as interventions to demolishment and rebuilding of built environment to solve the unhealthy urban environment, inadequate infrastructure and socioeconomic problems came up during the industrialization process. Considering the probability of urbanization process driving citizens to commit crimes, The United Nations Commission on Human Security’s focus on this theme is conferred to be a proper approach. In this study, the analysis and change in security before, through and after urban transformation, which is one of the tools related to urbanization process, is strived to be discussed through the case of Sincan County Saraycik District. The study also aims to suggest improvements to current legislation on public safety, urban resilience, and urban transformation. In spite of Saraycik District residing in a developing County in Ankara, Turkey, from urbanization perspective as well as socioeconomic and demographic indicators the District exhibits a negative view throughout the County and the country. When related to the county, rates of intentional harm reports, burglary reports, the offense of libel and threat reports and narcotic crime reports are higher. The District is defined as ‘crime hotspot’. Interviews with residents of Saraycik claim that the greatest issue of the neighborhood is Public Order and Security (82.44 %). The District becomes prominent with negative aspects, especially with the presence of unlicensed constructions, occurrence of important social issues such as crime and insecurity and complicated lives of inhabitants from poverty and low standard conditions of living. Additionally, the social structure and demographic properties and crime and insecurity of the field have been addressed in this study. Consequently, it is claimed that urban crime rates were related to level of education, employment and household income, poverty trap, physical condition of housing and structuration, accessibility of public services, security, migration, safety in terms of disasters and emphasized that urban transformation is one of the most important tools in order to provide urban security.

Keywords: urban security, urban crimes, urban transformation, Saraycik district

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Authors: Selin Tosun

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The improvements in technology have started to transform the way we live, work, play, and commute in our cities. The emerging smart city understanding has been paving the way for more efficient, more useful, and more profitable cities. Smart sensors, smart lighting, smart waste, water and electricity management, smart transportation and communication systems are introduced to cities at a rapid pace. In today's world, innovation is often correlated with start-up companies and technological pioneers seeking broader economic objectives such as production and competitiveness. The government's position is primarily that of an enabler, with creativity mostly coming from the private sector. The paper argues that to achieve sustainable development, the ways in which smart and sustainable city approaches are being applied to cities need to be redefined. The research aims to address common discussions in the discourse of smart and sustainable cities criticizing the priority of lifestyle sterilization over human-centered sustainable interventions and social innovation strategies. The dichotomy between the fact that smart cities are mostly motivated by the competitive global market and the fact that the delocalization is, in fact, their biggest problem in the way of becoming authentic, sustainable cities is the main challenge that we face today. In other words, the key actors in smart cities have different and somewhat conflicting interests and demands. By reviewing the roles of the public and private actors in smart city making, the paper aspires to reconceptualize the understanding of “smartness” in achieving sustainable development in which the “smartness” is understood as a multi-layered complex phenomenon that can be channeled through different dynamics. The case cities around the world are explored and compared in terms of their technological innovations, governance and policy innovations, public-private stakeholder relationships, and the understanding of the public realm. The study aims to understand the current trends and general dynamics in the field, key issues that are being addressed, the scale that is preferred to reflect upon and the projects that are designed for the particular issues.

Keywords: smart city, sustainable development, technological innovation, social innovation

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Authors: Anh Nguyen, Jane Fisher, Thach Tran, Anh T. T. Tran

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Trait Emotional Intelligence is the knowledge, beliefs, and attitudes an individual has about their own and other people’s emotions. It is believed that trait emotional intelligence is a component of personality. Petrides’ Trait Emotional Intelligence Questionnaire (TEIQue) is well regarded and well-established, with validation data about its functioning among adults from many countries. However, there is little data yet about its use among Asian populations, including adolescents. The aims were to translate and culturally verify the Trait Emotional Intelligence Adolescent Short Form (TEIQue-ASF) and investigate content validity, construct validity, and reliability among adolescents attending high schools in Vietnam. Content of the TEIQue-ASF was translated (English to Vietnamese) and back-translated (Vietnamese to English) in consultation with bilingual and bicultural health researchers and pilot tested among 51 potential respondents. Phraseology and wording were then adjusted and the final version is named the VN-TEIQue-ASF. The VN-TEIQue-ASF’s properties were investigated in a cross-sectional elf-report survey among high school students in Central Vietnam. In total 1,546 / 1,573 (98.3%) eligible students from nine high schools in rural, urban, and coastline areas completed the survey. Explanatory Factor Analysis yielded a four-factor solution, including some with facets that loaded differently compared to the original version: Well-being, Emotion in Relationships, Emotion Self-management, and Emotion Sensitivity. The Cronbach’s alpha of the global score for the VN-TEIQue-ASF was .77. The VN-TEIQue-ASF is comprehensible and has good content and construct validity and reliability among adolescents in Vietnam. The factor structure is only partly replicated the original version. The VN-TEIQue-ASF is recommended for use in school or community surveys and professional study in education, psychology, and public health to investigate the trait emotional intelligence of adolescents in Vietnam.

Keywords: adolescents, construct validity, content validity, factor analysis, questionnaire validity, trait emotional intelligence, Vietnam

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Authors: Theresa Belema Chris-Biriowu

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The change in trends in relation to gender representation in beer brand commercials was the thrust of the study. The study investigated how beer brand commercials reflect societal realities in their portrayals of gender roles within the span of a decade. The major objective of the study was to find out how gender was contextualized in selected beer brand commercials that both air on Nigerian television and stream on YouTube. The study was anchored on the muted group theory. The population of the study was in two streams: the total number of beer beverages that are produced by the eleven breweries in Nigeria and the registered advertising agencies in Lagos, Nigeria. The sample size was also two-pronged: the purposive selection of beer brands that have their commercials on television and YouTube and the purposive selection of an ad agency that has produced running commercials for beer brands within the period between 2010s and 2020s. They adopted visual framing analysis and narrative analysis research techniques. The study qualitatively analyzed the contents of beer brand commercials and conducted an interview with the management of the ad agency for data collection. The data was presented in images and words. The findings showed that females are underrepresented and misrepresented in the beer brand commercials and that the beer brands are not producing commercials that adequately reflect the realities of present times. It was also found that very little has changed in the ad industry between the periods studied, and commercial screenplays are not written with a specific aim to either target the female demographics or give them equal opportunities to thrive in the beer economy. The study concluded that the gender gap in beer commercials subsists and translates to gender discrimination, especially since it is established that females are also stakeholders in the beer economy. The study recommends that beer brands should produce commercials that appeal to their audience irrespective of gender, reflect contemporary realities, and give all genders equal opportunities to thrive in the increasingly competitive industry.

Keywords: beer brands, commercials, gender representation, visuals, television, YouTube

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Authors: Giang Ngo Tinh Nguyen

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Agriculture plays an important role in the economy of Vietnam and coffee is one of most crucial agricultural commodities for exporting but the current farming methods and processing infrastructure could not keep up with the development of the sector. There are many catastrophic impacts on the environment such as deforestation; soil degradation that leads to a decrease in the quality of coffee beans. Therefore, improving supply chain to develop the cultivation of sustainable coffee is one of the most important strategies to boost the coffee industry and create a competitive advantage for Vietnamese coffee in the worldwide market. If all stakeholders in the supply chain network unite together; the sustainable production of coffee will be scaled up and the future of coffee industry will be firmly secured. Buon Ma Thuot city, Dak Lak province is the principal growing region for Vietnamese coffee which accounted for a third of total coffee area in Vietnam. It plays a strategically crucial role in the development of sustainable Vietnamese coffee. Thus, the research is to improve the supply chain of sustainable Vietnamese coffee production in Buon Ma Thuot city, Dak Lak province, Vietnam for the purpose of increasing the yields and export availability as well as helping coffee farmers to be more flexible in an ever-changing market situation. It will help to affirm Vietnamese coffee brand when entering international market; improve the livelihood of farmers and conserve the environment of this area. Besides, after analyzing the data, a logistic regression model is established to explain the relationship between the dependent variable and independent variables to help sustainable coffee organizations forecast the probability of farmer will be having a sustainable certificate with their current situation and help them choose promising candidates to develop sustainable programs. It investigates opinions of local farmers through quantitative surveys. Qualitative interviews are also used to interview local collectors and staff of Trung Nguyen manufacturing company to have an overview of the situation.

Keywords: supply chain management, sustainable agricultural development, sustainable coffee, Vietnamese coffee

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Authors: Ranjot Kaur, Om P. Katare, Anupama Sharma, Sarah R. Dennison, Kamalinder K. Singh, Bhupinder Singh

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Respiratory microbial infections being among the top leading cause of death worldwide are difficult to treat as the microbes reside deep inside the airways, where only a small fraction of drug can access after traditional oral or parenteral routes. As a result, high doses of drugs are required to maintain drug levels above minimum inhibitory concentrations (MIC) at the infection site, unfortunately leading to severe systemic side-effects. Therefore, delivering antimicrobials directly to the respiratory tract provides an attractive way out in such situations. In this context, current study embarks on the systematic development of lung lia pid-modified chitosan nanoparticles for inhalation of voriconazole. Following the principles of quality by design, the chitosan nanoparticles were prepared by ionic gelation method and further coated with major lung lipid by precipitation method. The factor screening studies were performed by fractional factorial design, followed by optimization of the nanoparticles by Box-Behnken Design. The optimized formulation has a particle size range of 170-180nm, PDI 0.3-0.4, zeta potential 14-17, entrapment efficiency 45-50% and drug loading of 3-5%. The presence of a lipid coating was confirmed by FESEM, FTIR, and X-RD. Furthermore, the nanoparticles were found to be safe upto 40µg/ml on A549 and Calu-3 cell lines. The quantitative and qualitative uptake studies also revealed the uptake of nanoparticles in lung epithelial cells. Moreover, the data from Spraytec and next-generation impactor studies confirmed the deposition of nanoparticles in lower airways. Also, the interaction of nanoparticles with DPPC monolayers signifies its biocompatibility with lungs. Overall, the study describes the methodology and potential of lipid-coated chitosan nanoparticles in futuristic inhalation nanomedicine for the management of pulmonary aspergillosis.

Keywords: dipalmitoylphosphatidylcholine, nebulization, DPPC monolayers, quality-by-design

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Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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Authors: María García-García, Esther Simancas-González, Said Balhadj, Carmen Silva-Robles, Driss Ferhane

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Cooperation between the territories on both sides of the Strait of Gibraltar is an urgent reality. the south of Spain and northern Morocco share a common historical past and belong to a very similar geographical and ecological area. Economic, social and cultural relations make cooperation between the two countries’ (Spain and Morocco) a priority for the EU and both countries governments. Likewise, deepened changes happened in production systems and consumption patterns had seriously damaged and weakened the craftwork sector. The promotion of local crafts, and its economic value, and the cooperation with the north of Morocco has been an important issue for the Andalusian government in recent years. The main aim of this work is to understand the strengths and weaknesses of the Tangier - Tetuan region craftworks sector in order to develop accurate communication and promotion plans. From the knowledge of the real identity, the sector could be repositioned. Promotion and communication could be a spur to traditional sectors, such as crafts. Competitiveness requires "the culture of communication, the cooperation between different companies to build powerful territory brands and maintain the establishment confidence and effectiveness relationships among agencies and organizations". The lack of previous literature addressing how Tangier craftwork promote and communicate its value to their stakeholders, has conducted the study to an exploratory approach with a double dimension: internal, Tangier craftwork sector image, and external, Andalusia image of the sector in Tangier. Different interviews were conducted with Andalusian partners involved in the artisanal sector (9 master craftsmen and 3 institutions) and focus groups with 9 Tangiers craftsmen were developed. The result of these interviews and expert groups are reflected in a SWOT analysis which reveals a handcraft industry with a worrying wide-spread and undifferentiated identity and reluctance to innovation and new technologies.

Keywords: communication management, image, Moroccan crafts, Spain-Morocco cooperation

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Authors: Yinsheng Zhang

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Changes in the extent and amount of snow cover in Eurasia are of great interest because of their vital impacts on the global climate system and regional water resource management. This study investigated the spatial and temporal variability of the snow cover extent (SCE) and snow water equivalent (SWE) of continental Eurasia using the Northern Hemisphere Equal-Area Scalable Earth Grid (EASE-Grid) Weekly SCE data for 1972–2006 and the Global Monthly EASE-Grid SWE data for 1979–2004. The results indicated that, in general, the spatial extent of snow cover significantly decreased during spring and summer, but varied little during autumn and winter over Eurasia in the study period. The date at which snow cover began to disappear in spring has significantly advanced, whereas the timing of snow cover onset in autumn did not vary significantly during 1972–2006. The snow cover persistence period declined significantly in the western Tibetan Plateau as well as the partial area of Central Asia and northwestern Russia but varied little in other parts of Eurasia. ‘Snow-free breaks’ (SFBs) with intermittent snow cover in the cold season were mainly observed in the Tibetan Plateau and Central Asia, causing a low sensitivity of snow cover persistence period to the timings of snow cover onset and disappearance over the areas with shallow snow. The averaged SFBs were 1–14 weeks in the Tibetan Plateau during 1972–2006 and the maximum intermittence could reach 25 weeks in some extreme years. At a seasonal scale, the SWE usually peaked in February or March but fell gradually since April across Eurasia. Both annual mean and annual maximum SWE decreased significantly during 1979–2004 in most parts of Eurasia except for eastern Siberia as well as northwestern and northeastern China.

Keywords: Eurasia, snow cover extent, snow cover persistence period, snow-free breaks, onset and disappearance timings, snow water equivalent

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Authors: N. C. Shahi, Anupama Singh, E. Kate

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Drying is practiced to enhance the storage life, to minimize losses during storage, and to reduce transportation costs of agricultural products. Drying processes range from open sun drying to industrial drying. In most of the developing countries, use of fossil fuels for drying of agricultural products has not been practically feasible due to unaffordable costs to majority of the farmers. On the other hand, traditional open sun drying practiced on a large scale in the rural areas of the developing countries suffers from high product losses due to inadequate drying, fungal growth, encroachment of insects, birds and rodents, etc. To overcome these problems a middle technology dryer having low cost need to be developed for farmers. In case of mechanical dryers, the heated air is the main driving force for removal of moisture. The air is heated either electrically or by burning wood, coal, natural gas etc. using heaters. But, all these common sources have finite supplies. The lifetime is estimated to range from 15 years for a natural gas to nearly 250 years for coal. So, mankind must turn towards its safe and reliable utilization and may have undesirable side effects. The mechanical drying involves higher cost of drying and open sun drying deteriorates the quality. The solar tunnel dryer is one of promising option for drying various agricultural and agro-industrial products on large scale. The advantage of Solar tunnel dryer is its relatively cheaper cost of construction and operation. Although many solar dryers have been developed, still there is a scope of modification in them. Therefore, an attempt was made to develop Solar tunnel dryer and test its performance using highly perishable commodity i.e. leafy vegetables (spinach). The effect of air velocity, loading density and shade net on performance parameters namely, collector efficiency, drying efficiency, overall efficiency of dryer and specific heat energy consumption were also studied. Thus, the need for an intermediate level technology was realized and an effort was made to develop a small scale Solar Tunnel Dryer . A dryer consisted of base frame, semi cylindrical drying chamber, solar collector and absorber, air distribution system with chimney and auxiliary heating system, and wheels for its mobility were the main functional components. Drying of fenugreek was carried out to analyze the performance of the dryer. The Solar Tunnel Dryer temperature was maintained using the auxiliary heating system. The ambient temperature was in the range of 12-33oC. The relative humidity was found inside and outside the Solar Tunnel Dryer in the range of 21-75% and 35-79%, respectively. The solar radiation was recorded in the range of 350-780W/m2 during the experimental period. Studies revealed that total drying time was in range of 230 to 420 min. The drying time in Solar Tunnel Dryer was considerably reduced by 67% as compared to sun drying. The collector efficiency, drying efficiency, overall efficiency and specific heat consumption were determined and were found to be in the range of 50.06- 38.71%, 15.53-24.72%, 4.25 to 13.34% and 1897.54-3241.36 kJ/kg, respectively.

Keywords: overall efficiency, solar tunnel dryer, specific heat consumption, sun drying

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Authors: Dragan Zivotic, Mirjana Ilic, Aleksandra Perovic, Predrag Gavrilovic

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As with the provision of other services, the service quality perception is one of the key factors that the modern manager must pay attention to. Countries in which the state regulation is in transition also have specific features in providing fitness services. Identification of the dimensions in which the most significant different service quality perception between different types of fitness centers, enables managers to profile the offer according to the wishes and expectations of users. The aim of the paper was the comparison of the quality of services perception in the field of fitness in Serbia between three categories of fitness centers: the privately owned centers, the publicly owned centers, and the Public-private partnership centers. For this research 350 respondents of both genders (174 men and 176 women) were interviewed, aged between 18 and 68 years, being beneficiaries of fitness services for at least 1 year. Administered questionnaire with 100 items provided information about the 15 basic areas in which they expressed the service quality perception in the gym. The core sample was composed of 212 service users in private fitness centers, 69 service users in public fitness centers and 69 service users in the public-private partnership. Sub-samples were equal in representation of women and men, as well as by age and length of use of fitness services. The obtained results were subject of univariate analysis with the Kruskal-Wallis non-parametric analysis of variance. Significant differences between the analyzed sub-samples were not found solely in the areas of rapid response and quality outcomes. In the multivariate model, the results were processed by backward stepwise discriminant analysis that extracted 3 areas that maximize the differences between sub-samples: material and technical basis, secondary facilities and coaches. By applying the classification function 93.87% of private centers services users, 62.32% of public centers services users and 85.51% of the public-private partnership centers users of services were correctly classified (total 86.00%). These results allow optimizing the allocation of the necessary resources in profiling offers of a fitness center in order to optimally adjust it to the user’s needs and expectations.

Keywords: fitness, quality perception, management, public ownership, private ownership, public-private partnership, discriminative analysis

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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: Zeynep Aksoy

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Since global mobility of capital, information and people increase more and more, intercultural communication and management become a growing study field of investigating various aspects of the interaction between people from different cultural backgrounds. Human mobility, caused by several intentions from tourism to forced migration, often put people in facing communication barriers, issues or sometimes conflicts. This reality naturally enforces education institutions to develop international policies and programs for students in order to improve their intercultural experiences along with the educative objectives. Study-abroad programs, particularly the student exchanges in higher education provide an environment for participants to encounter with cultural differences. Therefore, international exchange programs (i.e. Erasmus Student Mobility, Global Exchange Program) are accepted to bring opportunities for intergroup contact, which may lead students to obtain new perspectives about the host culture, either in positive or negative ways, and new intercultural communication skills. This study aims to explore the role of short-term study abroad experience on intercultural communication competence with a qualitative approach. It attempts to reveal a comparative analysis, which is derived from two field studies conducted in Izmir (Turkey) and in Amsterdam (the Netherlands) in 2015 and 2016. They were both organized in two phases as pre-and-posttest to gain an insight into the changes (if any) in students’ attitudes and knowledge regarding the host culture, and their further motivations towards cross-cultural interactions. With this aim, focus group sessions and in-depth interviews have been taken place with participants at the beginning of their stay and at the end of the semester. The sample covers students mainly from Erasmus program (20 students in Izmir and 14 students in Amsterdam), and few from Global Exchange Program (5 students in Amsterdam). Data obtained from both studies were thematically analyzed and essential themes were identified within the framework of intercultural communication competence.

Keywords: Erasmus student mobility, intercultural communication competence, student exchange, short-term study abroad

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Authors: Ahmed Stifi, Sascha Gentes

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The contract in its simplest definition is an agreement involving parties with a number of documents which may be as little as a marriage contract involving two parties or as big as a contract of construction and operation of a nuclear power plant involving companies and stakeholders with hundreds or even thousands of documents. All parties in the construction industry, not only the contract experts, agree that the success of a project is linked primarily to the form of contract regulating the relationship between stakeholders of the project. Therefore it is essential for the construction industry to study, analyze and improve its contracts forms continuously. However, it should be mentioned that different contract forms are developed to suit the construction evolution in term of its machinery, materials and construction process. There exist some similarities in some clauses and variations in many of these forms depending upon the type of project, the kind of clients and more importantly the laws and regulations governing the transaction in the country where the project is carried out. This paper will discuss the most important forms of construction contracts starting from national level, intended to the contract form in Germany and moving on to the international level introducing FIDIC contracts and its different forms, some newly developed contracts forms namely the integrated form of agreement, the new engineering contract and the project alliance agreement. The result of the study shows that many of the contract’s paragraphs are similar and the main difference comes in the approach of the relationship between the parties. Is it based on co-operation and mutual trust, or in some cases a load of responsibility for a particular party which increases the problems and disputes that affects the success of the project negatively. Thus we can say that the form of the contract, that plays an essential role in the approach of the project management, which is ultimately the key factor for the success of the project. So we advise to use a form of contract, which enhance the mutual trust between the project parties, contribute to support the cooperation between them, distribute responsibility and risks on an equitable basis and build on the principle “win-win". In additional to the conventional role of the contract it should integrate all parties into one team to achieve the target value of the project.

Keywords: contract, FIDIC, integrated form of agreement, new engineering contract, project alliance agreemen

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Authors: Jovana Petrovic, Biljana Pajin, Ivana Loncarevic, Aleksandar Fistes, Antun Jozinivic, Durdica Ackar, Drago Subaric

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Recovery of food wastes and their conversion to economically viable products will play a vital role for the management strategies in the years to come. Apple pomace may be considered as wastes, but they contain considerable amounts of high value reusable materials. Apple pomace, the by-product of apple juice and cider production, is a good source of fibre, particularly insoluble one. The remaining apple pulp contains 12% dry residue, which is half dietary fibre. Another remarkable aspect is its richness in polyphenols, components with antioxidant activity. Apple pomace could be an interesting alternative source for fibre and polyphenols in extruded corn meals. The extruded corn meals with the addition of finely ground apple pomace were prepared (the ratio of corn meal: apple pomace was 85:15 and 70:30). Characterization of the extrudates in terms of determining the chemical composition and colour was performed. The color of samples was measured by MINOLTA Chroma Meter CR-400 (Minolta Co., Ltd., Osaka, Japan) using D 65 lighting, a 2º standard observer angle and an 8-mm aperture in the measuring head. The following CIELab color coordinates were determined: L* – lightness, a* – redness to greenness and b* – yellowness to blueness. Protein content decreased significantly from 7.91% to 5.19% with increase in pomace from 0% to 30%, while total fibre content increase from 3.39% to 16.62%. The apple pomace addition produced extrudates with a significantly lower L* value and significantly higher a* value. This study has been fully supported by the Provincial Secretariat for High Education and Scientific Research of the Government of Autonomous Province of Vojvodina, Republic of Serbia, project 142-451-2483/2017 and the Ministry of Science and Technological Development of the Republic of Serbia (Project no. 31014).

Keywords: apple pomace, chemical composition, colour, extruded corn snack products, food waste recovery

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Authors: Nathalie Gagnon, Andréanne Gagné, Julie Courcy

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Quebec's vocational education teachers experience an atypical induction process into the workplace and thus face unique challenges. In contrast to elementary and high school teachers, who must undergo initial teacher training in order to access the profession, vocational education teachers, in most cases, are hired based on their professional expertise in the trade they are teaching, without prior pedagogical training. In addition to creating significant stress, which does not foster the acquisition of teaching roles and skills, this approach also forces recruits into a particular posture during their practical training: that of juggling their dual identities as teacher and trainee simultaneously. Recruits are supported by Cooperating Teachers (CPs) who, as experienced educators, take a critical and constructive look at their practices, observe them in the classroom, give them constructive feedback, and encourage them in their reflective practice. Thus, the vocational setting CP also assumes a distinctive posture and role due to the characteristics of the trainees they support. Although it is recognized that preparation, training, and supervision of CPs are essential factors in improving the support provided to trainees, there is little research about how CPs develop their support skills, and very little research focuses on the distinct posture they occupy. However, in order for them to be properly equipped for the important role they play in recruits’ practical training, it is vital to know more about their experience. An individual’s competencies cannot be studied without first examining what characterizes their experience, how they experience any given situation on cognitive, emotional, and motivational levels, in addition to how they act and react in situ. Depending on its nature, the experience will or will not promote the development of a specific competency. The research from which this communication originates focuses on describing the overall experience of vocational education CP in an effort to better understand the mechanisms linked to the development of their mentoring competencies. Experience and competence were, therefore, the two main theoretical concepts leading the research. As per methodology choices, case study methods were used since it proves to be adequate to describe in a rich and detailed way contemporary phenomena within contexts of life. The set of data used was collected from semi-structured interviews conducted with 15 vocational education CP in Quebec (Canada), followed by the use of a data-driven semi-inductive analysis approach to let the categories emerge organically. Focusing on the development needs of vocational education CP to improve their mentoring skills, this paper presents the results of our research, namely the importance of adequate training, better support offered by university supervisors, greater recognition of their role, and specific time slots dedicated to trainee support. The knowledge resulting from this research could improve the quality of support for trainee teachers in vocational education settings and to a more successful induction into the workplace. This communication also presents recommendations regarding the development of training systems that meet the specific needs of vocational education CP.

Keywords: development of competencies, cooperating teacher, mentoring trainee teacher, practical training, vocational education

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Authors: Djeddi Khaled, Houssou Hind, Miloudi Abdelatif, Rabah Siham

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Camels play a vital role as multipurpose animals, providing milk meat and serving as a means of transportation. They serve as a financial reserve for pastoralists and hold significant cultural and social value. Camel milk, known for its exceptional nutritional properties, is considered a valuable substitute for human milk. However, udder infections, particularly mastitis, pose significant challenges to camel farming. Clinical and subclinical mastitis can lead to substantial economic losses. Mastitis, especially the subclinical form, is a persistent and prevalent condition affecting milk hygiene and quality in dairy camels. This review offers insights into the prevalence and risk factors associated with subclinical mastitis in camels. The prevalence of subclinical mastitis in dairy camels was found to range from 9.28% to 87.78%. Major pathogens responsible for camel mastitis include Staphylococcus aureus, Coagulase-negative Staphylococcus, Streptococcus agalactiae, Streptococcus dysgalactiae, Escherichia coli, Micrococcus spp, Pasteurella haemolytica and Corynebacterium spp. The study outlines key risk factors contributing to camel mastitis, emphasizing factors such as severe tick infestation, age, stage of lactation, parity, body condition score, skin lesion on the teats or udders, anti-suckling devices, previous history of the udder, conformation of the udder, breed, unhygienic milking practices, production system, amongst others have been reported to be important in the prevalence of subclinical mastitis. This comprehensive overview provides valuable insights into the multifaceted aspects of camel mastitis, encompassing prevalent bacterial pathogens and diverse risk factors. The findings underscore the importance of holistic management practices, emphasizing hygiene, health monitoring, and targeted interventions to ensure the well-being and productivity of camels in various agro-pastoral contexts.

Keywords: bacterial pathogens, camel, mastitis, risk factors

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Authors: Hala Alioua, Alberic Tellier

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This paper is designed to spotlight the research on corporate strategic planning, by emphasizing the role of middle manager of SBU’s and related issues such as the context of vision change. Previous research on strategic vision has been focused principally at the SME, with relatively limited consideration given to the role of middle managers SBU’s in the context of change. This project of research has been done by using a single case study. We formulated through our immersion for 2.5 years on the ground and by a qualitative method and abduction approach. This entity that we analyze is a subsidiary of multinational companies headquartered in Germany, specialized in manufacturing automotive equipment. The "Delta Company" is a French manufacturing plant that has undergone numerous changes over the past three years. The two major strategic changes that have a significant impact on the Delta plant are the strengths of its core business through « lead plant strategy» in 2011 and the implementation of a new strategic vision in 2014. These consecutive changes impact the purpose of the mission of the middle managers. The plant managers ask the following questions: How the middle managers make sense of the corporate strategic planning imposed by the parent company? How they appropriate the new vision and decline it into actions on the ground? We chose the individual interview technique through open-ended questions as the source of data collection. We first of all carried out an exploratory approach by interviewing 8 members of the Management committee’s decision and 19 heads of services. The first findings and results show that exist a divergence of opinion and interpretations of the corporate strategic planning among organization members and there are difficulties to make sense and interpretations of the signals of the environment. The lead plant strategy enables new projects which insure the workload of Delta Company. Nevertheless, it creates a tension and stress among the middle managers because its provoke lack of resources to the detriment of their main jobs as manufacturer plant. The middle managers does not have a clear vision and they are wondering if the new strategic vision means more autonomy and less support from the group.

Keywords: change, middle managers, vision, sensemaking

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Authors: António Inês, Ana Guimarães, José Maria, Vânia Laranjo, Armando Venâncio, Luís Abrunhosa

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Lactic acid bacteria (LAB) play a key role in the biopreservation of a wide range of fermented food products, such as yogurt, cheese, fermented milks, meat, fish, vegetables (sauerkraut, olives and pickles), certain beer brands, wines and silage, allowing their safe consumption, which gave to these bacteria a GRAS (Generally Recognised as Safe) status. Besides that, the use of LAB in food and feed is a promising strategy to reduce the exposure to dietary mycotoxins, improving their shelf life and reducing health risks, given the unique mycotoxin decontaminating characteristic of some LAB. Mycotoxins present carcinogenic, mutagenic, teratogenic, neurotoxic and immunosuppressive effects over animals and Humans, being the most important ochratoxin A (OTA), aflatoxins (AFB1), trichothecenes, zearalenone (ZEA), fumonisin (FUM) and patulin. In a previous work of our group it was observed OTA biodegradation by some strains of Pediococcus parvulus isolated from Douro wines. So, the aim of this study was to enlarge the screening of the biodetoxification over more mycotoxins besides OTA, including AFB1, and ZEA. This ability was checked in a collection of LAB isolated from vegetable (wine, olives, fruits and silage) and animal (milk and dairy products, sausages) sources. All LAB strains were characterized phenotypically (Gram, catalase) and genotypically. Molecular characterisation of all LAB strains was performed using genomic fingerprinting by MSP-PCR with (GTG)5 and csM13 primers. The identification of the isolates was confirmed by 16S rDNA sequencing. To study the ability of LAB strains to degrade OTA, AFB1 and ZEA, a MRS broth medium was supplemented with 2.0 μg/mL of each mycotoxin. For each strain, 2 mL of MRS supplemented with the mycotoxins was inoculated in triplicate with 109 CFU/mL. The culture media and bacterial cells were extracted by the addition of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v) to the culture tubes. A 2 mL sample was then collected and filtered into a clean 2 mL vial using PP filters with 0.45 μm pores. The samples were preserved at 4 °C until HPLC analysis. Among LAB tested, 10 strains isolated from milk were able to eliminate AFB1, belonging to Lactobacillus casei (7), Lb. paracasei (1), Lb. plantarum (1) and 1 to Leuconostoc mesenteroides. Two strains of Enterococcus faecium and one of Ec. faecalis from sausage eliminated ZEA. Concerning to strains of vegetal origin, one Lb. plantarum isolated from elderberry fruit, one Lb. buchnerii and one Lb. parafarraginis both isolated from silage eliminated ZEA. Other 2 strains of Lb. plantarum from silage were able to degrade both ZEA and OTA, and 1 Lb. buchnerii showed activity over AFB1. These enzymatic activities were also verified genotypically through specific gene PCR and posteriorly confirmed by sequencing analysis. In conclusion, due the ability of some strains of LAB isolated from different sources to eliminate OTA, AFB1 and ZEA one can recognize their potential biotechnological application to reduce the health hazards associated with these mycotoxins. They may be suitable as silage inoculants or as feed additives or even in food industry.

Keywords: bio-detoxification, lactic acid bacteria, mycotoxins, food and feed

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Authors: Hyunjoo Park, Taehyun Kim, Taehyun Kim

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Human life, activity, and culture depend on the wider environment. Cities offer economic opportunities for goods and services, but cannot exist in environments without food, energy, and water supply. Technological innovation in energy supply and transport speeds up the expansion of urban areas and the physical separation from agricultural land. As a result, division of urban agricultural areas causes more energy demand for food and goods transport between the regions. As the energy resources are leaking all over the world, the impact on the environment crossing the boundaries of cities is also growing. While advances in energy and other technologies can reduce the environmental impact of consumption, there is still a gap between energy supply and demand by current technology, even in technically advanced countries. Therefore, reducing energy demand is more realistic than relying solely on the development of technology for sustainable development. The purpose of this study is to introduce the application of carbon footprint assessment in fields of urban planning and geography. In urban studies, carbon footprint has been assessed at different geographical scales, such as nation, city, region, household, and individual. Carbon footprint assessment for a nation and a city is available by using national or city level statistics of energy consumption categories. By means of carbon footprint calculation, it is possible to compare the ecological capacity and deficit among nations and cities. Carbon footprint also offers great insight on the geographical distribution of carbon intensity at a regional level in the agricultural field. The study shows the background of carbon footprint applications in urban planning and geography by case studies such as figuring out sustainable land-use measures in urban planning and geography. For micro level, footprint quiz or survey can be adapted to measure household and individual carbon footprint. For example, first case study collected carbon footprint data from the survey measuring home energy use and travel behavior of 2,064 households in eight cities in Gyeonggi-do, Korea. Second case study analyzed the effects of the net and gross population densities on carbon footprint of residents at an intra-urban scale in the capital city of Seoul, Korea. In this study, the individual carbon footprint of residents was calculated by converting the carbon intensities of home and travel fossil fuel use of respondents to the unit of metric ton of carbon dioxide (tCO₂) by multiplying the conversion factors equivalent to the carbon intensities of each energy source, such as electricity, natural gas, and gasoline. Carbon footprint is an important concept not only for reducing climate change but also for sustainable development. As seen in case studies carbon footprint may be measured and applied in various spatial units, including but not limited to countries and regions. These examples may provide new perspectives on carbon footprint application in planning and geography. In addition, additional concerns for consumption of food, goods, and services can be included in carbon footprint calculation in the area of urban planning and geography.

Keywords: carbon footprint, case study, geography, urban planning

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Kishor Chandra Kandpal, Amit Kumar

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The Indian Himalaya region harbours approximately 1748 plants of medicinal importance, and as per International Union for Conservation of Nature (IUCN), the 112 plant species among these are threatened and endangered. To ease the pressure on these plants, the government of India is encouraging its in-situ cultivation. The Saussurea costus, Valeriana jatamansi, and Picrorhiza kurroa have also been prioritized for large scale cultivation owing to their market demand, conservation value and medicinal properties. These species are found from 1000 m to 4000 m elevation ranges in the Indian Himalaya. Identification of these plants in the field requires taxonomic skills, which is one of the major bottleneck in the conservation and management of these plants. In recent years, Hyperspectral remote sensing techniques have been precisely used for the discrimination of plant species with the help of their unique spectral signatures. In this background, a spectral library of the above 03 medicinal plants was prepared by collecting the spectral data using a handheld spectroradiometer (325 to 1075 nm) from farmer’s fields of Himachal Pradesh and Uttarakhand states of Indian Himalaya. The Random forest (RF) model was implied on the spectral data for the classification of the medicinal plants. The 80:20 standard split ratio was followed for training and validation of the RF model, which resulted in training accuracy of 84.39 % (kappa coefficient = 0.72) and testing accuracy of 85.29 % (kappa coefficient = 0.77). This RF classifier has identified green (555 to 598 nm), red (605 nm), and near-infrared (725 to 840 nm) wavelength regions suitable for the discrimination of these species. The findings of this study have provided a technique for rapid and onsite identification of the above medicinal plants in the field. This will also be a key input for the classification of hyperspectral remote sensing images for mapping of these species in farmer’s field on a regional scale. This is a pioneer study in the Indian Himalaya region for medicinal plants in which the applicability of hyperspectral remote sensing has been explored.

Keywords: himalaya, hyperspectral remote sensing, machine learning; medicinal plants, random forests

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Authors: Maria Monica D. Espinosa

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This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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