Search results for: cost control

Authors: Franck Acho

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This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Background and Aims: This meta-analysis aimed to evaluate the effect of vitamin D supplementation on key metabolic and cardiovascular parameters, such as glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), and total vitamin D levels in patients with Type 2 diabetes mellitus (T2DM). Methods: A systematic search was performed across databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov, from January 1990 to January 2024. A total of 4,177 relevant studies were initially identified. Using an unsupervised K-means clustering algorithm, publications were grouped based on common text features. Maximum entropy classification was then applied to filter studies that matched a pre-identified training set of 139 potentially relevant articles. These selected studies were manually screened for relevance. A parallel manual selection of all initially searched studies was conducted for validation. The final inclusion of studies was based on full-text evaluation, quality assessment, and meta-regression models using random effects. Sensitivity analysis and publication bias assessments were also performed to ensure robustness. Results: The unsupervised K-means clustering algorithm grouped the patients based on their responses to vitamin D supplementation, using key biomarkers such as HbA1C, FBS, LDL, HDL, SBP, and total vitamin D levels. Two primary clusters emerged: one representing patients who experienced significant improvements in these markers and another showing minimal or no change. Patients in the cluster associated with significant improvement exhibited lower HbA1C, FBS, and LDL levels after vitamin D supplementation, while HDL and total vitamin D levels increased. The analysis showed that vitamin D supplementation was particularly effective in reducing HbA1C, FBS, and LDL within this cluster. Furthermore, BMI, weight gain, and disease duration were identified as factors that influenced cluster assignment, with patients having lower BMI and shorter disease duration being more likely to belong to the improvement cluster. Conclusion: The findings of this machine learning-assisted meta-analysis confirm that vitamin D supplementation can significantly improve glycemic control and reduce the risk of cardiovascular complications in T2DM patients. The use of automated screening techniques streamlined the process, ensuring the comprehensive evaluation of a large body of evidence while maintaining the validity of traditional manual review processes.

Keywords: HbA1C, T2DM, SBP, FBS

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Authors: Secil Kaya Gulen

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Face to face and virtual classrooms that came up with different conditions and environments, but similar purposes have different characteristics. Although virtual classrooms have some similar facilities with face-to-face classes such as program, students, and administrators, they have no walls and corridors. Therefore, students can attend the courses from a distance and can control their own learning spaces. Virtual classrooms defined as simultaneous online environments where students in different places come together at the same time with the guidance of a teacher. Distance education and virtual classes require different intellectual and managerial skills and models. Therefore, for effective use of virtual classrooms, the virtual property should be taken into consideration. One of the most important factors that affect the spread and effective use of the virtual classrooms is the perceptions and opinions of students -as one the main participants-. Student opinions and recommendations are important in terms of providing information about the fulfillment of expectation. This will help to improve the applications and contribute to the more efficient implementations. In this context, ideas and perceptions of the students related to the virtual classrooms, in general, were determined in this study. Advantages and disadvantages of virtual classrooms expected contributions to the educational system and expected characteristics of virtual classrooms have examined in this study. Students of an online distance education graduate program in which all the courses offered by virtual classrooms have asked for their opinions. Online Distance Education Graduate Program has totally 19 students. The questionnaire that consists of open-ended and multiple choice questions sent to these 19 students and finally 12 of them answered the questionnaire. Analysis of the data presented as frequencies and percentages for each item. SPSS for multiple-choice questions and Nvivo for open-ended questions were used for analyses. According to the results obtained by the analysis, participants stated that they did not get any training on virtual classes before the courses; but they emphasize that newly enrolled students should be educated about the virtual classrooms. In addition, all participants mentioned that virtual classroom contribute their personal development and they want to improve their skills by gaining more experience. The participants, who mainly emphasize the advantages of virtual classrooms, express that the dissemination of virtual classrooms will contribute to the Turkish Education System. Within the advantages of virtual classrooms, ‘recordable and repeatable lessons’ and ‘eliminating the access and transportation costs’ are most common advantages according to the participants. On the other hand, they mentioned ‘technological features and keyboard usage skills affect the attendance’ is the most common disadvantage. Participants' most obvious problem during virtual lectures is ‘lack of technical support’. Finally ‘easy to use’, ‘support possibilities’, ‘communication level’ and ‘flexibility’ come to the forefront in the scope of expected features of virtual classrooms. Last of all, students' opinions about the virtual classrooms seems to be generally positive. Designing and managing virtual classrooms according to the prioritized features will increase the students’ satisfaction and will contribute to improve applications that are more effective.

Keywords: distance education, virtual classrooms, higher education, e-learning

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Authors: Samuel N. Forjuoh, Marcia G. Ory, Jaewoong Won, Samuel D. Towne, Suojin Wang, Chanam Lee

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The public health burden of obesity is well established as is the influence of physical activity (PA) on the health and wellness of individuals who are obese. This study examined the influence of selected demographic, health, and socioenvironmental factors on the walking behaviors of middle-aged and older overweight and obese adults. Online and paper surveys were administered to community-dwelling overweight and obese adults aged ≥ 50 years residing in four cities in central Texas and seen by a family physician in the primary care clinic from October 2013 to June 2014. Descriptive statistics were used to characterize participants’ anthropometric and demographic data as well as their health conditions and walking, socioenvironmental, and more broadly defined PA behaviors. Then Pearson chi-square tests were used to assess differences between participants who reported walking the recommended ≥ 150 minutes for any purpose in a typical week as a proxy to meeting the U.S. Centers for Disease Control and Prevention’s PA guidelines and those who did not. Finally, logistic regression was used to predict walking the recommended ≥ 150 minutes for any purpose, controlling for covariates. The analysis was conducted in 2016. Of the total sample (n=253, survey response rate of 6.8%), the majority were non-Hispanic white (81.7%), married (74.5%), male (53.5%), and reported an annual household income of ≥ $50,000 (65.7%). Approximately, half were employed (49.6%), or had at least a college degree (51.8%). Slightly more than 1 in 5 (n=57, 22.5%) reported walking the recommended ≥150 minutes for any purpose in a typical week. The strongest predictors of walking the recommended ≥ 150 minutes for any purpose in a typical week in adjusted analysis were related to education and a high favorable perception of the neighborhood environment. Compared to those with a high school diploma or some college, participants with at least a college degree were five times as likely to walk the recommended ≥ 150 minutes for any purpose (OR=5.55, 95% CI=1.79-17.25). Walking the recommended ≥ 150 minutes for any purpose was significantly associated with participants who disagreed that there were many distracted drivers (e.g., on the cell phone while driving) in their neighborhood (OR=4.08, 95% CI=1.47-11.36) and those who agreed that there are sidewalks or protected walkways (e.g., walking trails) in their neighborhood (OR=3.55, 95% CI=1.10-11.49). Those employed were less likely to walk the recommended ≥ 150 minutes for any purpose compared to those unemployed (OR=0.31, 95% CI=0.11-0.85) as were those who reported some difficulty walking for a quarter of a mile (OR=0.19, 95% CI=0.05-0.77). Other socio-environmental factors such as having care-giver responsibilities for elders, someone to walk with, or a dog in the household as well as Walk Score™ were not significantly associated with walking the recommended ≥ 150 minutes for any purpose in a typical week. Neighborhood perception appears to be an important factor associated with the walking behaviors of middle-aged and older overweight and obese individuals. Enhancing the neighborhood environment (e.g., providing walking trails) may promote walking among these individuals.

Keywords: determinants of walking, obesity, older adults, physical activity

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Authors: Dariusz M. Trzmielak, William Bradley Zehner, Elin Oftedal, Ilona Lipka-Matusiak

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The use of new technologies should create new value for all stakeholders in the healthcare system. The article focuses on demonstrating that technologies or products typically enable new functionality, a higher standard of service, or a higher level of knowledge and competence for clinicians. It also highlights the key benefits that can be achieved through the use of artificial intelligence, such as relieving clinicians of many tasks and enabling the expansion and greater specialisation of healthcare services. The comparative analysis allowed the authors to create a classification of new technologies in e-health according to health needs and benefits for patients, doctors, and healthcare systems, i.e., the main stakeholders in the implementation of new technologies and products in healthcare. The added value of the development of new technologies in healthcare is diagnosed. The work is both theoretical and practical in nature. The primary research methods are bibliographic analysis and analysis of research data and market potential of new solutions for healthcare organisations. The bibliographic analysis is complemented by the author's case studies of implemented technologies, mostly based on artificial intelligence or telemedicine. In the past, patients were often passive recipients, the end point of the service delivery system, rather than stakeholders in the system. One of the dangers of powerful new technologies is that patients may become even more marginalised. Healthcare will be provided and delivered in an increasingly administrative, programmed way. The doctor may also become a robot, carrying out programmed activities - using 'non-human services'. An alternative approach is to put the patient at the centre, using technologies, products, and services that allow them to design and control technologies based on their own needs. An important contribution to the discussion is to open up the different dimensions of the user (carer and patient) and to make them aware of healthcare units implementing new technologies. The authors of this article outline the importance of three types of patients in the successful implementation of new medical solutions. The impact of implemented technologies is analysed based on: 1) "Informed users", who are able to use the technology based on a better understanding of it; 2) "Engaged users" who play an active role in the broader healthcare system as a result of the technology; 3) "Innovative users" who bring their own ideas to the table based on a deeper understanding of healthcare issues. The authors' research hypothesis is that the distinction between informed, engaged, and innovative users has an impact on the perceived and actual quality of healthcare services. The analysis is based on case studies of new solutions implemented in different medical centres. In addition, based on the observations of the Polish author, who is a manager at the largest medical research institute in Poland, with analytical input from American and Norwegian partners, the added value of the implementations for patients, clinicians, and the healthcare system will be demonstrated.

Keywords: innovation, management, medicine, e-health, artificial intelligence

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Authors: Ngoc Nguyen

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There is large plantation of Eucalyptus globulus established which has been grown to produce pulpwood. This resource is not suitable for the production of decorative products, principally due to low grades of wood and “dull” appearance but many trials have been already undertaken for the production of veneer and veneer-based engineered wood products, such as plywood and laminated veneer lumber (LVL). The manufacture of veneer-based products has been recently identified as an unprecedented opportunity to promote higher value utilisation of plantation resources. However, many uncertainties remain regarding the impacts of inferior wood quality of young plantation trees on product recovery and value, and with respect to optimal processing techniques. Moreover, the quality of veneer and veneer-based products is far from optimal as trees are young and have small diameters; and the veneers have the significant colour variation which affects to the added value of final products. Developing production methods which would enhance appearance of low-quality veneer would provide a great potential for the production of high-value wood products such as furniture, joinery, flooring and other appearance products. One of the methods of enhancing appearance of low quality veneer, developed in Italy, involves the production of multilaminar veneer, also named “reconstructed veneer”. An important stage of the multilaminar production is colouring the veneer which can be achieved by dyeing veneer with dyes of different colours depending on the type of appearance products, their design and market demand. Although veneer dyeing technology has been well advanced in Italy, it has been focused on poplar veneer from plantation which wood is characterized by low density, even colour, small amount of defects and high permeability. Conversely, the majority of plantation eucalypts have medium to high density, have a lot of defects, uneven colour and low permeability. Therefore, detailed study is required to develop dyeing methods suitable for colouring eucalypt veneers. Brown reactive dye is used for veneer colouring process. Veneers from sapwood and heartwood of two moisture content levels are used to conduct colouring experiments: green veneer and veneer dried to 12% MC. Prior to dyeing, all samples are treated. Both soaking (dipping) and vacuum pressure methods are used in the study to compare the results and select most efficient method for veneer dyeing. To date, the results of colour measurements by CIELAB colour system showed significant differences in the colour of the undyed veneers produced from heartwood part. The colour became moderately darker with increasing of Sodium chloride, compared to control samples according to the colour measurements. It is difficult to conclude a suitable dye solution used in the experiments at this stage as the variables such as dye concentration, dyeing temperature or dyeing time have not been done. The dye will be used with and without UV absorbent after all trials are completed using optimal parameters in colouring veneers.

Keywords: Eucalyptus globulus, veneer colouring/dyeing, multilaminar veneer, reactive dye

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Authors: Liliana Gomez Cardona, Echo Parent-Racine, Joy Outerbridge, Arlene Laliberté, Outi Linnaranta

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Suicide rates among Inuit in Nunavik are six to eleven times larger than the Canadian average. The colonization, religious missions, residential schools as well as economic and political marginalization are factors that have challenged the well-being and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous peoples because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Inuit in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Inuit population. Qualitative, collaborative, and participatory action research project which respects First Nations and Inuit protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Inuit. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Inuit in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in resilience and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Inuit population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Inuit, mental health, Nunavik, resiliency

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Authors: Alison L. Miles

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Almost all major financial institutions in the world suffered losses due to the financial crisis of 2007, but the extent varied widely. The causes of the crash of 2007 are well documented and predominately focus on the role and complexity of the financial markets. The dominant theme of the literature suggests the causes of the crash were a combination of globalization, financial sector innovation, moribund regulation and short termism. While these arguments are undoubtedly true, they do not tell the whole story. A key weakness in the current analysis is the lack of consideration of those leading the banks pre and during times of crisis. This purpose of this study is to examine the possible link between the leadership styles and characteristics of the CEO, CFO and chairman and the financial institutions that failed or needed recapitalization. As such, it contributes to the literature and debate on international financial crises and systemic risk and also to the debate on risk management and regulatory reform in the banking sector. In order to first test the proposition (p1) that there are prevalent leadership characteristics or traits in financial institutions, an initial study was conducted using a sample of the top 65 largest global banks and financial institutions according to the Banker Top 1000 banks 2014. Secondary data from publically available and official documents, annual reports, treasury and parliamentary reports together with a selection of press articles and analyst meeting transcripts was collected longitudinally from the period 1998 to 2013. A computer aided key word search was used in order to identify the leadership styles and characteristics of the chairman, CEO and CFO. The results were then compared with the leadership models to form a picture of leadership in the sector during the research period. As this resulted in separate results that needed combining, SPSS data editor was used to aggregate the results across the studies using the variables ‘leadership style’ and ‘company financial performance’ together with the size of the company. In order to test the proposition (p2) that there was a prevalent leadership style in the banks that failed and the proposition (P3) that this was different to those that did not, further quantitative analysis was carried out on the leadership styles of the chair, CEO and CFO of banks that needed recapitalization, were taken over, or required government bail-out assistance during 2007-8. These included: Lehman Bros, Merrill Lynch, Royal Bank of Scotland, HBOS, Barclays, Northern Rock, Fortis and Allied Irish. The findings show that although regulatory reform has been a key mechanism of control of behavior in the banking sector, consideration of the leadership characteristics of those running the board are a key factor. They add weight to the argument that if each crisis is met with the same pattern of popular fury with the financier, increased regulation, followed by back to business as usual, the cycle of failure will always be repeated and show that through a different lens, new paradigms can be formed and future clashes avoided.

Keywords: banking, financial crisis, leadership, risk

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Authors: N. B. Chandrakala

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Domestic violence is one of the most under-reported crimes. Problem with domestic violence is that it is not even considered as abuse in many parts of the world especially certain parts of Asia, Africa and Middle East. It is viewed as “doing the needful”. Domestic violence could be in form of emotional harassment, physical injury or psychological abuse perpetrated by one of the family members to another. It is a worldwide phenomenon mainly targeting women. The acts of violence have terrible negative impact on women. It is also an infringement of women’s rights and can be safely termed as human rights abuse. In cases pertaining to domestic violence, male adults often misuses his authority and power to control another using physical or psychological means. Violence and other forms of abuse are common in domestic violence. Sexual assaults, molestation and battering are common in these cases. Domestic violence is a human rights issue and a serious deterrent to development. Domestic violence could also take place in subtle forms like making the person feel worthless or not giving the victims any personal space or freedom. The problematic aspect is cases of domestic violence are very rarely reported. The majority of the victims are women but children are also made to suffer silently. They are abused and neglected. Their innocent minds are adversely affected with the incidents of domestic violence. According to a report by World Health Organization (WHO), sexual trafficking, female feticide, dowry death, public humiliation and physical torture are some of the most common forms of domestic violence against Indian women. Such acts belie our growth and claim as an economic superpower. It is ironic that we claim to be one of the most rapidly advancing countries in the world and yet we have done hardly anything of note against social hazards like domestic violence. Laws are not that stringent when it comes to reporting acts of domestic violence. Even if the report is filed it turns out to be a long drawn process and not every victim has that much resource to fight till the end. It is also a social taboo to make your family matters public. The big challenge in front now is to enforce it in true sense. Steps that are actually needed; tough laws against domestic violence, speedy execution and change in the mindset of society only then we can expect to have some improvement in such inhuman cases. An effective response to violence must be multi-sectoral; addressing the immediate practical needs of women experiencing abuse; providing long-term follow up and assistance; and focusing on changing those cultural norms, attitudes and legal provisions that promote the acceptance of and even encourage violence against women, and undermine women's enjoyment of their full human rights and freedoms. Hence the responses to the problem must be based on integrated approach. The effectiveness of measures and initiatives will depend on coherence and coordination associated with their design and implementation.

Keywords: domestic violence, human rights, sexual assaults, World Health Organization

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Authors: A. Pallavi, N. Vijay Mohan

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A nation can be economically progressive only when the citizens have sufficient capacity to work efficiently to increase the productivity. So, good health must be regarded as a primary need of the community. This helps the growth and development of the body and the mind, which in turn leads to progress and prosperity of the nation. An optimum growth is a necessity for an efficient existence in a biologically adverse and economically competitive world. It is also necessary for the execution of daily routine work. Yoga is a method or a system for the complete development of the personality in a human being. It can be further elaborated as an all-around and complete development of the body, mind, morality, intellect and soul of a being. Sri Aurobindo defines yoga as 'a methodical effort towards self-perfection by the development of the potentialities in the individual.' Aerobic exercise as any activity that uses large muscle groups, can be maintained continuously, and is rhythmic I nature. It is a type of exercise that overloads the heart and lungs and causes them to work harder than at rest. The important idea behind aerobic exercise today, is to get up and get moving. There are more activities that ever to choose from, whether it is a new activity or an old one. Find something you enjoy doing that keeps our heart rate elevated for a continuous time period and get moving to a healthier life. Middle aged selected and served as the subjects for the purpose of this study. The selected subjects were in the age group of 30 to 40 years. By going through the literature and after consulting the experts in yoga and aerobic training, the investigator had chosen the variables which are specifically related to the middle-aged men. The selected physiological variables are pulse rate, diastolic blood pressure, systolic blood pressure; percent body fat and vital capacity. The selected psychological variables are job anxiety, occupational stress. The study was formulated as a random group design consisting of aerobic exercise and yogic exercises groups. The subjects (N=60) were at random divided into three equal groups of twenty middle-aged men each. The groups were assigned the names as follows: 1. Experimental group I- aerobic exercises group, 2. Experimental group II- yogic exercises, 3. Control group. All the groups were subjected to pre-test prior to the experimental treatment. The experimental groups participated in their respective duration of twenty-four weeks, six days in a week throughout the study. The various tests administered were: prior to training (pre-test), after twelfth week (second test) and twenty-fourth weeks (post-test) of the training schedule.

Keywords: pulse rate, diastolic blood pressure, systolic blood pressure; percent body fat and vital capacity, psychological variables, job anxiety, occupational stress, aerobic exercise, yogic exercise

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Authors: Fatemeh Faramarzi, Hosein Mahjoob

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Building dams on rivers for utilization of water resources causes problems in hydrodynamic equilibrium and results in leaving all or part of the sediments carried by water in dam reservoir. This phenomenon has also significant impacts on water and sediment flow regime and in the long term can cause morphological changes in the environment surrounding the river, reducing the useful life of the reservoir which threatens sustainable development through inefficient management of water resources. In the past, empirical methods were used to predict the sedimentation amount in dam reservoirs and to estimate its efficient lifetime. But recently the mathematical and computational models are widely used in sedimentation studies in dam reservoirs as a suitable tool. These models usually solve the equations using finite element method. This study compares the results from tow software packages, GSTARS4 & HEC-6, in the prediction of the sedimentation amount in Dez dam, southern Iran. The model provides a one-dimensional, steady-state simulation of sediment deposition and erosion by solving the equations of momentum, flow and sediment continuity and sediment transport. GSTARS4 (Generalized Sediment Transport Model for Alluvial River Simulation) which is based on a one-dimensional mathematical model that simulates bed changes in both longitudinal and transverse directions by using flow tubes in a quasi-two-dimensional scheme to calibrate a period of 47 years and forecast the next 47 years of sedimentation in Dez Dam, Southern Iran. This dam is among the highest dams all over the world (with its 203 m height), and irrigates more than 125000 square hectares of downstream lands and plays a major role in flood control in the region. The input data including geometry, hydraulic and sedimentary data, starts from 1955 to 2003 on a daily basis. To predict future river discharge, in this research, the time series data were assumed to be repeated after 47 years. Finally, the obtained result was very satisfactory in the delta region so that the output from GSTARS4 was almost identical to the hydrographic profile in 2003. In the Dez dam due to the long (65 km) and a large tank, the vertical currents are dominant causing the calculations by the above-mentioned method to be inaccurate. To solve this problem, we used the empirical reduction method to calculate the sedimentation in the downstream area which led to very good answers. Thus, we demonstrated that by combining these two methods a very suitable model for sedimentation in Dez dam for the study period can be obtained. The present study demonstrated successfully that the outputs of both methods are the same.

Keywords: Dez Dam, prediction, sedimentation, water resources, computational models, finite element method, GSTARS4, HEC-6

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Authors: C.Ardil

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Open Science translates the understanding and application of various theories and practices in open science philosophy, systems, paradigms and epistemology. Open Science originates with the premise that universal scientific knowledge is a product of a collective scholarly and social collaboration involving all stakeholders and knowledge belongs to the global society. Scientific outputs generated by public research are a public good that should be available to all at no cost and without barriers or restrictions. Open Science has the potential to increase the quality, impact and benefits of science and to accelerate advancement of knowledge by making it more reliable, more efficient and accurate, better understandable by society and responsive to societal challenges, and has the potential to enable growth and innovation through reuse of scientific results by all stakeholders at all levels of society, and ultimately contribute to growth and competitiveness of global society. Open Science is a global movement to improve accessibility to and reusability of research practices and outputs. In its broadest definition, it encompasses open access to publications, open research data and methods, open source, open educational resources, open evaluation, and citizen science. The implementation of open science provides an excellent opportunity to renegotiate the social roles and responsibilities of publicly funded research and to rethink the science system as a whole. Open Science is the practice of science in such a way that others can collaborate and contribute, where research data, lab notes and other research processes are freely available, under terms that enable reuse, redistribution and reproduction of the research and its underlying data and methods. Open Science represents a novel systematic approach to the scientific process, shifting from the standard practices of publishing research results in scientific publications towards sharing and using all available knowledge at an earlier stage in the research process, based on cooperative work and diffusing scholarly knowledge with no barriers and restrictions. Open Science refers to efforts to make the primary outputs of publicly funded research results (publications and the research data) publicly accessible in digital format with no limitations. Open Science is about extending the principles of openness to the whole research cycle, fostering, sharing and collaboration as early as possible, thus entailing a systemic change to the way science and research is done. Open Science is the ongoing transition in how open research is carried out, disseminated, deployed, and transformed to make scholarly research more open, global, collaborative, creative and closer to society. Open Science involves various movements aiming to remove the barriers for sharing any kind of output, resources, methods or tools, at any stage of the research process. Open Science embraces open access to publications, research data, source software, collaboration, peer review, notebooks, educational resources, monographs, citizen science, or research crowdfunding. The recognition and adoption of open science practices, including open science policies that increase open access to scientific literature and encourage data and code sharing, is increasing in the open science philosophy. Revolutionary open science policies are motivated by ethical, moral or utilitarian arguments, such as the right to access digital research literature for open source research or science data accumulation, research indicators, transparency in the field of academic practice, and reproducibility. Open science philosophy is adopted primarily to demonstrate the benefits of open science practices. Researchers use open science applications for their own advantage in order to get more offers, increase citations, attract media attention, potential collaborators, career opportunities, donations and funding opportunities. In open science philosophy, open data findings are evidence that open science practices provide significant benefits to researchers in scientific research creation, collaboration, communication, and evaluation according to more traditional closed science practices. Open science considers concerns such as the rigor of peer review, common research facts such as financing and career development, and the sacrifice of author rights. Therefore, researchers are recommended to implement open science research within the framework of existing academic evaluation and incentives. As a result, open science research issues are addressed in the areas of publishing, financing, collaboration, resource management and sharing, career development, discussion of open science questions and conclusions.

Keywords: Open Science, Open Science Philosophy, Open Science Research, Open Science Data

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Authors: M. K. Sheikh, Y. M. Laghari., P. K. Lashari., N. T. Narejo

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The Indus River is one of the longest important rivers of the world in Asia that flows southward through Pakistan, merges into the Arabian Sea near the port city of Karachi in Sindh Province, and forms the Indus Delta. Fish are an important resource for humans worldwide, especially as food. In fish, healthy nutriments are present which are not found in any other meat source because it have a huge quantity of omega- 3 fatty acids, which are very essential for the human body. Ichthyologic surveys were conducted to explore the diversity of freshwater fishes, distribution, abundance and current status of the fishes at different spatial scale of the downstream, Indus River. Total eight stations were selected namely Railo Miyan (RM), Karokho (Kk), Khanpur (Kp), Mullakatiyar (Mk), Wasi Malook Shah (WMS), Branch Morie (BM), Sujawal (Sj) and Jangseer (JS). The study was carried in the period of January 2016 to December 2019 to identify River and biodiversity threats and to suggest recommendations for conservation. The data were analysed by different population diversity index. Altogether, 124 species were recorded belonging to 12 Orders and 43 Families from the downstream of Indus River. Among 124 species, 29% belong to high commercial value and 35% were trash fishes. 31% of fishes were identified as marine/estuarine origin (migratory) and 05% were exotic fish species. Perciformes is the most predominated order, contributing to 41% of families. Among 43 families, the family Cyprinidae was the richest family from all localities of downstream, represented by 24% of fish species demonstrating a significant dominance in the number of species. A significant difference was observed for species abundance in between all sites, the maximum abundance species were found at first location RM having 115 species and minimum observed at the last station JS 56 genera. In the recorded Ichthyofauna, seven groups were found according to the International Union for Conservation of Nature status (IUCN), where a high species ratio was collected, in Least Concern (LC) having 94 species, 11 were found as not evaluated (NE), whereas 8 was identified as near threatened (NT), 1 was recorded as critically endangered (CR), 11 were collected as data deficient (DD), and while 8 was observed as vulnerable (VU) and 3 endangered (EN) species. Different diversity index has been used extensively in environmental studies to estimate the species richness and abundance of ecosystems outputs of their wellness; a positive environment (biodiversity rich) with species at RM had an environmental wellness and biodiversity levels of 4.566% while a negative control environment (biodiversity poor) on last station JS had an environmental wellness and biodiversity levels of 3.931%. The status of fish biodiversity and river has been found under serious threat. Due to the lower diversity of fishes, it became not only venerable for fish but also risky for fishermen. Necessary steps are recommended to protect the biodiversity by conducting further conservative research in this area.

Keywords: ichthyofaunal biodiversity, threatened species, diversity index, Indus River downstream

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Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

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Authors: Gadanya, A.M., Ponfa, S., Jibril, M.M., Abubakar, S. M.

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Background: Edible insects such as grasshopper are important sources of food for humans, and have been consumed as traditional foods by many indigenous communities especially in Africa, Asia, and Latin America. These communities have developed their skills and techniques in harvesting, preparing, consuming, and preserving edible insects, widely contributing to the role played by the use of insects in human nutrition. Aim/ objective: This study was aimed at determining the effect of insect enriched sprouted soyabean /millet based food on some gut health markers in albino rats. Methods. Four different formulations of Complementary foods (i.e Complementary Food B (CFB): sprouted millet (SM), Complementary Food C (CFC): sprouted soyabean (SSB), Complementary Food D (CFD): sprouted soybean and millet (SSBM) in a ratio of (50:50) and Complementary Food E (CFE): insect (grasshopper) enriched sprouted soybean and millet (SSBMI) in a ratio of (50:25:25)) were prepared. Proximate composition and short chain fatty acid contents were determined. Thirty albino rats were divided into5 groups of six rats each. Group 1(CDA) were fed with basal diet and served as a control group, while groups 2,3,4 and 5 were fed with the corresponding complimentary foods CFB, CFC, CFD and CFE respectively daily for four weeks. Concentrations of fecal protein, serum total carotenoids and nitric oxide were determined. DNA extraction for molecular isolation and characterization were carried out followed by PCR, the use of mega 11 software and NCBI blast for construction of the phylogenetic tree and organism identification respectively. Results: Significant increase (P<0.05) in percentage ash, fat, protein and moisture contents, as well as short chain fatty acid (acetate, butyrate and propionate) concentrations were recorded in the insect enriched sprouted composite food (CFE) when compared with the CFA, CFB, CFC and CFD composite food. Faecal protein, carotenoid and nitric oxide concentrations were significantly lower (P>0.05) in group 5 in comparison to groups 1to 4. Ruminococcus bromii and Bacteroidetes were molecularly isolated and characterized by 16s rRNA from the sprouted millet/sprouted soybean and the insect enriched sprouted soybean/sprouted millet based food respectively. The presence of these bacterial strains in the feaces of the treated rats is an indication that the gut of the treated rats is colonized by good gut bacteria, hence, an improved gut health. Conclusion: Insect enriched sprouted soya bean/sprouted millet based complementary diet showed a high composition of ash, fat, protein and fiber. Thus, could increase the availability of short chain fatty acids whose role to the host organism cannot be overemphasized. It was also found to have decrease the level of faecal protein, carotenoid and nitric oxide in the serum which is an indication of an improvement in the immune system function.

Keywords: gut-health, insect, millet, soybean, sprouted

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Authors: Rojan Dahal

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One Health refers to a collaborative effort between multiple disciplines - locally, nationally, and globally - to attain optimal health. Although there were unprecedented intersectoral alliances between the animal and human health sectors during the avian influenza outbreak, there are different views and perceptions concerning institutionalizing One Health in South Asia. It is likely a structural barrier between the relevant professionals working in different entities or ministries when it comes to collaborating on One Health actions regarding zoonotic diseases. Politicians and the public will likely need to invest large amounts of money, demonstrate political will, and understand how One Health works to overcome these barriers. One Health might be hard to invest in South Asian countries, where the benefits are based primarily on models and projections and where numerous issues related to development and health need urgent attention. The other potential barrier to enabling the One Health concept in responding to zoonotic diseases is a failure to represent One Health in zoonotic disease control and prevention measures in the national health policy, which is a critical component of institutionalizing the One Health concept. One Health cannot be institutionalized without acknowledging the linkages between animal, human, and environmental sectors in dealing with zoonotic diseases. Efforts have been made in the past to prepare a preparedness plan for One Health implementation, but little has been done to establish a policy environment to institutionalize One Health. It is often assumed that health policy refers specifically to medical care issues and health care services. When drafting, reviewing, and redrafting the policy, it is important to engage a wide range of stakeholders. One Health institutionalization may also be hindered by the interplay between One Health professionals and bureaucratic inertia in defining the priorities of diseases due to competing interests on limited budgets. There is a possibility that policymakers do not recognize the importance of veterinary professionals in preventing human diseases originating in animals. Compared to veterinary medicine, the human health sector has produced most of the investment and research outputs related to zoonotic diseases. The public health profession may consider itself superior to the veterinary profession. Zoonotic diseases might not be recognized as threats to human health, impeding integrated policies. The effort of One Health institutionalization remained only among the donor agencies and multi-sectoral organizations. There is a need for strong political will and state capacity to overcome the existing institutional, financial, and professional barriers for its effective implementation. There is a need to assess the structural challenges, policy challenges, and the attitude of the professional working in the multiple disciplines related to One Health. Limited research has been conducted to identify the reasons behind the barriers to institutionalizing the One Health concept in South Asia. Institutionalizing One Health in responding to zoonotic diseases breaks down silos and integrates animals, humans, and the environment.

Keywords: one health, institutionalization, South Asia, institutionalizations

Procedia PDF Downloads 99

Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

Procedia PDF Downloads 108

Authors: Jaeyoung Lee, Minji Je

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Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

Procedia PDF Downloads 192

Authors: Margareth Guimaraes Lima, Marilisa Berti A. Barros, Deborah Carvalho Malta

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The relationship between physical activity (PA) and depression has been investigated, in both, observational and clinical studies: PA can integrate the treatments for depression; the physical inactivity (PI) may contribute to increase depression symptoms; and on the other hand, emotional problems can decrease PA. The main of this study was analyze the association among leisure and transportation PI and time watching television (TV) according to depression (minor and major), evaluated with the Patient Health Questionnaire (PHQ-9). The association was also analyzed by gender. This is a cross-sectional study. Data were obtained from the National Health Survey 2013 (PNS), performed with representative sample of the Brazilian adult population, in 2013. The PNS collected information from 60,202 individuals, aged 18 years or more. The independent variable were: leisure time physical inactivity (LTPI), considering inactive or insufficiently actives (categories were linked for analyzes), those who do not performed a minimum of 150 or 74 minutes of moderate or vigorous LTPA, respectively, by week; transportation physical inactivity (TPI), individuals who did not reached 150 minutes, by week, travelling by bicycle or on foot to work or other activities; daily time watching TV > 5 hours. The principal independent variable was depression, identified by PHQ-9. Individuals were classified with major depression, with > 5 symptoms, more than seven days, but one of the symptoms was “depressive mood” or “lack of interest or pleasure”. The others had minor depression. The variables used to adjustment were gender, age, schooling and chronic disease. The prevalence of LTPI, TPI and TV time were estimated according to depression, and differences were tested with Chi-Square test. Adjusted prevalence ratios were estimated using multiple Poisson regression models. The analyzes also had stratification by gender. Mean age of the studied population was 42.9 years old (CI95%:42.6-43.2) and 52.9% were women. 77.5% and 68.1% were inactive or insufficiently active in leisure and transportation, respectively and 13.3% spent time watching TV 5 > hours. 6% and 4.1% of the Brazilian population were diagnosed with minor or major depression. LTPI prevalence was 5% and 9% higher among individuals with minor and major depression, respectively, comparing with no depression. The prevalence of TPI was 7% higher in those with major depression. Considering larger time watching TV, the prevalence was 45% and 74% higher among those with minor and major depression, respectively. Analyzing by gender, the associations were greater in men than women and TPI was note be associated, in women. The study detected the higher prevalence of leisure time physical inactivity and, especially, time spent watching TV, among individuals with major and minor depression, after to adjust for a number of potential confounding factors. TPI was only associated with major disorders and among men. Considering the cross-sectional design of the research, these associations can point out the importance of the mental problems control of the population to increase PA and decrease the sedentary lifestyle; on the other hand, the study highlight the need of interventions by encouraging people with depression, to practice PA, even to transportation.

Keywords: depression, physical activity, PHQ-9, sedentary lifestyle

Procedia PDF Downloads 156

Authors: Seema Dhariwal, Kiran Maan, Ruchi Baghel, Apoorva Sharma, Poonam Rana

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Introduction: Traumatic brain injury (TBI) is defined as the temporary or permanent alteration in brain function and pathology caused by an external mechanical force. It represents the leading cause of mortality and morbidity among children and youth individuals. Various models of TBI in rodents have been developed in the laboratory to mimic the scenario of injury. Blast overpressure injury is common among civilians and military personnel, followed by accidents or explosive devices. In addition to this, the lateral Controlled cortical impact (CCI) model mimics the blunt, penetrating injury. Method: In the present study, we have developed two different mild TBI models using blast and CCI injury. In the blast model, helium gas was used to create an overpressure of 130 kPa (±5) via a shock tube, and CCI injury was induced with an impact depth of 1.5mm to create diffusive and focal injury, respectively. C57BL/6J male mice (10-12 weeks) were divided into three groups: (1) control, (2) Blast treated, (3) CCI treated, and were exposed to different injury models. Serum was collected on Day1 and day7, followed by biphasic extraction using MTBE/Methanol/Water. Prepared samples were separated on Charged Surface Hybrid (CSH) C18 column and acquired on UHPLC-Q-TOF-MS using ESI probe with inhouse optimized parameters and method. MS peak list was generated using Markerview TM. Data were normalized, Pareto-scaled, and log-transformed, followed by multivariate and univariate analysis in metaboanalyst. Result and discussion: Untargeted profiling of lipids generated extensive data features, which were annotated through LIPID MAPS® based on their m/z and were further confirmed based on their fragment pattern by LipidBlast. There is the final annotation of 269 features in the positive and 182 features in the negative mode of ionization. PCA and PLS-DA score plots showed clear segregation of injury groups to controls. Among various lipids in mild blast and CCI, five lipids (Glycerophospholipids {PC 30:2, PE O-33:3, PG 28:3;O3 and PS 36:1 } and fatty acyl { FA 21:3;O2}) were significantly altered in both injury groups at Day 1 and Day 7, and also had VIP score >1. Pathway analysis by Biopan has also shown hampered synthesis of Glycerolipids and Glycerophospholipiods, which coincides with earlier reports. It could be a direct result of alteration in the Acetylcholine signaling pathway in response to TBI. Understanding the role of a specific class of lipid metabolism, regulation and transport could be beneficial to TBI research since it could provide new targets and determine the best therapeutic intervention. This study demonstrates the potential lipid biomarkers which can be used for injury severity diagnosis and identification irrespective of injury type (diffusive or focal).

Keywords: LipidBlast, lipidomic biomarker, LIPID MAPS®, TBI

Procedia PDF Downloads 113

Authors: Shamim Mushtaq, Moazzam Shahid

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Breast cancer (BC) claims the lives of half a million women every year and is the most common cause of death in the developing world. In 2019, it was estimated that BC alone accounts for 15% of all cancer deaths in younger women (aged < 45 years old) with advanced-stage lung metastasis. According to the World Health Organization & International Union against Cancer, in Asia, a high number of cancer-related deaths will be observed in 2020, whereas the burden will be reduced in Western countries due to awareness about the disease, better health facilities and advanced treatments. In the last 15 years, it has been reported that the incidence of BC has increased by 1.1% among Asian compared to the US population from 2003 to 2012. To date, several BC biological subtypes have been reported so far, which are associated with different treatment responses. The heterogeneity and diversity of BC reflected these different subtypes, including Luminal A (23.7% prevalence) and B (38.8% prevalence) that have pathological estrogen receptor (ER+)-positive tumors, the human epidermal growth factor receptor 2 (HER2) (11.2% prevalence) and triple-negative breast cancer (TNBC) (25% prevalence). According to Shaukat Khanum Memorial Cancer Hospital and Research Centre – Pakistan, ten years of data showed that among 636 BC patients, 30.5% had TNBC who were <40 years of age, which is an extremely alarming situation. Therefore, there is a dire need to explore and develop therapeutic targets for the treatment of early TNBC. Since the last decade, unfortunately, there has been little success in understanding the complexity of TNBC and in discovering new biological therapeutic targets. However, conventional chemotherapy is the only choice of treatment for TNBC patients. Many investigators revealed advances in multi-omics (multiple "omes", e.g., genome, proteome, transcriptome, epigenome, and microbiome) which were later identified as actionable targets and increased prevalence in TNBC patients. However, various drugs have been identified so far which are related to a particular diagnostic and prognostic biomarker. For example, Epidermal growth factor receptor ( EGFR or ErbB-1), HER-2/neu (ErbB-2), HER-3 (ErbB-3), and HER-4 (ErbB-4). Protein Transglin-2 (TAGLN 2 ) and Profilins-1 (Pfn-1 ) are the ubiquitously expressed large family of proteins present in all eukaryotes, enabling actin cytoskeletal reorganization. It is known that the oncogenic transformation of cells is accompanied by alteration in the actin cytoskeleton. There are causal connections between altered expression of actin cytoskeletal regulators and cancer progression. Our case-control study identified TAGLN-2 and Pfn-1 proteins in TNBC blood by mass spectrometry. Both TAGLN-2 and Pfn-1 proteins are differentially expressed in early and advanced stages of TNBS patients, which could be potential predictors or therapeutic targets for TNBC.

Keywords: TNBC, blood biomarkers, mass spectrometry, qPCR, ELISA

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Authors: Barbara Behre, Verolien Cauberghe, Dieneke Van de Sompel

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Sustainable consumption is on the rise, yet it has still not entered the mainstream in several industries, such as the fashion industry. In online fashion contexts, sustainability cues have been used to signal the sustainable benefits of certain garments to promote sustainable consumption. These sustainable cues may focus on the ecological or social dimension of sustainability. Since sustainability, in general, relates to distant, abstract benefits, the current study aims to examine if and how psychological distance may mediate the effects of exposure to different sustainability cues on consumption outcomes. Following the framework of Construal Level Theory of Psychological Distance, reduced psychological distance renders the construal level more concrete, which may influence attitudes and subsequent behavior in situations like fashion shopping. Most studies investigated sustainability as a composite, failing to differentiate between ecological and societal aspects of sustainability. The few studies examining sustainability more in detail uncovered that environmental sustainability is rather perceived in abstract cognitive construal, whereas social sustainability is linked to concrete construal. However, the construal level affiliation of the sustainability dimensions likely is not universally applicable to different domains and stages of consumption, which further suggest a need to clarify the relationships between environmental and social sustainability dimensions and the construal level of psychological distance within fashion brand consumption. While psychological distance and construal level have been examined in the context of sustainability, these studies yielded mixed results. The inconsistent findings of past studies might be due to the context-dependence of psychological distance as inducing construal differently in diverse situations. Especially in a hedonic consumption context like online fashion shopping, the role of visual processing of information could determine behavioural outcomes as linked to situational construal. Given the influence of the mode of processing on psychological distance and construal level, the current study examines the moderating role of verbal versus non-verbal presentation of the sustainability cues. In a 3 (environmental sustainability vs. social sustainability vs. control) x 2 (non-verbal message vs. verbal message) between subjects experiment, the present study thus examines how consumers evaluate sustainable brands in online shopping contexts in terms of psychological distance and construal level, as well as the impact on brand attitudes and buying intentions. The results among 246 participants verify the differential impact of the sustainability dimensions on fashion brand purchase intent as mediated by construal level and perceived psychological distance. The ecological sustainability cue is perceived as more concrete, which might be explained by consumer bias induced by the predominance of pro-environmental sustainability messages. The verbal versus non-verbal presentation of the sustainability cue neither had a significant influence on distance perceptions and construal level nor on buying intentions. This study offers valuable contributions to the sustainable consumption literature, as well as a theoretical basis for construal-level framing as applied in sustainable fashion branding.

Keywords: construal level theory, environmental vs social sustainability, online fashion shopping, sustainable fashion

Procedia PDF Downloads 103

Authors: Al Sayed Al Soudy, Valeria Maselli, Gianluca Polese, Anna Di Cosmo

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Cephalopods are considered as a model organism with a rich behavioral repertoire. Sophisticated behaviors were widely studied and described in different species such as Octopus vulgaris, who has evolved the largest and more complex nervous system among invertebrates. In O. vulgaris, cognitive abilities in problem-solving tasks and learning abilities are associated with long-term memory and spatial memory, mediated by highly developed sensory organs. They are equipped with sophisticated eyes, able to discriminate colors even with a single photoreceptor type, vestibular system, ‘lateral line analogue’, primitive ‘hearing’ system and olfactory organs. They can recognize chemical cues either through direct contact with odors sources using suckers or by distance through the olfactory organs. Cephalopods are able to detect widespread waterborne molecules by the olfactory organs. However, many volatile odorant molecules are insoluble or have a very low solubility in water, and must be perceived by direct contact. O. vulgaris, equipped with many chemosensory neurons located in their suckers, exhibits a peculiar behavior that can be provocatively described as 'smell by touch'. The aim of this study is to establish the priority given to chemical vs. visual perception in food choice. Materials and methods: Three different types of food (anchovies, clams, and mussels) were used, and all sessions were recorded with a digital camera. During the acclimatization period, Octopuses were exposed to the three types of food to test their natural food preferences. Later, to verify if food preference is maintained, food was provided in transparent screw-jars with pierced lids to allow both visual and chemical recognition of the food inside. Subsequently, we tested alternatively octopuses with food in sealed transparent screw-jars and food in blind screw-jars with pierced lids. As a control, we used blind sealed jars with the same lid color to verify a random choice among food types. Results and discussion: During the acclimatization period, O. vulgaris shows a higher preference for anchovies (60%) followed by clams (30%), then mussels (10%). After acclimatization, using the transparent and pierced screw jars octopus’s food choices resulted in 50-50 between anchovies and clams, avoiding mussels. Later, guided by just visual sense, with transparent but not pierced jars, their food preferences resulted in 100% anchovies. With pierced but not transparent jars their food preference resulted in 100% anchovies as first food choice, the clams as a second food choice result (33.3%). With no possibility to select food, neither by vision nor by chemoreception, the results were 20% anchovies, 20% clams, and 60% mussels. We conclude that O. vulgaris uses both chemical and visual senses in an integrative way in food choice, but if we exclude one of them, it appears clear that its food preference relies on chemical sense more than on visual perception.

Keywords: food choice, Octopus vulgaris, olfaction, sensory organs, visual sense

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Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

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AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

Procedia PDF Downloads 162

Authors: Markéta Chmelíková, David Ullrich, Iva Burešová

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The paper maps the possibilities and limits of diagnosing selected personality and performance characteristics of military leadership and psychology students in the context of coping with challenging situations. Individuals vary greatly inter-individually in their ability to effectively manage extreme situations, yet existing diagnostic tools are often criticized mainly for their low predictive power. Nowadays, every modern army focuses primarily on the systematic minimization of potential risks, including the prediction of desirable forms of behavior and the performance of military commanders. The context of military leadership is well known for its life-threatening nature. Therefore, it is crucial to research stress load in the specific context of military leadership for the purpose of possible anticipation of human failure in managing extreme situations of military leadership. The aim of the submitted pilot study, using an experiment of 24 hours duration, is to verify the possibilities of a specific combination of psychodiagnostic to predict people who possess suitable equipment for coping with increased stress load. In our pilot study, we conducted an experiment of 24 hours duration with an experimental group (N=13) in the bomb shelter and a control group (N=11) in a classroom. Both groups were represented by military leadership students (N=11) and psychology students (N=13). Both groups were equalized in terms of study type and gender. Participants were administered the following test battery of personality characteristics: Big Five Inventory 2 (BFI-2), Short Dark Triad (SD-3), Emotion Regulation Questionnaire (ERQ), Fatigue Severity Scale (FSS), and Impulsive Behavior Scale (UPPS-P). This test battery was administered only once at the beginning of the experiment. Along with this, they were administered a test battery consisting of the Test of Attention (d2) and the Bourdon test four times overall with 6 hours ranges. To better simulate an extreme situation – we tried to induce sleep deprivation - participants were required to try not to fall asleep throughout the experiment. Despite the assumption that a stay in an underground bomb shelter will manifest in impaired cognitive performance, this expectation has been significantly confirmed in only one measurement, which can be interpreted as marginal in the context of multiple testing. This finding is a fundamental insight into the issue of stress management in extreme situations, which is crucial for effective military leadership. The results suggest that a 24-hour stay in a shelter, together with sleep deprivation, does not seem to simulate sufficient stress for an individual, which would be reflected in the level of cognitive performance. In the context of these findings, it would be interesting in future to extend the diagnostic battery with physiological indicators of stress, such as: heart rate, stress score, physical stress, mental stress ect.

Keywords: bomb shelter, extreme situation, military leadership, psychodiagnostic

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Authors: Jacqueline Y. Thompson, Sam Watson, Lee Middleton, Karla Hemming

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Introduction: The odds ratio (estimated via logistic regression) is a well-established and common approach for estimating covariate-adjusted binary treatment effects when comparing a treatment and control group with dichotomous outcomes. Its popularity is primarily because of its stability and robustness to model misspecification. However, the situation is different for the relative risk and risk difference, which are arguably easier to interpret and better suited to specific designs such as non-inferiority studies. So far, there is no equivalent, widely acceptable approach to estimate an adjusted relative risk and risk difference when conducting clinical trials. This is partly due to the lack of a comprehensive evaluation of available candidate methods. Methods/Approach: A simulation study is designed to evaluate the performance of relevant candidate methods to estimate relative risks to represent conditional and marginal estimation approaches. We consider the log-binomial, generalised linear models (GLM) with iteratively weighted least-squares (IWLS) and model-based standard errors (SE); log-binomial GLM with convex optimisation and model-based SEs; log-binomial GLM with convex optimisation and permutation tests; modified-Poisson GLM IWLS and robust SEs; log-binomial generalised estimation equations (GEE) and robust SEs; marginal standardisation and delta method SEs; and marginal standardisation and permutation test SEs. Independent and identically distributed datasets are simulated from a randomised controlled trial to evaluate these candidate methods. Simulations are replicated 10000 times for each scenario across all possible combinations of sample sizes (200, 1000, and 5000), outcomes (10%, 50%, and 80%), and covariates (ranging from -0.05 to 0.7) representing weak, moderate or strong relationships. Treatment effects (ranging from 0, -0.5, 1; on the log-scale) will consider null (H0) and alternative (H1) hypotheses to evaluate coverage and power in realistic scenarios. Performance measures (bias, mean square error (MSE), relative efficiency, and convergence rates) are evaluated across scenarios covering a range of sample sizes, event rates, covariate prognostic strength, and model misspecifications. Potential Results, Relevance & Impact: There are several methods for estimating unadjusted and adjusted relative risks. However, it is unclear which method(s) is the most efficient, preserves type-I error rate, is robust to model misspecification, or is the most powerful when adjusting for non-prognostic and prognostic covariates. GEE estimations may be biased when the outcome distributions are not from marginal binary data. Also, it seems that marginal standardisation and convex optimisation may perform better than GLM IWLS log-binomial.

Keywords: binary outcomes, statistical methods, clinical trials, simulation study

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Authors: Kaling Taki, Rohit Gahlot, Manish Kumar

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Disposal of Sewage Sludge (SS) is a big issue especially in developing nation like India, where there is no control in the dynamicity of SS produced. The present research work demonstrates the potential application of SS amended with varying percentage (0-100%) of Fly Ash (FA) for brick manufacturing as an alternative of SS management. SS samples were collected from Jaspur sewage treatment plant (Ahmedabad, India) and subjected to different preconditioning treatments: (i) atmospheric drying (ii) pulverization (iii) heat treatment in oven (110°C, moisture removal) and muffle furnace (440°C, organic content removal). Geotechnical parameters of the SS were obtained as liquid limit (52%), plastic limit (24%), shrinkage limit (10%), plasticity index (28%), differential free swell index (DFSI, 47%), silt (68%), clay (27%), organic content (5%), optimum moisture content (OMC, 20%), maximum dry density (MDD, 1.55gm/cc), specific gravity (2.66), swell pressure (57kPa) and unconfined compressive strength (UCS, 207kPa). For FA liquid limit, plastic limit and specific gravity was 44%, 0% and 2.2 respectively. Initially, for brick casting pulverized SS sample was heat treated in a muffle furnace around 440℃ (5 hours) for removal of organic matter. Later, mixing of SS, FA and water by weight ratio was done at OMC. 7*7*7 cm3 sample mold was used for casting bricks at MDD. Brick samples were then first dried in room temperature for 24 hours, then in oven at 100℃ (24 hours) and finally firing in muffle furnace for 1000℃ (10 hours). The fired brick samples were then cured for 3 days according to Indian Standards (IS) common burnt clay building bricks- specification (5th revision). The Compressive strength of brick samples (0, 10, 20, 30, 40, 50 ,60, 70, 80, 90, 100%) of FA were 0.45, 0.76, 1.89, 1.83, 4.02, 3.74, 3.42, 3.19, 2.87, 0.78 and 4.95MPa when evaluated through compressive testing machine (CTM) for a stress rate of 14MPa/min. The highest strength was obtained at 40% FA mixture i.e. 4.02MPa which is much higher than the pure SS brick sample. According to IS 1077: 1992 this combination gives strength more than 3.5 MPa and can be utilized as common building bricks. The loss in weight after firing was much higher than the oven treatment, this might be due to degradation temperature higher than 100℃. The thermal conductivity of the fired brick was obtained as 0.44Wm-1K-1, indicating better insulation properties than other reported studies. TCLP (Toxicity characteristic leaching procedure) test of Cr, Cu, Co, Fe and Ni in raw SS was found as 69, 70, 21, 39502 and 47 mg/kg. The study positively concludes that SS and FA at optimum ratio can be utilized as common building bricks such as partitioning wall and other small strength requirement works. The uniqueness of the work is it emphasizes on utilization of FA for stabilizing SS as construction material as a replacement of natural clay as reported in existing studies.

Keywords: Compressive strength, Curing, Fly Ash, Sewage Sludge.

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Authors: Nikolai A. Khlebnikov, Vladimir N. Krasilnikov, Evgenii V. Polyakov, Anastasia A. Maltceva

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Carbon materials with advanced surfaces are widely used both in modern industry and in environmental protection. The physical-chemical nature of these materials is determined by the morphology of primary atomic and molecular carbon structures, which are the basis for synthesizing the following materials: zero-dimensional (fullerenes), one-dimensional (fiber, tubes), two-dimensional (graphene) carbon nanostructures, three-dimensional (multi-layer graphene, graphite, foams) with unique physical-chemical and functional properties. Experience shows that the microscopic morphological level is the basis for the creation of the next mesoscopic morphological level. The dependence of the morphology on the chemical way and process prehistory (crystallization, colloids formation, liquid crystal state and other) is the peculiarity of the last called level. These factors determine the consumer properties of carbon materials, such as specific surface area, porosity, chemical resistance in corrosive environments, catalytic and adsorption activities. Based on the developed ideology of thin precursor synthesis, the authors discuss one of the approaches of the porosity control of carbon-containing materials with a given aggregates morphology. The low-temperature thermolysis of precursors in a gas environment of a given composition is the basis of the above-mentioned idea. The processes of carbothermic precursor synthesis of two different compounds: tungsten carbide WC:nC and zinc oxide ZnO:nC containing an impurity phase in the form of free carbon were selected as subjects of the research. In the first case, the transition metal (tungsten) forming carbides was the object of the synthesis. In the second case, there was selected zinc that does not form carbides. The synthesis of both kinds of transition metals compounds was conducted by the method of precursor carbothermic synthesis from the organic solution. ZnO:nC composites were obtained by thermolysis of succinate Zn(OO(CH2)2OO), formate glycolate Zn(HCOO)(OCH2CH2O)1/2, glycerolate Zn(OCH2CHOCH2OH), and tartrate Zn(OOCCH(OH)CH(OH)COO). WC:nC composite was synthesized from ammonium paratungstate and glycerol. In all cases, carbon structures that are specific for diamond- like carbon forms appeared on the surface of WC and ZnO particles after the heat treatment. Tungsten carbide and zinc oxide were removed from the composites by selective chemical dissolution preserving the amorphous carbon phase. This work presents the results of investigating WC:nC and ZnO:nC composites and carbon nanopowders with tubular, tape, plate and onion morphologies of aggregates that are separated by chemical dissolution of WC and ZnO from the composites by the following methods: SEM, TEM, XPA, Raman spectroscopy, and BET. The connection between the carbon morphology under the conditions of synthesis and chemical nature of the precursor and the possibility of regulation of the morphology with the specific surface area up to 1700-2000 m2/g of carbon-structured materials are discussed.

Keywords: carbon morphology, composite materials, precursor synthesis, tungsten carbide, zinc oxide

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Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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Authors: Amar Ghelani

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People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

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