Search results for: unethical events

Authors: John Ahluwalia

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As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Why is it that Canada has not shared the same fate as the US (and many other nations) that have realized much worse outcomes relative to the COVID-19 pandemic? Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal healthcare is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, Canada, GIS, temporal analysis, ESRI

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Authors: Adel Dalilottojari, Bahman Delalat, Frances J. Harding, Michaelia P. Cockshell, Claudine S. Bonder, Nicolas H. Voelcker

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Endothelial Progenitor Cell (EPC) based therapies continue to be of interest to treat ischemic events based on their proven role to promote blood vessel formation and thus tissue re-vascularisation. Current strategies for the production of clinical-grade EPCs requires the in vitro isolation of EPCs from peripheral blood followed by cell expansion to provide sufficient quantities EPCs for cell therapy. This study aims to examine the use of different biomolecules to significantly improve the current strategy of EPC capture and expansion on collagen type I (Col I). In this study, four different biomolecules were immobilised on a surface and then investigated for their capacity to support EPC capture and proliferation. First, a cell microarray platform was fabricated by coating a glass surface with epoxy functional allyl glycidyl ether plasma polymer (AGEpp) to mediate biomolecule binding. The four candidate biomolecules tested were Col I, collagen type II (Col II), collagen type IV (Col IV) and vascular endothelial growth factor A (VEGF-A), which were arrayed on the epoxy-functionalised surface using a non-contact printer. The surrounding area between the printed biomolecules was passivated with polyethylene glycol-bisamine (A-PEG) to prevent non-specific cell attachment. EPCs were seeded onto the microarray platform and cell numbers quantified after 1 h (to determine capture) and 72 h (to determine proliferation). All of the extracellular matrix (ECM) biomolecules printed demonstrated an ability to capture EPCs within 1 h of cell seeding with Col II exhibiting the highest level of attachment when compared to the other biomolecules. Interestingly, Col IV exhibited the highest increase in EPC expansion after 72 h when compared to Col I, Col II and VEGF-A. These results provide information for significant improvement in the capture and expansion of human EPC for further application.

Keywords: biomolecules, cell microarray platform, cell therapy, endothelial progenitor cells, high throughput screening

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Authors: Erkingul Soltanaeva, Omyrkhan Abdimanuly, Alua Temirbolat

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In this article, the public and social functions of literature and art in the Republic of Kazakhstan were analyzed on the basis of formal and informal literary organizations. The external and internal, subjective and objective factors which influenced the modern literary process were determined. The literary forces, their consolidation, types of organization in the art of word were examined. The periods of the literary process as planning, organization, promotion, and evaluation and their leading forces and approaches were analyzed. The right point of view to the language and mentality of the society force will influence to the literary process. The Ministry of Culture, the Writers' Union of RK and various non-governmental organizations are having different events for the promotion of literary process and to glorify literary personalities in the entire territory of Kazakhstan. According to the cultural plan of different state administration, there was a big program in order to publish their literary encyclopedia, to glorify and distribute books of own poets and writers of their region to the country. All of these official measures will increase the reader's interest in the book and will also bring up people to the patriotic education and improve the status of the native language. The professional literary publications such as the newspaper ‘Kazakh literature’, magazine ‘Zhuldyz’, and journal ‘Zhalyn’ materials which were published in the periods 2013-2015 on the basis of statistical analysis of the Kazakh literature topical to the issues and the field of themes are identified and their level of connection with the public situations are defined. The creative freedom, relations between society and the individual, the state of the literature, the problems of advantages and disadvantages were taken into consideration in the same articles. The level of functions was determined through the public role of literature, social feature, personal peculiarities. Now the stages as the literature management planning, organization, motivation, as well as the evaluation are forming and developing in Kazakhstan. But we still need the development of literature management to satisfy the actual requirements of the today’s agenda.

Keywords: literature management, material, literary process, social functions

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Authors: Phusit Phukamchanoad, Chutchai Ditchareon, Suwaree Yordchim

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This research was to study on background and social and cultural context of Kamchanoad community for sustainable tourism management. All data was collected through in-depth interview with village headmen, community committees, teacher, monks, Kamchanoad forest field officers and respected senior citizen above 60 years old in the community who have lived there for more than 40 years. Altogether there were 30 participants for this research. After analyzing the data, content from interview and discussion, Kamchanoad has both high land and low land in the region as well as swamps that are very capable of freshwater animals’ conservation. Kamchanoad is also good for agriculture and animal farming. 80% of Kamchanoad’s land are forest, freshwater and rice farms. Kamchanoad was officially set up as community in 1994 as “Baan Nonmuang”. Inhabitants in Kamchanoad make a living by farming based on sufficiency economy. They have rice farm, eucalyptus farm, cassava farm and rubber tree farm. Local people in Kamchanoad still believe in the myth of Srisutto Naga. They are still religious and love to preserve their traditional way of life. In order to understand how to create successful tourism business in Kamchanoad, we have to study closely on local culture and traditions. Outstanding event in Kamchanoad is the worship of Grand Srisutto, which is on the full-moon day of 6th month or Visakhabucha Day. Other big events are also celebration at the end of Buddhist lent, Naga firework, New Year celebration, Boon Mahachart, Songkran, Buddhist Lent, Boon Katin and Loy Kratong. Buddhism is the main religion in Kamchanoad. The promotion of tourism in Kamchanoad is expected to help spreading more income for this region. More infrastructures will be provided for local people as well as funding for youth support and people activities.

Keywords: social and culture area, tourism management, Kamchanoad Community, Udon Thani Province

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Authors: Aurélia Jandot

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With the oil and economic crises which began in the 1970’s, it has progressively appeared necessary to convince the French “general public“ that a use of new energy sources was essential. In this field, nuclear energy represented the future and concentrated lots of hopes. However, the discourse about nuclear energy has progressively seen negative arguments growing in the French media. The gradual changes in the perception of nuclear energy will be studied here through the arguments given in the main French weekly newsmagazines, which had a great impact on the readers, thus on the “general public“, from the 1970’s to the end of the 1980’s. Indeed, to understand better these changes will be taken into account the major international events, the reorientations of the French domestic policy, and the evolutions of the nuclear technology. As this represents a considerable amount of copies and thus of information, will be selected here the main articles which emphasize the “mental images“ aiming to direct the thought of the readers, and which have led the public awareness and acceptance to evolve. From the 1970’s to the end of the 1980’s, two dichotomous trends are in confrontation : one is promoting the perception of the nuclear energy, the other is discrediting it. Moreover, these two trends are organized in two axes. The first axis is about the engineerings evolutions, such as the main French media represent them, with its approximations, its exaggerations, its fictions sometimes. Is added the will to make accessible to the “general public“ some concepts which are quite difficult to understand for the largest number. The second axis rests on the way the major accidents of the period are approached, including those of Three Mile Island and Chernobyl. Thanks to these accidents and because of the international relations evolutions, the ecologist movements and their impacts have progressively grown, with evident consequences on the public perception of nuclear energy and on the way the successive governments can implement new power plants in France. Then, in both cases, over the period considered, the language has changed, as the perceptible objectives of the communication, allowing to discern the deepest intentions of the newsmagazines editing. This is all these changes that will be emphasized, over a period where the nuclear energy technology, to there a field for specialists, bearing mystery and secret, has become a social issue seemingly open to all.

Keywords: social issues, public acceptance, mediatization, discourse changes

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Authors: Yiyuan Tao

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Under the impact of global warming together with the intensification of human activities, the hydrological regimes may be altered, and the traditional stationary assumption was no longer satisfied. However, most of the current design standards of water infrastructures were still based on the hypothesis of stationarity, which may inevitably result in severe biases. Many critical impacts of climate on ecosystems, society, and the economy are controlled by extreme events rather than mean values. Therefore, it is of great significance to identify the non-stationarity of precipitation extremes and model the precipitation extremes in a nonstationary framework. The Wei River Basin (WRB), located in a continental monsoon climate zone in China, is selected as a case study in this study. Six extreme precipitation indices were employed to investigate the changing patterns and stationarity of precipitation extremes in the WRB. To identify if precipitation extremes are stationary, the Mann-Kendall trend test and the Pettitt test, which is used to examine the occurrence of abrupt changes are adopted in this study. Extreme precipitation indices series are fitted with non-stationary distributions that selected from six widely used distribution functions: Gumbel, lognormal, Weibull, gamma, generalized gamma and exponential distributions by means of the time-varying moments model generalized additive models for location, scale and shape (GAMLSS), where the distribution parameters are defined as a function of time. The results indicate that: (1) the trends were not significant for the whole WRB, but significant positive/negative trends were still observed in some stations, abrupt changes for consecutive wet days (CWD) mainly occurred in 1985, and the assumption of stationarity is invalid for some stations; (2) for these nonstationary extreme precipitation indices series with significant positive/negative trends, the GAMLSS models are able to capture well the temporal variations of the indices, and perform better than the stationary model. Finally, the differences between the quantiles of nonstationary and stationary models are analyzed, which highlight the importance of nonstationary modeling of precipitation extremes in the WRB.

Keywords: extreme precipitation, GAMLSSS, non-stationary, Wei River Basin

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Authors: Maiko Kiyohara, Toshiki Ito

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In this study, we used a psychotherapy process for patient with dissociative disorder and the graphic Rorschach (Digital version) (GRD). A dissociative disorder is a type of dissociation characterized by multiple alternating personalities (also called alternate identity or another identity). "dissociation" is a state in which consciousness, memory, thinking, emotion, perception, behavior, body image, and so on are divided and experienced. Dissociation symptoms, such as lack of memory, are seen, and the repetition of blanks in daily events causes serious problems in life. Although the pathological mechanism of dissociation has not yet been fully elucidated, it is said that it is caused by childhood abuse or shocking trauma. In case of Japan, no reliable data has been reported on the number of patients and prevalence of dissociative disorders, no drug is compatible with dissociation symptoms, and no clear treatment has been established. GRD is a method that the author revised in 2017 to a Graphic Rorschach, which is a special technique for subjects to draw language responses when enforce Rorschach. GRD reduces the burden on both the subject and the examiner, reduces the complexity of organizing data, improves the simplicity of organizing data, and improves the accuracy of interpretation by introducing a tablet computer during the drawing reaction. We are conducting research for the purpose. The patient in this case is a woman in her 50s, and has multiple personalities since childhood. At present, there are about 10 personalities whose main personality is just grasped. The patients is raising her junior high school sons as single parent, but personal changes often occur at home, which makes the home environment inferior and economically oppressive, and has severely hindered daily life. In psychotherapy, while a personality different from the main personality has appeared, I have also conducted psychotherapy with her son. In this case, the psychotherapy process and the GRD were performed to understand the personality characteristics, and the possibility of therapeutic significance to personality integration is reported.

Keywords: GRD, dissociative disorder, a case study of psychotherapy process, dissociation

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Authors: Marie Fouet, Olivier Maire, Cécile Masse, Hugues Blanchet, Salomé Coignard, Nicolas Lavesque, Guillaume Bernard

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Exacerbated by global change, extreme climatic events such as atmospheric and marine heat waves may interact with the spread of non-indigenous species and their associated impacts on marine ecosystems. Since the 1970’s, the introduction of non-indigenous species due to oyster exchanges has been numerous. Among them, the Asian date mussel Arcuatula senhousia has colonized a large number of ecosystems worldwide (e.g., California, New Zealand, Italy). In these places, A.senhousia led to important habitat modifications in the benthic compartment through physical, biological, and biogeochemical effects associated with the development of dense mussel populations. In Arcachon Bay (France), a coastal lagoon of the French Atlantic and hotspot of oyster farming, abundances of A. senhousia recently increased, following a lag time of ca. 20 years since the first record of the species in 2002. Here, we addressed the potential effects of the interaction between A. senhousia invasion and heatwave intensity on ecosystem functioning within an intertidal mudflat. More precisely, two realistic intensities (“High” and “Severe”) of combined marine and atmospheric heatwaves have been simulated in an experimental tidal mesocosm system onto which naturally varying densities of A. senhousia and associated benthic communities were exposed in sediment cores collected in situ. Following a six-day exposure, community-scale responses were assessed by measuring benthic metabolism (oxygen and nutrient fluxes) in each core. Results show that besides significantly enhanced benthic metabolism with increasing heatwave intensity, mussel density clearly mediated the magnitude of the community-scale response, thereby highlighting the importance of understanding the interactive effects of environmental stressors co-occurring with non-indigenous species and their dependencies for a better assessment of their impacts.

Keywords: arcuatula senhousia, benthic habitat, ecosystem functioning, heatwaves, metabolism

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Authors: Desmond Okorie, Emmanuel Prince

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Availability of portable water has been a global challenge especially to the developing continents/nations such as Africa/Nigeria. The World Health Organization WHO has produced the guideline for drinking water quality GDWQ which aims at ensuring water safety from source to consumer. Portable water parameters test include physical (colour, odour, temperature, turbidity), chemical (PH, dissolved solids) biological (algae, plytoplankton). This paper discusses the use of wireless sensor networks to monitor water quality using efficient and effective sensors that have the ability to sense, process and transmit sensed data. The integration of wireless sensor network to a portable sensing device offers the feasibility of sensing distribution capability, on site data measurements and remote sensing abilities. The current water quality tests that are performed in government water quality institutions in Benue State Nigeria are carried out in problematic locations that require taking manual water samples to the institution laboratory for examination, to automate the entire process based on wireless sensor network, a system was designed. The system consists of sensor node containing one PH sensor, one temperature sensor, a microcontroller, a zigbee radio and a base station composed by a zigbee radio and a PC. Due to the advancement of wireless sensor network technology, unexpected contamination events in water environments can be observed continuously. local area network (LAN) wireless local area network (WLAN) and internet web-based also commonly used as a gateway unit for data communication via local base computer using standard global system for mobile communication (GSM). The improvement made on this development show a water quality monitoring system and prospect for more robust and reliable system in the future.

Keywords: local area network, Ph measurement, wireless sensor network, zigbee

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Authors: B. Laurita

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The importance of Water Harvesting (WH) as an effective mean to deal with water scarcity is universally recognized. The collection and storage of rainwater, floodwater or quick runoff and their conversion to productive uses can ensure water availability for domestic and agricultural use, enabling a lower exploitation of the aquifer, preventing erosion events and providing significant ecosystem services. At the same time, it has been proven that it can reduce the insurgence of water conflicts if supported by a cooperative process of planning and management. On the other hand, the construction of water harvesting structures changes the hydrological regime, affecting upstream-downstream dynamics and changing water allocation, often causing contentions. Furthermore, dynamics existing between water harvesting and water conflict are not properly investigated yet. Thus, objective of this study is to analyze the relations between water harvesting and the insurgence of water conflicts, providing a solid theoretical basis and foundations for future studies. Two search engines were selected in order to perform the study: Google Scholar and Scopus. Separate researches were conducted on the mutual influences between water conflicts and the four main water harvesting techniques: rooftop harvesting, surface harvesting, underground harvesting, runoff harvesting. Some of the aforementioned water harvesting techniques have been developed and implemented on scales ranging from the small, household-sided ones, to gargantuan dam systems. Instead of focusing on the collisions related to large-scale systems, this review is aimed to look for and collect examples of the effects that the implementation of small water harvesting systems has had on the access to the water resource and on water governance. The present research allowed to highlight that in the studies that have been conducted up to now, water harvesting, and in particular those structures that allow the collection and storage of water for domestic use, is usually recognized as a positive, palliative element during contentions. On the other hand, water harvesting can worsen and, in some cases, even generate conflicts for water management. This shows the necessity of studies that consider both benefits and negative influences of water harvesting, analyzing its role respectively as triggering or as mitigating factor of conflicting situations.

Keywords: arid areas, governance, water conflicts, water harvesting

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Authors: Anand Malik

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The Himalayas with high tectonic activities poses a great threat to human life and property. Climate change is another reason which triggering extreme events multiple fold effect on high mountain glacial environment, rock falls, landslides, debris flows, flash flood and snow avalanches. One such extreme event of cloud burst along with breach of moraine dammed Chorabri Lake occurred from June 14 to June 17, 2013, triggered flooding of Saraswati and Mandakini rivers in the Kedarnath Valley of Rudraprayag district of Uttrakhand state of India. As a result, huge volume of water with its high velocity created a catastrophe of the century, which resulted into loss of large number of human/animals, pilgrimage, tourism, agriculture and property. Thus a comprehensive assessment of debris flow hazards requires GIS-based modeling using numerical methods. The aim of present study is to focus on analysis and mapping of debris flow movements using geospatial data with flow-r (developed by team at IGAR, University of Lausanne). The model is based on combined probabilistic and energetic algorithms for the assessment of spreading of flow with maximum run out distances. Aster Digital Elevation Model (DEM) with 30m x 30m cell size (resolution) is used as main geospatial data for preparing the run out assessment, while Landsat data is used to analyze land use land cover change in the study area. The results of the study area show that model can be applied with great accuracy as the model is very useful in determining debris flow areas. The results are compared with existing available landslides/debris flow maps. ArcGIS software is used in preparing run out susceptibility maps which can be used in debris flow mitigation and future land use planning.

Keywords: debris flow, geospatial data, GIS based modeling, flow-R

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ila Chauhan, Ruchi Joshi, Binoy Bhargavan

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Reliability and safety are essential for the success of mission-critical and safety-critical defense systems. Humans are part of the entire life cycle of defense systems development and deployment. The majority of industrial accidents or disasters are attributed to human errors. Therefore, considerations of human performance and human reliability are critical in all complex systems, including defense systems. Defense systems are operating from the ground, naval and aerial platforms in diverse conditions impose unique physical and psychological challenges to the human operators. Some of the safety and mission-critical defense systems with human-machine interactions are fighter planes, submarines, warships, combat vehicles, aerial and naval platforms based missiles, etc. Human roles and responsibilities are also going through a transition due to the infusion of artificial intelligence and cyber technologies. Human operators, not accustomed to such challenges, are more likely to commit errors, which may lead to accidents or loss events. In such a scenario, it is imperative to understand the human factors in defense systems for better systems performance, safety, and cost-effectiveness. A case study using Task Analysis (TA) based methodology for assessment and reduction of human errors in the Air and Missile Defense System in the context of emerging technologies were presented. Action-oriented task analysis techniques such as Hierarchical Task Analysis (HTA) and Operator Action Event Tree (OAET) along with Critical Action and Decision Event Tree (CADET) for cognitive task analysis was used. Human factors assessment based on the task analysis helps in realizing safe and reliable defense systems. These techniques helped in the identification of human errors during different phases of Air and Missile Defence operations, leading to meet the requirement of a safe, reliable and cost-effective mission.

Keywords: defence systems, reliability, risk, safety

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Authors: Gabriella Notarianni Burk

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The present study investigates the Aspect Hypothesis (AH) in Italian child language in the production of frog story narratives from the CHILDES database. The AH is based on the assumption that children initially encode aspectual and lexical distinctions rather than temporal relations. Children from a variety of first languages have been shown to mark past initially with achievements and accomplishments (telic predicates) and in later stages with states and activities (atelic predicates). Aspectual distinctions in Romance languages are obligatorily and overtly encoded in the inflectional morphology. In Italian the perfective viewpoint is realized by the passato prossimo, which expresses a temporal and aspectual meaning of pastness and perfectivity, whereas the imperfective viewpoint in the past tense is realized by the imperfetto. The aim of this study is to assess the role of lexical aspect in the acquisition of tense and aspect morphology and to understand if Italian children’s mapping of aspectual and temporal distinctions follows consistent developmental patterns across languages. The research methodology aligns with the cross-linguistic designs, tasks and coding procedures previously developed in the frog story literature. Results from two-factor ANOVA show that Italian children (age range: 4-6) exhibited a statistically significant distinction between foregrounded perfective and backgrounded imperfective marking. However, a closer examination of the sixty narratives reveals an idiosyncratic production pattern for Italian children, whereby the marking of imperfetto deviates from the tenets of AH and emerges as deictic tense to entail completed and bounded events in foreground clauses. Instances of ‘perfective’ uses of imperfetto were predominantly found in the four-year old narratives (25%). Furthermore, the analysis of the perfective marking suggests that morphological articulation and diatopic variation may influence the child production of formal linguistic devices in discourse.

Keywords: actionality, aspect, grounding, temporal reference

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Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

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Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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Authors: In Kyong Yi, Yun Jeong Chae, Jihoon Hwang, Sook-Young Lee, Jong-Yeop Kim

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Background: Pentax airway scope (AWS) is a recently developed video laryngoscope for use in both normal and difficult airways, providing a good laryngeal view. The purpose of this randomized noninferior study was to evaluate the efficacy of the Pentax-AWS regarding intubation time, laryngeal view and ease of intubation in pediatric patients with normal airway, compared to Macintosh laryngoscope. Method: A total of 136 pediatric patients aged 1 to 10 with American Society of Anesthesiologists physical status I or II undergoing general anesthesia required orotracheal intubation were randomly allocated into two groups: Macintosh laryngoscope (n =68) and Pentax AWS (n=68). Anesthesia was induced with propofol, rocuronium, and sevoflurane. The primary outcome was intubation time. Cormack-Lehane laryngeal view grade, application of optimal laryngeal external manipulation (OELM), intubation difficulty scale (IDS), intubation failure rate and adverse events were also measured. Result: No significant difference was observed between the two groups regarding intubation time (Macintosh; 23[22-26] sec vs. Pentax; 23.5[22-27.75] sec, p=0.713). As for the laryngeal view grade, the Pentax group showed less number of grade 2a or higher grade cases compared to the Macintosh group (1/2a/2b/3; 52.9%/41.2%/4.4%/1.5% vs. 98.5%/1.5%/0%/0%, p=0.000). No optimal laryngeal external manipulation application was required in the Pentax group (38.2% vs. 0%, p=0.000). Intubation difficulty scale resulted in lower values for Pentax group (0 [0-2] vs. 0 [0-0.55], p=0.001). Failure rate was not different between the two groups (1.5% vs. 4.4%, p=0.619). Adverse event-wise, slightly higher incidence of bleeding (1.5% vs. 5.9%, p=0.172) and teeth injury (0% vs. 5.9%, p=0.042) occurred in the Pentax group. Conclusion: In conclusion, Pentax-AWS provided better laryngeal view, similar intubation time and similar success rate compared with Macintosh laryngoscope in children with normal airway. However, the risk of teeth injury might increase and warrant special attention.

Keywords: Pentax-AWS, pediatric, video laryngoscope, intubation

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Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

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The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

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Authors: McKenna Halverson, Allison Karpyn

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Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.

Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC

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Authors: Anna Lierova, Jitka Kasparova, Marcela Jelicova, Lucie Korecka, Zuzana Bilkova, Zuzana Sinkorova

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Hyaluronic acid (HA) is a simple linear, unbranched polysaccharide with a lot of exceptional physiological and chemical properties such as high biocompatibility and biodegradability, strong hydration and viscoelasticity that depend on the size of the molecule. It plays the important role in a variety of molecular events as tissue hydration, mechanical protection of tissues and as well as during inflammation, leukocyte migration, and extracellular matrix remodeling. Also, HA-based biomaterials, including HA scaffolds, hydrogels, thin membranes, matrix grafts or nanoparticles are widely use in various biomedical applications. Our goal is to determine the radioprotective effect of hyaluronic acid nanoparticles (HA NPs). We are investigating effect of ionizing radiation on stability of HA NPs, in vitro relative toxicity of nanoscale as well as effect on cell lines and specific surface receptors and their response to ionizing radiation. An exposure to ionizing radiation (IR) can irreversibly damage various cell types and may thus have implications for the level of the whole tissue. Characteristic manifestations are formation of over-granulated tissue, remodeling of extracellular matrix (ECM) and abortive wound healing. Damages are caused by either direct interaction with DNA and IR proteins or indirectly by radicals formed during radiolysis of water Accumulation and turnover of ECM are a hallmark of radiation induces lung injury, characterized by inflammation, repair or remodeling health pulmonary tissue. HA is a major component of ECM in lung and plays an important role in regulating tissue injury, accelerating tissue repair, and controlling disease outcomes. Due to that, HA NPs were applied to in vivo model (C57Bl/6J mice) before total body or partial thorax irradiation. This part of our research is targeting on effect of exogenous HA on the development and/or mitigating acute radiation syndrome and radiation induced lung injuries.

Keywords: hyaluronic acid, ionizing radiation, nanoparticles, radiation induces lung damages

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Authors: Norbert W. Paul

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Since a number of years, scientific interest in human resilience is rapidly increasing especially in psychology and more recently and highly visible in neurobiological research. Concepts of resilience are regularly discussed in the light of liminal experiences and existential challenges in human life. Resilience research is providing both, explanatory models and strategies to promote or foster human resilience. Surprisingly, these approaches attracted little attention so far in philosophy in general and in ethics in particular. This is even more astonishing given the fact that the neurosciences as such have been and still are of major interest to philosophy and ethics and even brought about the specialized field of neuroethics, which, however, is not concerned with concepts of resilience, so far. As a result of the little attention given to the topic of resilience, the whole concept has to date been a philosophically under-theorized. This abstinence of ethics and philosophy in resilience research is lamentable because resilience as a concept as well as resilience interventions based on neurobiological findings do undoubtedly pose philosophical, social and ethical questions. In this paper, we will argue that particular notions of resilience are crossing the sometimes fine line between maintaining a person’s mental health despite the impact of severe psychological or physical adverse events and ethically more debatable discourses of enhancement. While we neither argue for or against enhancement nor re-interpret resilience research and interventions by subsuming them strategies of psychological and/or neuro-enhancement, we encourage those who see social or ethical problems with enhancement technologies should also take a closer look on resilience and the related neurobiological concepts. We will proceed in three steps. In our first step, we will describe the concept of resilience in general and its neurobiological study in particular. Here, we will point out some important differences in the way ‘resilience’ is conceptualized and how neurobiological research understands resilience. In what follows we will try to show that a one-sided concept of resilience – as it is often presented in neurobiological research on resilience – does pose social and ethical problems. Secondly, we will identify and explore the social and ethical challenges of (neurobiological) enhancement. In the last and final step of this paper, we will argue that a one-sided reading of resilience can be understood as latent form of enhancement in transition and poses ethical questions similar to those discussed in relation to other approaches to the biomedical enhancement of humans.

Keywords: resilience, neurosciences, epistemology, bioethics

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Authors: Francesca Nicolosi, Teresa Cosola

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Climate changes in Mediterranean areas, such as the increase of average seasonal temperatures, the urban heat island phenomenon, the intensification of solar radiation and the extreme weather threats, cause disruption events, so that climate adaptation has become a pressing issue. Due to the strategic role that the built heritage holds in terms of environmental impact and energy waste and its potentiality, it is necessary to assess the vulnerability and the adaptive capacity of the existing building to climate change, in order to define different mitigation scenarios. The aim of this research work is to define an optimized and integrated methodology for the assessment of resilience levels and adaptation scenarios for existing buildings in Mediterranean urban areas. Moreover, the study of resilience indicators allows us to define building environmental and energy performance in order to identify the design and technological solutions for the improvement of the building and its urban area potentialities. The methodology identifies step-by-step different phases, starting from the detailed study of characteristic elements of urban system: climatic, natural, human, typological and functional components are analyzed in their critical factors and their potential. Through the individuation of the main perturbing factors and the vulnerability degree of the system to the risks linked to climate change, it is possible to define mitigation and adaptation scenarios. They can be different, according to the typological, functional and constructive features of the analyzed system, divided into categories of intervention, and characterized by different analysis levels (from the single building to the urban area). The use of software simulations allows obtaining information on the overall behavior of the building and the urban system, to generate predictive models in the medium and long-term environmental and energy retrofit and to make a comparative study of the mitigation scenarios identified. The studied methodology is validated on a case study.

Keywords: climate impact mitigation, energy efficiency, existing building heritage, resilience

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Authors: Chulpan Gromova, Rezeda Khairutdinova, Dina Birman

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One of the most significant issues that schools all over the world face today is the ways teachers respond to increasing diversity. The study was informed by the tripartite model of multicultural competence, with awareness of personal biases a necessary component, together with knowledge of different cultures, and skills to work with students from diverse backgrounds. The paper presents the results of qualitative descriptive studies that help to understand how school teachers in Russia treat migrant children, how they solve the problems of adaptation of migrant children. The purpose of this study was to determine: a) educational practices used by primary school teachers when working with migrant children; b) relationship between practices and attitudes of teachers. Empirical data were collected through interviews. The participants were informed that a conversation was being recorded. They were also warned that the study was voluntary, absolutely anonymous, no personal data was disclosed. Consent was received from 20 teachers. The findings were analyzed using directive content analysis (Graneheim and Lundman, 2004). The analysis was deductive according to the categories of practices and attitudes identified in the literature review and enriched inductively to identify variation within these categories. Studying practices is an essential part of preparing future teachers for working in a multicultural classroom. For language and academic support, teachers mostly use individual work. In order to create a friendly classroom climate and environment teachers have productive conversations with students, organize multicultural events for the whole school or just for an individual class. The majority of teachers have positive attitudes toward migrant children. In most cases, positive attitudes lead to high expectations for their academic achievements. Conceptual orientation of teacher attitudes toward cultural diversity is mostly pluralistic. Positive attitudes, high academic expectations and conceptual orientation toward pluralism are favorably reflected in teachers’ practice.

Keywords: intercultural education, migrant children schooling, teachers attitudes, teaching practices

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Authors: Natarajan Tirupattur Srinivasan

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Quantum mechanics( QM) and (special) relativity (SR) have indeed revolutionized the very thinking of physicists, and the spectacular successes achieved over a century due to these two theories are mind-boggling. However, there is still a strong disquiet among some physicists. While the mathematical structure of these two theories has been established beyond any doubt, their physical interpretations are still being contested by many. Even after a hundred years of their existence, we cannot answer a very simple question, “What is an electron”? Physicists are struggling even now to come to grips with the different interpretations of quantum mechanics with all their ramifications. However, it is indeed strange that the (special) relativity theory of Einstein enjoys many orders of magnitude of “acceptance”, though both theories have their own stocks of weirdness in the results, like time dilation, mass increase with velocity, the collapse of the wave function, quantum jump, tunnelling, etc. Here, in this paper, it would be shown that by postulating an intrinsic internal motion to these enigmatic electrons, one can build a fairly consistent picture of reality, revealing a very simple picture of nature. This is also evidenced by Schrodinger’s ‘Zitterbewegung’ motion, about which so much has been written. This leads to a helical trajectory of electrons when they move in a laboratory frame. It will be shown that the helix is a three-dimensional wave having all the characteristics of our familiar 2D wave. Again, the helix, being a geodesic on an imaginary cylinder, supports ‘quantization’, and its representation is just the complex exponentials matching with the wave function of quantum mechanics. By postulating the instantaneous velocity of the electrons to be always ‘c’, the velocity of light, the entire relativity comes alive, and we can interpret the ‘time dilation’, ‘mass increase with velocity’, etc., in a very simple way. Thus, this model unifies both QM and SR without the need for a counterintuitive postulate of Einstein about the constancy of the velocity of light for all inertial observers. After all, if the motion of an inertial frame cannot affect the velocity of light, the converse that this constant also cannot affect the events in the frame must be true. But entire relativity is about how ‘c’ affects time, length, mass, etc., in different frames.

Keywords: quantum reconstruction, special theory of relativity, quantum mechanics, zitterbewegung, complex wave function, helix, geodesic, Schrodinger’s wave equations

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Authors: Shyamli Singh, Ishupinder Kaur, Vinod K. Sharma

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Climate Change refers to the change in climate for extended period of time. Climate is changing from the past history of earth but anthropogenic activities accelerate this rate of change and which is now being a global issue. Increase in greenhouse gas emissions is causing global warming and climate change related issues at an alarming rate. Increasing temperature results in climate variability across the globe. Changes in rainfall patterns, intensity and extreme events are some of the impacts of climate change. Rainfall variability refers to the degree to which rainfall patterns varies over a region (spatial) or through time period (temporal). Temporal rainfall variability can be directly or indirectly linked to climate change. Such variability in rainfall increases the vulnerability of communities towards climate change. Increasing urbanization and unplanned developmental activities, the air quality is deteriorating. This paper mainly focuses on the rainfall variability due to increasing level of greenhouse gases. Rainfall data of 65 years (1951-2015) of Safdarjung station of Delhi was collected from Indian Meteorological Department and analyzed using Mann-Kendall test for time-series data analysis. Mann-Kendall test is a statistical tool helps in analysis of trend in the given data sets. The slope of the trend can be measured through Sen’s slope estimator. Data was analyzed monthly, seasonally and yearly across the period of 65 years. The monthly rainfall data for the said period do not follow any increasing or decreasing trend. Monsoon season shows no increasing trend but here was an increasing trend in the pre-monsoon season. Hence, the actual rainfall differs from the normal trend of the rainfall. Through this analysis, it can be projected that there will be an increase in pre-monsoon rainfall than the actual monsoon season. Pre-monsoon rainfall causes cooling effect and results in drier monsoon season. This will increase the vulnerability of communities towards climate change and also effect related developmental activities.

Keywords: greenhouse gases, Mann-Kendall test, rainfall variability, Sen's slope

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Authors: Tong Mei Yan

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Introduction: The experience of infertility could be excruciating but has not received much attention in Hong Kong. The strong Confucian culture pressures couples to continue their family lineage resulting in women facing more stress than men in the social-cultural milieu. In Vitro Fertilization (IVF) treatment is one of the common ways to deal with the problem. Abundant literature exists the psychological trajectories of people receiving IVF treatment in Europe, the USA and other east Asian societies but not in Hong Kong. Aim: This study aims to highlight the circumstances and needs of the women before, during and after IVF treatment through examining their lived experiences. It is hoped that the public, once informed of regarding their tribulations and needs , would support the adequate provision of the required psychological support . Methods: Qualitative analysis was adopted in this study. In-depth interviews were conducted with six women who have undergone at least one complete cycle of IVF treatment within the past five years. Data was analyzed through thematic analysis and narrative analysis. Results: 4 broad themes were found, including (i) emotional responses; (ii) experiences in medical consultation; (iii) impacts of the treatment; and (iv) their coping strategies. Additionally, specific events in three cases were chosen for narrative analysis to further examine their unresolved emotional distress and the ethical issues. Conclusion: IVF treatment distressed the interviewees immensely, both physically and psychologically, with the negative emotions outweighing their physical strains, a result unexpected by all of the interviewees. The pressure for lineage continuation, the demanding treatment process and the dearth of support from health professionals all contribute to their emotional pain which could linger for both successful and unsuccessful cases. Although a number of coping strategies were attempted, most of them completely failed to ease their psychological tension. The findings of this study therefore evidence the need for psychological support for this population. A service model to cater their needs of IVF treatment before, during and after treatment is therefore proposed.

Keywords: coping strategies, emotional experiences, impacts of IVF, infertility, IVF treatment, medical experiences

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Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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Authors: Angela Odero, Chrysoula Karathanasi, Michèle Baumann

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Integration of foreign communities has been a forefront issue in Luxembourg for some time now. The country’s continued progress depends largely on the successful integration of immigrants. The aim of our study was to analyze factors which intervene in the course of integration of Non-EU citizens through the discourse of Non-EU citizens residing in Luxembourg, who have signed the Welcome and Integration Contract (CAI). The two-year contract offers integration services to assist foreigners in getting settled in the country. Semi-structured focus group discussions with 50 volunteers were held in English, French, Spanish, Serbo-Croatian or Chinese. Participants were asked to talk about their integration experiences. Recorded then transcribed, the transcriptions were analyzed with the help of NVivo 10, a qualitative analysis software. A systematic and reiterative analysis of decomposing and reconstituting was realized through (1) the identification of predetermined categories (difficulties, challenges and integration needs) (2) initial coding – the grouping together of similar ideas (3) axial coding – the regrouping of items from the initial coding in new ways in order to create sub-categories and identify other core dimensions. Our results show that intervening factors include language acquisition, professional career and socio-cultural activities or events. Each of these factors constitutes different components whose weight shifts from person to person and from situation to situation. Connecting these three emergent factors are two elements essential to the success of the immigrant’s integration – the role of time and deliberate effort from the immigrants, the community, and the formal institutions charged with helping immigrants integrate. We propose a theoretical model where the factors described may be classified in terms of how they predispose, facilitate, and / or reinforce the process towards a successful integration. Measures currently in place propose one size fits all programs yet integrative measures which target the family unit and those customized to target groups based on their needs would work best.

Keywords: integration, integration services, non-eu citizens, qualitative analysis, third country nationals

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Authors: Marzieh Khedmati, Shannon L. Bartelt-Hunt

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Vegetative Filter Strips (VFS) are used for controlling the volume of runoff and decreasing contaminant concentrations in runoff before entering water bodies. Many studies have investigated the role of VFS in sediment and nutrient removal, but little is known about their efficiency for the removal of emerging contaminants such as antimicrobial resistance genes (ARGs). Vegetative Filter Strip Modeling System (VFSMOD) was used to simulate the efficiency of VFS in this regard. Several studies demonstrated the ability of VFSMOD to predict reductions in runoff volume and sediment concentration moving through the filters. The objectives of this study were to calibrate the VFSMOD with experimental data and assess the efficiency of the model in simulating the filter behavior in removing ARGs (ermB) and tylosin. The experimental data were obtained from a prior study conducted at the University of Nebraska (UNL) Rogers Memorial Farm. Three treatment factors were tested in the experiments, including manure amendment, narrow grass hedges and rainfall events. Sediment Delivery Ratio (SDR) was defined as the filter efficiency and the related experimental and model values were compared to each other. The VFS Model generally agreed with the experimental results and as a result, the model was used for predicting filter efficiencies when the runoff data are not available. Narrow Grass Hedges (NGH) were shown to be effective in reducing tylosin and ARGs concentration. The simulation showed that the filter efficiency in removing ARGs is different for different soil types and filter lengths. There is an optimum length for the filter strip that produces minimum runoff volume. Based on the model results increasing the length of the filter by 1-meter leads to higher efficiency but widening beyond that decreases the efficiency. The VFSMOD, which was proved to work well in estimation of VFS trapping efficiency, showed confirming results for ARG removal.

Keywords: antimicrobial resistance genes, emerging contaminants, narrow grass hedges, vegetative filter strips, vegetative filter strip modeling system

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Authors: Mohd Asharf Ganie, Aafia Rashid, Mohd Afzal Zargar, Showkat Ali Zargar, Syed Mudasar, Tabasum Parvaiz, Zafar Amin Shah

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Accumulating evidence suggests that Vitamin D deficiency (VDD) might at least contribute to the metabolic co-morbidities in PCOS. Hence, we aimed to study the effect of vitamin D supplementation in co-prescription with insulin sensitizers like metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. In this open label randomized, controlled trial a total of 120 women with PCOS diagnosis (AE-PCOS 2009 Criteria) were assigned to four treatment groups (n= 30 in each): group I (metformin 1 gm/day in combination with cholecalciferol 4000 IU/day), group II (pioglitazone 30 mg/day in combination with cholecalciferol 4000 IU/day), group III (metformin 1 gm /day) and group IV (pioglitazone 30 mg/day). Vitamin D supplementation was given as 60,000 units every two weeks for 24 weeks. All the subjects were routinely evaluated for clinical, biochemical, hormonal and insulin sensitivity parameters in addition to various safety parameters especially serum calcium levels at baseline and after 24 weeks of the treatment. Our results indicate that 95.5% of PCOS women were vitamin D deficient at baseline. Serum 25 (OH) D levels increased significantly (p < 0.001) in groups I and II without any adverse effects after 24 weeks of oral administration of 4000 IU cholecalciferol daily. However, serum 25 (OH) D levels remained unchanged in group III and IV. By six months, number of menstrual cycles per year increased whereas Ferriman-Gallwey score, serum total testosterone and HOMA-IR decreased significantly (P < 0.001) in the treatment groups supplemented with cholecalciferol as compared to those treated either drug alone. No significant beneficial changes were observed on weight, BMI, blood pressure, glucose tolerance and serum lipids in any of the groups supplemented with cholecalciferol. We conclude that daily dose of 4000 IU cholecalciferol might be a useful adjunct in complex treatment of PCOS with fewer adverse events. Furthermore, pioglitazone and cholecalciferol combination seems to be marginally better although there was no statistical significance.

Keywords: PCOS, vitamin D supplementation, insulin resistance, spironolactone, metformin, pioglitazone

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Authors: Pranay Mathur, Carlo Michelassi, Simi Karatha, Gilda Pedoto

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Industrial plant uptime is top most importance for reliable, profitable & sustainable operation. Trip and failed start has major impact on plant reliability and all plant operators focussed on efforts required to minimise the trips & failed starts. The performance of these CTQs are measured with 2 metrics, MTBT(Mean time between trips) and SR (Starting reliability). These metrics helps to identify top failure modes and identify units need more effort to improve plant reliability. Baker Hughes Trip reduction program structured to reduce these unwanted trip 1. Real time machine operational parameters remotely available and capturing the signature of malfunction including related boundary condition. 2. Real time alerting system based on analytics available remotely. 3. Remote access to trip logs and alarms from control system to identify the cause of events. 4. Continuous support to field engineers by remotely connecting with subject matter expert. 5. Live tracking of key CTQs 6. Benchmark against fleet 7. Break down to the cause of failure to component level 8. Investigate top contributor, identify design and operational root cause 9. Implement corrective and preventive action 10. Assessing effectiveness of implemented solution using reliability growth models. 11. Develop analytics for predictive maintenance With this approach , Baker Hughes team is able to support customer in achieving their Reliability Key performance Indicators for monitored units, huge cost savings for plant operators. This Presentation explains these approach while providing successful case studies, in particular where 12nos. of LNG and Pipeline operators with about 140 gas compressing line-ups has adopted these techniques and significantly reduce the number of trips and improved MTBT

Keywords: reliability, availability, sustainability, digital infrastructure, weibull, effectiveness, automation, trips, fail start

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