Search results for: health Information
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18005

Search results for: health Information

1025 The Relationship between the Skill Mix Model and Patient Mortality: A Systematic Review

Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

Abstract:

Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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1024 Timely Palliative Screening and Interventions in Oncology

Authors: Jaci Marie Mastrandrea, Rosario Haro

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening and intervention is directly associated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project was to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated, evidence-based PC referral criteria. The tool was initially implemented using paper forms, and data was collected over a period of eight weeks. Patients were screened by nurses on the SLCTC oncology treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher received an educational handout on the topic of PC and education about PC and symptom management. A score of five or higher indicates that PC referral is strongly recommended, and the patient’s EHR is flagged for the oncology provider to review orders for PC referral. The PSNA tool was approved by Sky Lakes administration for full integration into Epic-Beacon. The project lead collaborated with the Sky Lakes’ information systems team and representatives from Epic on the tool’s aesthetic and functionality within the Epic system. SLCTC nurses and physicians were educated on how to document the PSNA within Epic and where to view results. Results: Prior to the implementation of the PSNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the completed screening assessments of 100 patients under active treatment at the SLCTC. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting criteria were flagged in EPIC for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met the criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative and supportive care, symptom management, outpatient oncology, palliative screening tool

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1023 Furnishing Ancillary Alternatives for High Speed Corridors and Pedestrian Crossing: Elevated Cycle Track, an Expedient to Urban Space Prototype in New Delhi

Authors: Suneet Jagdev, Hrishabh Amrodia, Siddharth Menon, Abhishek Singh, Mansi Shivhare

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Delhi, the National Capital, has undergone a surge in development rate, consequently engendering an unprecedented increase in population. Over the years the city has transformed into a car-centric infrastructure with high-speed corridors, flyovers and fast lanes. A considerable section of the population is hankering to rehabilitate to the good old cycling days, in order to contribute towards a green environment as well as to maintain their physical well-being. Furthermore, an extant section of Delhi’s population relies on cycles as their primary means of commuting in the city. Delhi has the highest number of cyclists and second highest number of pedestrians in the country. However, the tumultuous problems of unregulated traffic, inadequate space on roads, adverse weather conditions stifle them to opt for cycling. Lately, the city has been facing a conglomeration of problems such as haphazard traffic movement, clogged roads, congestion, pollution, accidents, safety issues, etc. In 1957, Delhi’s cyclists accounted for 36 per cent of trips which dropped down to a mere 4 per cent in 2008. The declining rate is due to unsafe roads and lack of proper cycle lanes. Now as the 10 percent of the city has cycle tracks. There is also a lack of public recreational activities in the city. These conundrums incite the need of a covered elevated cycling bridge track to facilitate the safe and smooth cycle commutation in the city which would also serve the purpose of an alternate urban public space over the cycle bridge reducing the cost as well as the space requirement for the same, developing a user–friendly transportation and public interaction system for urban areas in the city. Based on the archival research methodologies, the following research draws information and extracts records from the data accounts of the Delhi Metro Rail Corporation Ltd. as well as the Centre for Science and Environment, India. This research will predominantly focus on developing a prototype design for high speed elevated bicycle lanes based on different road typologies, which can be replicated with minor variations in similar situations, all across the major cities of our country including the proposed smart cities. Furthermore, how these cycling lanes could be utilized for the place making process accommodating cycle parking and renting spaces, public recreational spaces, food courts as well as convenient shopping facilities with appropriate optimization. How to preserve and increase the share of smooth and safe cycling commute cycling for the routine transportation of the urban community of the polluted capital which has been on a steady decline over the past few decades.

Keywords: bicycle track, prototype, road safety, urban spaces

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1022 Social Factors and Suicide Risk in Modern Russia

Authors: Maria Cherepanova, Svetlana Maximova

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Background And Aims: Suicide is among ten most common causes of death of the working-age population in the world. According to the WHO forecasts, by 2025 suicide will be the third leading cause of death, after cardiovascular diseases and cancer. In 2019, the global suicide rate in the world was 10,5 per 100,000 people. In Russia, the average figure was 11.6. However, in some depressed regions of Russia, such as Buryatia and Altai, it reaches 35.3. The aim of this study was to develop models based on the regional factors of social well-being deprivation that provoke the suicidal risk of various age groups of Russian population. We also investigated suicidal risk prevention in modern Russia, analyzed its efficacy, and developed recommendations for suicidal risk prevention improvement. Methods: In this study, we analyzed the data from sociological surveys from six regions of Russia. Totally we interviewed 4200 people, the age of the respondents was from 16 to 70 years. The results were subjected to factorial and regression analyzes. Results: The results of our study indicate that young people are especially socially vulnerable, which result in ineffective patterns of self-preservation behavior and increase the risk of suicide. That is due to lack of anti-suicidal barriers formation; low importance of vital values; the difficulty or impossibility to achieve basic needs; low satisfaction with family and professional life; and decrease in personal unconditional significance. The suicidal risk of the middle-aged population is due to a decrease in social well-being in the main aspects of life, which determines low satisfaction, decrease in ontological security, and the prevalence of auto-aggressive deviations. The suicidal risk of the elderly population is due to increased factors of social exclusion which result in narrowing the social space and limiting the richness of life. Conclusions: The existing system for lowering suicide risk in modern Russia is predominantly oriented to a medical treatment, which provides only intervention to people who already committed suicide, that significantly limits its preventive effectiveness and social control of this deviation. The national strategy for suicide risk reduction in modern Russian society should combine medical and social activities, designed to minimize possible situations resulting to suicide. The strategy for elimination of suicidal risk should include a systematic and significant improvement of the social well-being of the population and aim at overcoming the basic aspects of social disadvantages such as poverty, unemployment as well as implementing innovative mental health improvement, developing life-saving behavior that will help to counter suicides in Russia.

Keywords: social factors, suicide, prevention, Russia

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1021 Mapping the State of the Art of European Companies Doing Social Business at the Base of the Economic Pyramid as an Advanced Form of Strategic Corporate Social Responsibility

Authors: Claudio Di Benedetto, Irene Bengo

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The objective of the paper is to study how large European companies develop social business (SB) at the base of the economic pyramid (BoP). BoP markets are defined as the four billions people living with an annual income below $3,260 in local purchasing power. Despite they are heterogeneous in terms of geographic range they present some common characteristics: the presence of significant unmet (social) needs, high level of informal economy and the so-called ‘poverty penalty’. As a result, most people living at BoP are excluded from the value created by the global market economy. But it is worth noting, that BoP population with an aggregate purchasing power of around $5 trillion a year, represent a huge opportunity for companies that want to enhance their long-term profitability perspective. We suggest that in this context, the development of SB is, for companies, an innovative and promising way to satisfy unmet social needs and to experience new forms of value creation. Indeed, SB can be considered a strategic model to develop CSR programs that fully integrate the social dimension into the business to create economic and social value simultaneously. Despite in literature many studies have been conducted on social business, only few have explicitly analyzed such phenomenon from a company perspective and their role in the development of such initiatives remains understudied with fragmented results. To fill this gap the paper analyzes the key characteristics of the social business initiatives developed by European companies at BoP. The study was performed analyzing 1475 European companies participating in the United Nation Global Compact, the world’s leading corporate social responsibility program. Through the analysis of the corporate websites the study identifies companies that actually do SB at BoP. For SB initiatives identified, information were collected according to a framework adapted from the SB model developed by preliminary results show that more than one hundred European companies have already implemented social businesses at BoP accounting for the 6,5% of the total. This percentage increases to 15% if the focus is on companies with more than 10.440 employees. In terms of geographic distribution 80% of companies doing SB at BoP are located in western and southern Europe. The companies more active in promoting SB belong to financial sector (20%), energy sector (17%) and food and beverage sector (12%). In terms of social needs addressed almost 30% of the companies develop SB to provide access to energy and WASH, 25% of companies develop SB to reduce local unemployment or to promote local entrepreneurship and 21% of companies develop SB to promote financial inclusion of poor. In developing SB companies implement different social business configurations ranging from forms of outsourcing to internal development models. The study identifies seven main configurations through which company develops social business and each configuration present distinguishing characteristics respect to the involvement of the company in the management, the resources provided and the benefits achieved. By performing different analysis on data collected the paper provides detailed insights on how European companies develop SB at BoP.

Keywords: base of the economic pyramid, corporate social responsibility, social business, social enterprise

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1020 The Positive Effects of Top-Sharing: A Case Study

Authors: Maike Andresen, Georg Dochtmann

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Due to political, social, and societal changes in labor organization, top-sharing, defined as job-sharing in leading positions, becomes more important in HRM. German companies are looking for practical and economically meaningful solutions that allow to enduringly increase women’s ratio in management, not only because of a recently implemented quota. Furthermore, supporting employees in achieving work-life balance is perceived as an important goal for a sustainable HRM to gain competitive advantage. Top-sharing is seen as being suitable to reach both goals. To evaluate determinants leading to effective top-sharing, a case study of a newly implemented top-sharing tandem in a large German enterprise was conducted over a period of 15 months. In this company, a full leadership position was split into two 60%-part-time positions held by an experienced female leader in her late career and a female college who took over her first leadership position (mid-career). We assumed a person-person fit in terms of a match of the top sharing partners’ personality profiles (Big Five) and their leadership motivations to be important prerequisites for an effective collaboration between them. We evaluated the person-person fit variables once before the tandem started to work. Both leaders were expected to learn from each other (mentoring, competency development). On an operational level, they were supposed to lead together the same employees in an effective manner (leader-member exchange), presupposing an effective cooperation between both (handing over information). To see developments over time, these processes were evaluated three times over the span of the project. Top-Sharing and the underlined processes are expected to positively influence the tandem’s performance which has been evaluated twice, at the beginning and the end of the project, to assess its development over time as well. The evaluation of the personality and the basic motives suggests that both executives can be a successful top-sharing tandem. The competency evaluations (supervisor as well as self-assessment) increased over the time span. Although the top sharing tandem worked on equal terms, they implemented rather classical than peer-mentoring due to different career ambitions of the tandem partners. Thus, opportunities were not used completely. Team-member exchange scores proved the good cooperation between the top-sharers. Although the employees did not evaluate the leader-member-exchange between them and the two leaders of the tandem homogeneously, the top-sharing tandem itself did not have the impression that the employees’ task performance depended on whom of the tandem was responsible for the task. Furthermore, top-sharing did not negatively influence the performance of both leaders. During qualitative interviews with the top-sharers and their team, we found that the top-sharers could focus more easily on their tasks. The results suggest positive outcomes of top-sharing (e.g. competency improvement, learning from each other through mentoring). Top-Sharing does not hamper performance. Thus, further research and practical implementations are suggested. As part-time jobs are still more often a female solution to increase their work-life- and work-family-balance, top-sharing may be a suitable solution to increase the woman’s ratio in leadership positions as well as to sustainable increase work-life-balance of executives.

Keywords: mentoring, part-time leadership, top-sharing, work-life-balance

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1019 Language and Power Relations in Selected Political Crisis Speeches in Nigeria: A Critical Discourse Analysis

Authors: Isaiah Ifeanyichukwu Agbo

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Human speech is capable of serving many purposes. Power and control are not always exercised overtly by linguistic acts, but maybe enacted and exercised in the myriad of taken-for-granted actions of everyday life. Domination, power control, discrimination and mind control exist in human speech and may lead to asymmetrical power relations. In discourse, there are persuasive and manipulative linguistic acts that serve to establish solidarity and identification with the 'we group' and polarize with the 'they group'. Political discourse is crafted to defend and promote the problematic narrative of outright controversial events in a nation’s history thereby sustaining domination, marginalization, manipulation, inequalities and injustices, often without the dominated and marginalized group being aware of them. They are designed and positioned to serve the political and social needs of the producers. Political crisis speeches in Nigeria, just like in other countries concentrate on positive self-image, de-legitimization of political opponents, reframing accusation to one’s advantage, redefining problematic terms and adopting reversal strategy. In most cases, the people are ignorant of the hidden ideological positions encoded in the text. Few researches have been conducted adopting the frameworks of critical discourse analysis and systemic functional linguistics to investigate this situation in the political crisis speeches in Nigeria. In this paper, we focus attention on the analyses of the linguistic, semantic, and ideological elements in selected political crisis speeches in Nigeria to investigate if they create and sustain unequal power relations and manipulative tendencies from the perspectives of Critical Discourse Analysis (CDA) and Systemic Functional Linguistics (SFL). Critical Discourse Analysis unpacks both opaque and transparent structural relationships of power dominance, power relations and control as manifested in language. Critical discourse analysis emerged from a critical theory of language study which sees the use of language as a form of social practice where social relations are reproduced or contested and different interests are served. Systemic function linguistics relates the structure of texts to their function. Fairclough’s model of CDA and Halliday’s systemic functional approach to language study are adopted in this paper. This paper probes into language use that perpetuates inequalities. This study demystifies the hidden implicature of the selected political crisis speeches and reveals the existence of information that is not made explicit in what the political actors actually say. The analysis further reveals the ideological configurations present in the texts. These ideological standpoints are the basis for naturalizing implicit ideologies and hegemonic influence in the texts. The analyses of the texts further uncovered the linguistic and discursive strategies deployed by text producers to manipulate the unsuspecting members of the public both mentally and conceptually in order to enact, sustain and maintain unhealthy power relations at crisis times in the Nigerian political history.

Keywords: critical discourse analysis, language, political crisis, power relations, systemic functional linguistics

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1018 The Impact of Illegal Firearms Possession, Limited Security Staff and Porosity of Border on Human Security in Ipokia Local Government Area, Ogun State

Authors: Ogunmefun Folorunsho Muyideen, Aluko Tolulope Evelyn

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One of the trending menaces faced in the world today is centered on the porosity of borders and proliferation of illegal weapons among the state members without the state authorizations. The proliferation of weapons along porous borders remains a germane and unsolvable question among developed and developing nations due to crisis degenerated from the menace (loss of lives, properties, traumatization, civil unrest and retrogressive economic development). A mixed method was adopted while the survey method was used for communities’ selection (Oke-Odan, Ajilete, Illaise, Lanlate) at Ipokia Local Government as a sample frame. Multi-stage sampling was employed to break down the site into wards, streets, and different house numbers before randomizing administration of the questionnaires using face to face method, while purposive sampling was used for collecting verbal information through an in-depth interviews method. The population size for the site is 150.398, while 399 was the sample size derived from the use of Yamane sample size formula. After retrieval of structured questionnaires, 346 were found useful, while 10 percent (399) of the quantitative instruments was summed to 30 participants that were interviewed using the in-depth interviews technique. The result of the first hypothesis shows a composite relationship between the variables tested (independents and dependent). The result indicated that the porosity of the border, illegal possession of guns, and limited security staff jointly predispose insecurity among the residents of the selected study site. The result of the second hypothesis deciphers that the illegal gun possession (independent) variable predict business outcome among the residents of the study site because sporadic gun shoot will regress the business activities in the study area. The result of third result indicated that the independent (porosity of borders) variable predict social bonding network because a high level of insecurity will destroy the level of trust in the communication among the residents of the study area. The last questions give comprehensive meaning to one of the recommendations derived using content systematic analysis, which explains that out of 30 participants interviewed, 18 submitted individual involvement in monitoring communities will solve the problem, 7 out of 30 opines that governmental agents are to be trained for effective combat, 3 participants out 30 submits that the fight is for both government and the citizens while 2 participants out of 30 claimed that there must be an agreement between Nigerian and neighbouring countries on border security. International donors must totally control the sales of weapons to unauthorized personalities. Criminal cases must be treated with deterrence measures and target hardened procedures through decoying and blending, stakeout, and sting tactics.

Keywords: human security, illegal weapons, porous borders, development

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1017 Staying When Everybody Else Is Leaving: Coping with High Out-Migration in Rural Areas of Serbia

Authors: Anne Allmrodt

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Regions of South-East Europe are characterised by high out-migration for decades. The reasons for leaving range from the hope of a better work situation to a better health care system and beyond. In Serbia, this high out-migration hits the rural areas in particular so that the population number is in the red repeatedly. It might not be hard to guess that this negative population growth has the potential to create different challenges for those who stay in rural areas. So how are they coping with the – statistically proven – high out-migration? Having this in mind, the study is investigating the people‘s individual awareness of the social phenomenon high out-migration and their daily life strategies in rural areas. Furthermore, the study seeks to find out the people’s resilient skills in that context. Is the condition of high out-migration conducive for resilience? The methodology combines a quantitative and a qualitative approach (mixed methods). For the quantitative part, a standardised questionnaire has been developed, including a multiple choice section and a choice experiment. The questionnaire was handed out to people living in rural areas of Serbia only (n = 100). The sheet included questions about people’s awareness of high out-migration, their own daily life strategies or challenges and their social network situation (data about the social network was necessary here since it is supposed to be an influencing variable for resilience). Furthermore, test persons were asked to make different choices of coping with high out-migration in a self-designed choice experiment. Additionally, the study included qualitative interviews asking citizens from rural areas of Serbia. The topics asked during the interview focused on their awareness of high out-migration, their daily life strategies, and challenges as well as their social network situation. Results have shown the following major findings. The awareness of high out-migration is not the same with all test persons. Some declare it as something positive for their own life, others as negative or not effecting at all. The way of coping generally depended – maybe not surprising – on the people’s social network. However – and this might be the most important finding - not everybody with a certain number of contacts had better coping strategies and was, therefore, more resilient. Here the results show that especially people with high affiliation and proximity inside their network were able to cope better and shew higher resilience skills. The study took one step forward in terms of knowledge about societal resilience as well as coping strategies of societies in rural areas. It has shown part of the other side of nowadays migration‘s coin and gives a hint for a more sustainable rural development and community empowerment.

Keywords: coping, out-migration, resilience, rural development, social networks, south-east Europe

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1016 A Hybrid of BioWin and Computational Fluid Dynamics Based Modeling of Biological Wastewater Treatment Plants for Model-Based Control

Authors: Komal Rathore, Kiesha Pierre, Kyle Cogswell, Aaron Driscoll, Andres Tejada Martinez, Gita Iranipour, Luke Mulford, Aydin Sunol

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Modeling of Biological Wastewater Treatment Plants requires several parameters for kinetic rate expressions, thermo-physical properties, and hydrodynamic behavior. The kinetics and associated mechanisms become complex due to several biological processes taking place in wastewater treatment plants at varying times and spatial scales. A dynamic process model that incorporated the complex model for activated sludge kinetics was developed using the BioWin software platform for an Advanced Wastewater Treatment Plant in Valrico, Florida. Due to the extensive number of tunable parameters, an experimental design was employed for judicious selection of the most influential parameter sets and their bounds. The model was tuned using both the influent and effluent plant data to reconcile and rectify the forecasted results from the BioWin Model. Amount of mixed liquor suspended solids in the oxidation ditch, aeration rates and recycle rates were adjusted accordingly. The experimental analysis and plant SCADA data were used to predict influent wastewater rates and composition profiles as a function of time for extended periods. The lumped dynamic model development process was coupled with Computational Fluid Dynamics (CFD) modeling of the key units such as oxidation ditches in the plant. Several CFD models that incorporate the nitrification-denitrification kinetics, as well as, hydrodynamics was developed and being tested using ANSYS Fluent software platform. These realistic and verified models developed using BioWin and ANSYS were used to plan beforehand the operating policies and control strategies for the biological wastewater plant accordingly that further allows regulatory compliance at minimum operational cost. These models, with a little bit of tuning, can be used for other biological wastewater treatment plants as well. The BioWin model mimics the existing performance of the Valrico Plant which allowed the operators and engineers to predict effluent behavior and take control actions to meet the discharge limits of the plant. Also, with the help of this model, we were able to find out the key kinetic and stoichiometric parameters which are significantly more important for modeling of biological wastewater treatment plants. One of the other important findings from this model were the effects of mixed liquor suspended solids and recycle ratios on the effluent concentration of various parameters such as total nitrogen, ammonia, nitrate, nitrite, etc. The ANSYS model allowed the abstraction of information such as the formation of dead zones increases through the length of the oxidation ditches as compared to near the aerators. These profiles were also very useful in studying the behavior of mixing patterns, effect of aerator speed, and use of baffles which in turn helps in optimizing the plant performance.

Keywords: computational fluid dynamics, flow-sheet simulation, kinetic modeling, process dynamics

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1015 Digimesh Wireless Sensor Network-Based Real-Time Monitoring of ECG Signal

Authors: Sahraoui Halima, Dahani Ameur, Tigrine Abedelkader

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DigiMesh technology represents a pioneering advancement in wireless networking, offering cost-effective and energy-efficient capabilities. Its inherent simplicity and adaptability facilitate the seamless transfer of data between network nodes, extending the range and ensuring robust connectivity through autonomous self-healing mechanisms. In light of these advantages, this study introduces a medical platform harnessed with DigiMesh wireless network technology characterized by low power consumption, immunity to interference, and user-friendly operation. The primary application of this platform is the real-time, long-distance monitoring of Electrocardiogram (ECG) signals, with the added capacity for simultaneous monitoring of ECG signals from multiple patients. The experimental setup comprises key components such as Raspberry Pi, E-Health Sensor Shield, and Xbee DigiMesh modules. The platform is composed of multiple ECG acquisition devices labeled as Sensor Node 1 and Sensor Node 2, with a Raspberry Pi serving as the central hub (Sink Node). Two communication approaches are proposed: Single-hop and multi-hop. In the Single-hop approach, ECG signals are directly transmitted from a sensor node to the sink node through the XBee3 DigiMesh RF Module, establishing peer-to-peer connections. This approach was tested in the first experiment to assess the feasibility of deploying wireless sensor networks (WSN). In the multi-hop approach, two sensor nodes communicate with the server (Sink Node) in a star configuration. This setup was tested in the second experiment. The primary objective of this research is to evaluate the performance of both Single-hop and multi-hop approaches in diverse scenarios, including open areas and obstructed environments. Experimental results indicate the DigiMesh network's effectiveness in Single-hop mode, with reliable communication over distances of approximately 300 meters in open areas. In the multi-hop configuration, the network demonstrated robust performance across approximately three floors, even in the presence of obstacles, without the need for additional router devices. This study offers valuable insights into the capabilities of DigiMesh wireless technology for real-time ECG monitoring in healthcare applications, demonstrating its potential for use in diverse medical scenarios.

Keywords: DigiMesh protocol, ECG signal, real-time monitoring, medical platform

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1014 Burden of Dengue in Northern India

Authors: Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, A. C. Dhariwal, Pawana Murthy

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Burden of Dengue in Northern India Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, AC Dhariwal, Pawana Murthy. All India Institute of Medical Sciences, NVBDCP,WHO New Delhi, India Aim: This study was conducted to estimate the burden of dengue in capital region of India. Methodology:Seropositivity of Dengue for IgM Ab, NS1 Ag and IgG Ab were performed among the blood donors’ samples from blood bank, those who were coming to donate blood for the requirement of blood for the admitted patients in hospital. Blood samplles were collected through out the year to estimate seroprevalance of dengue with or without outbreak season. All the subjects were asymptomatic at the time of blood donation. Results: A total of 1558 donors were screened for the study. On the basis of inclusion/ exclusion criteria, we enrolled 1531subjects for the study.Twenty seven donors were excluded from the study, out of which 6 were detected HIV +ve, 11 were positive for HBsAg and 10 were found positive for HCV.Mean age was 30.51 ± 7.75 years.Of 1531subjects, 18 (1.18%) had a past history of typhoid fever, 28 (1.83%) had chikungunya fever, 9 (0.59%) had malaria and 43 subjects (2.81%) had a past history of symptomatic dengue infection.About 2.22% (34) of subjects were found to have sero-positive for NS1 Ag with a peak point prevalence of 7.14% in the month of October and sero-positive of IgM Ab was observed about 5.49% (84)with a peak point prevalence of 14.29% in the month of October. Sero-prevalnce of IgGwas detected in about 64.21% (983) of subjects. Conclusion: Acute asymptomatic dengue (NS1 Ag+ve) was observed in 7.14%, as the subjects were having no symptoms at the time of sampling. This group of subjects poses a potential public health threat for transmitting dengue infection through blood transfusion (TTI) in the community as evident by presence of active viral infection due to NS1Ag +VE. Therefore a policy may be implemented in the blood bank for testing NS1 Ag to look for active dengue infection for preventing dengue transmission through blood transfusion (TTI). Acute or Subacute dengue infection ( IgM Ab+ve) was observed from 5.49% to 14.29% which is a peak point prevalence in the month of October. About 64.21% of the population were immunized by natural dengue infection ( IgG Ab+ve) in theNorthern province of India. This might be helpful for implementing the dengue vaccine in a region. Blood samples in blood banks should be tested for dengue before transfusion to any other person to prevent transfusion transmitted dengue infection as we estimated upto 7.14% positivity of NS1 Ag in our study which indicates presence of dengue virus in blood donors’ samples.

Keywords: Dengue Burden, Seroprevalance, Asymptomatic dengue, Dengue transmission through blood transfusion

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1013 Implementation of Project-Based Learning with Peer Assessment in Large Classes under Consideration of Faculty’s Scare Resources

Authors: Margit Kastner

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To overcome the negative consequences associated with large class sizes and to support students in developing the necessary competences (e.g., critical thinking, problem-solving, or team-work skills) a marketing course has been redesigned by implementing project-based learning with peer assessment (PBL&PA). This means that students can voluntarily take advantage of this supplementary offer and explore -in addition to attending the lecture where clicker questions are asked- a real-world problem, find a solution, and assess the results of peers while working in small collaborative groups. In order to handle this with little further effort, the process is technically supported by the university’s e-learning system in such a way that students upload their solution in form of an assignment which is then automatically distributed to peer groups who have to assess the work of three other groups. Finally, students’ work is graded automatically considering both, students’ contribution to the project and the conformity of the peer assessment. The purpose of this study is to evaluate students’ perception of PBL&PA using an online-questionnaire to collect the data. More specifically, it aims to discover students’ motivations for (not) working on a project and the benefits and problems students encounter. In addition to the survey, students’ performance was analyzed by comparing the final grades of those who participated in PBL&PA with those who did not participate. Among the 260 students who filled out the questionnaire, 47% participated in PBL&PA. Besides extrinsic motivations (bonus credits), students’ participation was often motivated by learning and social benefits. Reasons for not working on a project were connected to students’ organization and management of their studies (e.g., time constraints, no/wrong information) and teamwork concerns (e.g., missing engagement of peers, prior negative experiences). In addition, high workload and insufficient extrinsic motivation (bonus credits) were mentioned. With regards to benefits and problems students encountered during the project, students provided more positive than negative comments. Positive aspects most often stated were learning and social benefits while negative ones were mainly attached to the technical implementation. Interestingly, bonus credits were hardly named as a positive aspect meaning that intrinsic motivations have become more important when working on the project. Team aspects generated mixed feelings. In addition, students who voluntarily participated in PBL&PA were, in general, more active and utilized further course offers such as clicker questions. Examining students’ performance at the final exam revealed that students without participating in any of the offered active learning tasks performed poorest in the exam while students who used all activities were best. In conclusion, the goals of the implementation were met in terms of students’ perceived benefits and the positive impact on students’ exam performance. Since the comparison of the automatic grading with faculty grading showed valid results, it is possible to rely only on automatic grading in the future. That way, the additional workload for faculty will be within limits. Thus, the implementation of project-based learning with peer assessment can be recommended for large classes.

Keywords: automated grading, large classes, peer assessment, project-based learning

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1012 Alternate Optical Coherence Tomography Technologies in Use for Corneal Diseases Diagnosis in Dogs and Cats

Authors: U. E. Mochalova, A. V. Demeneva, Shilkin A. G., J. Yu. Artiushina

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Objective. In medical ophthalmology OCT has been actively used in the last decade. It is a modern non-invasive method of high-precision hardware examination, which gives a detailed cross-sectional image of eye tissues structure with a high level of resolution, which provides in vivo morphological information at the microscopic level about corneal tissue, structures of the anterior segment, retina and optic nerve. The purpose of this study was to explore the possibility of using the OCT technology in complex ophthalmological examination in dogs and cats, to characterize the revealed pathological structural changes in corneal tissue in cats and dogs with some of the most common corneal diseases. Procedures. Optical coherence tomography of the cornea was performed in 112 animals: 68 dogs and 44 cats. In total, 224 eyes were examined. Pathologies of the organ of vision included: dystrophy and degeneration of the cornea, endothelial corneal dystrophy, dry eye syndrome, chronic superficial vascular keratitis, pigmented keratitis, corneal erosion, ulcerative stromal keratitis, corneal sequestration, chronic glaucoma and also postoperative period after performed keratoplasty. When performing OCT, we used certified medical devices: "Huvitz HOCT-1/1F», «Optovue iVue 80» and "SOCT Copernicus Revo (60)". Results. The results of a clinical study on the use of optical coherence tomography (OCT)of the cornea in cats and dogs, performed by the authors of the article in the complex diagnosis of keratopathies of variousorigins: endothelial corneal dystrophy, pigmented keratitis, chronic keratoconjunctivitis, chronic herpetic keratitis, ulcerative keratitis, traumatic corneal damage, sequestration of the cornea of cats, chronic keratitis, complicating the course of glaucoma. The characteristics of the OCT scans are givencorneas of cats and dogs that do not have corneal pathologies. OCT scans of various corneal pathologies in dogs and cats with a description of the revealed pathological changes are presented. Of great clinical interest are the data obtained during OCT of the cornea of animals undergoing keratoplasty operations using various forms of grafts. Conclusions. OCT makes it possible to assess the thickness and pathological structural changes of the corneal surface epithelium, corneal stroma and descemet membrane. We can measure them, determine the exact localization, and record pathological changes. Clinical observation of the dynamics of the pathological process in the cornea using OCT makes it possible to evaluate the effectiveness of drug treatment. In case of negative dynamics of corneal disease, it is necessary to determine the indications for surgical treatment (to assess the thickness of the cornea, the localization of its thinning zones, to characterize the depth and area of pathological changes). According to the OCT of the cornea, it is possible to choose the optimal surgical treatment for the patient, the technique and depth of optically constructive surgery (penetrating or anterior lamellar keratoplasty).; determine the depth and diameter of the planned microsurgical trepanation of corneal tissue, which will ensure good adaptation of the edges of the donor material.

Keywords: optical coherence tomography, corneal sequestration, optical coherence tomography of the cornea, corneal transplantation, cat, dog

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1011 Numerical Study of Homogeneous Nanodroplet Growth

Authors: S. B. Q. Tran

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Drop condensation is the phenomenon that the tiny drops form when the oversaturated vapour present in the environment condenses on a substrate and makes the droplet growth. Recently, this subject has received much attention due to its applications in many fields such as thin film growth, heat transfer, recovery of atmospheric water and polymer templating. In literature, many papers investigated theoretically and experimentally in macro droplet growth with the size of millimeter scale of radius. However few papers about nanodroplet condensation are found in the literature especially theoretical work. In order to understand the droplet growth in nanoscale, we perform the numerical simulation work to study nanodroplet growth. We investigate and discuss the role of the droplet shape and monomer diffusion on drop growth and their effect on growth law. The effect of droplet shape is studied by doing parametric studies of contact angle and disjoining pressure magnitude. Besides, the effect of pinning and de-pinning behaviours is also studied. We investigate the axisymmetric homogeneous growth of 10–100 nm single water nanodroplet on a substrate surface. The main mechanism of droplet growth is attributed to the accumulation of laterally diffusing water monomers, formed by the absorption of water vapour in the environment onto the substrate. Under assumptions of quasi-steady thermodynamic equilibrium, the nanodroplet evolves according to the augmented Young–Laplace equation. Using continuum theory, we model the dynamics of nanodroplet growth including the coupled effects of disjoining pressure, contact angle and monomer diffusion with the assumption of constant flux of water monomers at the far field. The simulation result is validated by comparing with the published experimental result. For the case of nanodroplet growth with constant contact angle, our numerical results show that the initial droplet growth is transient by monomer diffusion. When the flux at the far field is small, at the beginning, the droplet grows by the diffusion of initially available water monomers on the substrate and after that by the flux at the far field. In the steady late growth rate of droplet radius and droplet height follow a power law of 1/3, which is unaffected by the substrate disjoining pressure and contact angle. However, it is found that the droplet grows faster in radial direction than high direction when disjoining pressure and contact angle increase. The simulation also shows the information of computational domain effect in the transient growth period. When the computational domain size is larger, the mass coming in the free substrate domain is higher. So the mass coming in the droplet is also higher. The droplet grows and reaches the steady state faster. For the case of pinning and de-pinning droplet growth, the simulation shows that the disjoining pressure does not affect the droplet radius growth law 1/3 in steady state. However the disjoining pressure modifies the growth rate of the droplet height, which then follows a power law of 1/4. We demonstrate how spatial depletion of monomers could lead to a growth arrest of the nanodroplet, as observed experimentally.

Keywords: augmented young-laplace equation, contact angle, disjoining pressure, nanodroplet growth

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1010 Triazenes: Unearthing Their Hidden Arsenal Against Malaria and Microbial Menace

Authors: Frans J. Smit, Wisdom A. Munzeiwa, Hermanus C. M. Vosloo, Lyn-Marie Birkholtz, Richard K. Haynes

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Malaria and antimicrobial infections remain significant global health concerns, necessitating the continuous search for novel therapeutic approaches. This abstract presents an overview of the potential use of triazenes as effective agents against malaria and various antimicrobial pathogens. Triazenes are a class of compounds characterized by a linear arrangement of three nitrogen atoms, rendering them structurally distinct from their cyclic counterparts. This study investigates the efficacy of triazenes against malaria and explores their antimicrobial activity. Preliminary results revealed significant antimalarial activity of the triazenes, as evidenced by in vitro screening against P. falciparum, the causative agent of malaria. Furthermore, the compounds exhibited broad-spectrum antimicrobial activity, indicating their potential as effective antimicrobial agents. These compounds have shown inhibitory effects on various essential enzymes and processes involved in parasite survival, replication, and transmission. The mechanism of action of triazenes against malaria involves interactions with critical molecular targets, such as enzymes involved in the parasite's metabolic pathways and proteins responsible for host cell invasion. The antimicrobial activity of the triazenes against bacteria and fungi was investigated through disc diffusion screening. The antimicrobial efficacy of triazenes has been observed against both Gram-positive and Gram-negative bacteria, as well as multidrug-resistant strains, making them potential candidates for combating drug-resistant infections. Furthermore, triazenes possess favourable physicochemical properties, such as good stability, solubility, and low toxicity, which are essential for drug development. The structural versatility of triazenes allows for the modification of their chemical composition to enhance their potency, selectivity, and pharmacokinetic properties. These modifications can be tailored to target specific pathogens, increasing the potential for personalized treatment strategies. In conclusion, this study highlights the potential of triazenes as promising candidates for the development of novel antimalarial and antimicrobial therapeutics. Further investigations are necessary to determine the structure-activity relationships and optimize the pharmacological properties of these compounds. The results warrant additional research, including MIC studies, to further explore the antimicrobial activity of the triazenes. Ultimately, these findings contribute to the development of more effective strategies for combating malaria and microbial infections.

Keywords: malaria, anti-microbials, triazene, resistance

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1009 Arsenic Contamination in Drinking Water Is Associated with Dyslipidemia in Pregnancy

Authors: Begum Rokeya, Rahelee Zinnat, Fatema Jebunnesa, Israt Ara Hossain, A. Rahman

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Background and Aims: Arsenic in drinking water is a global environmental health problem, and the exposure may increase dyslipidemia and cerebrovascular diseases mortalities, most likely through causing atherosclerosis. However, the mechanism of lipid metabolism, atherosclerosis formation, arsenic exposure and impact in pregnancy is still unclear. Recent epidemiological evidences indicate close association between inorganic arsenic exposure via drinking water and Dyslipidemia. However, the exact mechanism of this arsenic-mediated increase in atherosclerosis risk factors remains enigmatic. We explore the association of the effect of arsenic on serum lipid profile in pregnant subjects. Methods: A total 200 pregnant mother screened in this study from arsenic exposed area. Our study group included 100 exposed subjects were cases and 100 Non exposed healthy pregnant were controls requited by a cross-sectional study. Clinical and anthropometric measurements were done by standard techniques. Lipidemic status was assessed by enzymatic endpoint method. Urinary As was measured by inductively coupled plasma-mass spectrometry and adjusted with specific gravity and Arsenic exposure was assessed by the level of urinary arsenic level > 100 μg/L was categorized as arsenic exposed and < 100 μg/L were categorized as non-exposed. Multivariate logistic regression and Student’s t - test was used for statistical analysis. Results: Systolic and diastolic blood pressure both were significantly higher in the Arsenic exposed pregnant subjects compared to the Non-exposed group (p<0.001). Arsenic exposed subjects had 2 times higher chance of developing hypertensive pregnancy (Odds Ratio 2.2). In parallel to the findings in Ar exposed subjects showed significantly higher proportion of triglyceride and total cholesterol and low density of lipo protein when compare to non- arsenic exposed pregnant subjects. Significant correlation of urinary arsenic level was also found with SBP, DBP, TG, T chol and serum LDL-Cholesterol. On multivariate logistic regression showed urinary arsenic had a positive association with DBP, SBP, Triglyceride and LDL-c. Conclusion: In conclusion, arsenic exposure may induce dyslipidemia like atherosclerosis through modifying reverse cholesterol transport in cholesterol metabolism. For decreasing atherosclerosis related mortality associated with arsenic, preventing exposure from environmental sources in early life is an important element.

Keywords: Arsenic Exposure, Dyslipidemia, Gestational Diabetes Mellitus, Serum lipid profile

Procedia PDF Downloads 115
1008 Landslide Hazard Assessment Using Physically Based Mathematical Models in Agricultural Terraces at Douro Valley in North of Portugal

Authors: C. Bateira, J. Fernandes, A. Costa

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The Douro Demarked Region (DDR) is a production Porto wine region. On the NE of Portugal, the strong incision of the Douro valley developed very steep slopes, organized with agriculture terraces, have experienced an intense and deep transformation in order to implement the mechanization of the work. The old terrace system, based on stone vertical wall support structure, replaced by terraces with earth embankments experienced a huge terrace instability. This terrace instability has important economic and financial consequences on the agriculture enterprises. This paper presents and develops cartographic tools to access the embankment instability and identify the area prone to instability. The priority on this evaluation is related to the use of physically based mathematical models and develop a validation process based on an inventory of the past embankment instability. We used the shallow landslide stability model (SHALSTAB) based on physical parameters such us cohesion (c’), friction angle(ф), hydraulic conductivity, soil depth, soil specific weight (ϱ), slope angle (α) and contributing areas by Multiple Flow Direction Method (MFD). A terraced area can be analysed by this models unless we have very detailed information representative of the terrain morphology. The slope angle and the contributing areas depend on that. We can achieve that propose using digital elevation models (DEM) with great resolution (pixel with 40cm side), resulting from a set of photographs taken by a flight at 100m high with pixel resolution of 12cm. The slope angle results from this DEM. In the other hand, the MFD contributing area models the internal flow and is an important element to define the spatial variation of the soil saturation. That internal flow is based on the DEM. That is supported by the statement that the interflow, although not coincident with the superficial flow, have important similitude with it. Electrical resistivity monitoring values which related with the MFD contributing areas build from a DEM of 1m resolution and revealed a consistent correlation. That analysis, performed on the area, showed a good correlation with R2 of 0,72 and 0,76 at 1,5m and 2m depth, respectively. Considering that, a DEM with 1m resolution was the base to model the real internal flow. Thus, we assumed that the contributing area of 1m resolution modelled by MFD is representative of the internal flow of the area. In order to solve this problem we used a set of generalized DEMs to build the contributing areas used in the SHALSTAB. Those DEMs, with several resolutions (1m and 5m), were built from a set of photographs with 50cm resolution taken by a flight with 5km high. Using this maps combination, we modelled several final maps of terrace instability and performed a validation process with the contingency matrix. The best final instability map resembles the slope map from a DEM of 40cm resolution and a MFD map from a DEM of 1m resolution with a True Positive Rate (TPR) of 0,97, a False Positive Rate of 0,47, Accuracy (ACC) of 0,53, Precision (PVC) of 0,0004 and a TPR/FPR ratio of 2,06.

Keywords: agricultural terraces, cartography, landslides, SHALSTAB, vineyards

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1007 Hear Me: The Learning Experience on “Zoom” of Students With Deafness or Hard of Hearing Impairments

Authors: H. Weigelt-Marom

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Over the years and up to the arousal of the COVID-19 pandemic, deaf or hard of hearing students studying in higher education institutions, participated lectures on campus using hearing aids and strategies adapted for frontal learning in a classroom. Usually, these aids were well known to them from their earlier study experience in school. However, the transition to online lessons, due to the latest pandemic, led deaf or hard of hearing students to study outside of their physical, well known learning environment. The change of learning environment and structure rose new challenges for these students. The present study examined the learning experience, limitations, challenges and benefits regarding learning online with lecture and classmates via the “Zoom” video conference program, among deaf or hard of hearing students in academia setting. In addition, emotional and social aspects related to learning in general versus the “Zoom” were examined. The study included 18 students diagnosed as deaf or hard of hearing, studying in various higher education institutions in Israel. All students had experienced lessons on the “Zoom”. Following allocation of the group study by the deaf and hard of hearing non-profit organization “Ma’agalei Shema”, and receiving the participants inform of consent, students were requested to answer a google form questioner and participate in an interview. The questioner included background information (e.g., age, year of studying, faculty etc.), level of computer literacy, and level of hearing and forms of communication (e.g., lip reading, sign language etc.). The interviews included a one on one, semi-structured, in-depth interview, conducted by the main researcher of the study (interview duration: up to 60 minutes). The interviews were held on “ZOOM” using specific adaptations for each interviewee: clear face screen of the interviewer for lip and face reading, and/ or professional sign language or live text transcript of the conversation. Additionally, interviewees used their audio devices if needed. Questions regarded: learning experience, difficulties and advantages studying using “Zoom”, learning in a classroom versus on “Zoom”, and questions concerning emotional and social aspects related to learning. Thematic analysis of the interviews revealed severe difficulties regarding the ability of deaf or hard of hearing students to comprehend during ”Zoom“ lessons without adoptive aids. For example, interviewees indicated difficulties understanding “Zoom” lessons due to their inability to use hearing devices commonly used by them in the classroom (e.g., FM systems). 80% indicated that they could not comprehend “Zoom” lessons since they could not see the lectures face, either because lectures did not agree to open their cameras or, either because they did not keep a straight forward clear face appearance while teaching. However, not all descriptions regarded learning via the “zoom” were negative. For example, 20% reported the recording of “Zoom” lessons as a main advantage. Enabling then to repeatedly watch the lessons at their own pace, mostly assisted by friends and family to translate the audio output into an accessible input. These finding and others regarding the learning experience of the group study on the “Zoom”, as well as their recommendation to enable deaf or hard of hearing students to study inclusively online, will be presented at the conference.

Keywords: deaf or hard of hearing, learning experience, Zoom, qualitative research

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1006 In vitro Study of Inflammatory Gene Expression Suppression of Strawberry and Blackberry Extracts

Authors: Franco Van De Velde, Debora Esposito, Maria E. Pirovani, Mary A. Lila

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The physiology of various inflammatory diseases is a complex process mediated by inflammatory and immune cells such as macrophages and monocytes. Chronic inflammation, as observed in many cardiovascular and autoimmune disorders, occurs when the low-grade inflammatory response fails to resolve with time. Because of the complexity of the chronic inflammatory disease, major efforts have focused on identifying novel anti-inflammatory agents and dietary regimes that prevent the pro-inflammatory process at the early stage of gene expression of key pro-inflammatory mediators and cytokines. The ability of the extracts of three blackberry cultivars (‘Jumbo’, ‘Black Satin’ and ‘Dirksen’), and one strawberry cultivar (‘Camarosa’) to inhibit four well-known genetic biomarkers of inflammation: inducible nitric oxide synthase (iNOS), cyclooxynase-2 (Cox-2), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in an in vitro lipopolysaccharide-stimulated murine RAW 264.7 macrophage model were investigated. Moreover, the effect of latter extracts on the intracellular reactive oxygen species (ROS) and nitric oxide (NO) production was assessed. Assay was conducted with 50 µg/mL crude extract concentration, an amount that is easily achievable in the gastrointestinal tract after berries consumption. The mRNA expression levels of Cox-2 and IL-6 were reduced consistently (more than 30%) by extracts of ‘Jumbo’ and ‘Black Satin’ blackberries. Strawberry extracts showed high reduction in mRNA expression levels of IL-6 (more than 65%) and exhibited moderate reduction in mRNA expression of Cox-2 (more than 35%). The latter behavior mirrors the intracellular ROS production of the LPS stimulated RAW 264.7 macrophages after the treatment with blackberry ‘Black Satin’ and ‘Jumbo’, and strawberry ‘Camarosa’ extracts, suggesting that phytochemicals from these fruits may play a role in the health maintenance by reducing oxidative stress. On the other hand, effective inhibition in the gene expression of IL-1β and iNOS was not observed by any of blackberry and strawberry extracts. However, suppression in the NO production in the activated macrophages among 5–25% was observed by ‘Jumbo’ and ‘Black Satin’ blackberry extracts and ‘Camarosa’ strawberry extracts, suggesting a higher NO suppression property by phytochemicals of these fruits. All these results suggest the potential beneficial effects of studied berries as functional foods with antioxidant and anti-inflammatory roles. Moreover, the underlying role of phytochemicals from these fruits in the protection of inflammatory process will deserve to be further explored.

Keywords: cyclooxygenase-2, functional foods, interleukin-6, reactive oxygen species

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1005 A Conceptual Model of Sex Trafficking Dynamics in the Context of Pandemics and Provisioning Systems

Authors: Brian J. Biroscak

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In the United States (US), “sex trafficking” is defined at the federal level in the Trafficking Victims Protection Act of 2000 as encompassing a number of processes such as recruitment, transportation, and provision of a person for the purpose of a commercial sex act. It involves the use of force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age. Accumulating evidence suggests that sex trafficking is exacerbated by social and environmental stressors (e.g., pandemics). Given that “provision” is a key part of the definition, “provisioning systems” may offer a useful lens through which to study sex trafficking dynamics. Provisioning systems are the social systems connecting individuals, small groups, entities, and embedded communities as they seek to satisfy their needs and wants for goods, services, experiences and ideas through value-based exchange in communities. This project presents a conceptual framework for understanding sex trafficking dynamics in the context of the COVID pandemic. The framework is developed as a system dynamics simulation model based on published evidence, social and behavioral science theory, and key informant interviews with stakeholders from the Protection, Prevention, Prosecution, and Partnership sectors in one US state. This “4 P Paradigm” has been described as fundamental to the US government’s anti-trafficking strategy. The present research question is: “How do sex trafficking systems (e.g., supply, demand and price) interact with other provisioning systems (e.g., networks of organizations that help sexually exploited persons) to influence trafficking over time vis-à-vis the COVID pandemic?” Semi-structured interviews with stakeholders (n = 19) were analyzed based on grounded theory and combined for computer simulation. The first step (Problem Definition) was completed by open coding video-recorded interviews, supplemented by a literature review. The model depicts provision of sex trafficking services for victims and survivors as declining in March 2020, coincidental with COVID, but eventually rebounding. The second modeling step (Dynamic Hypothesis Formulation) was completed by open- and axial coding of interview segments, as well as consulting peer-reviewed literature. Part of the hypothesized explanation for changes over time is that the sex trafficking system behaves somewhat like a commodities market, with each of the other subsystems exhibiting delayed responses but collectively keeping trafficking levels below what they would be otherwise. Next steps (Model Building & Testing) led to a ‘proof of concept’ model that can be used to conduct simulation experiments and test various action ideas, by taking model users outside the entire system and seeing it whole. If sex trafficking dynamics unfold as hypothesized, e.g., oscillated post-COVID, then one potential leverage point is to address the lack of information feedback loops between the actual occurrence and consequences of sex trafficking and those who seek to prevent its occurrence, prosecute the traffickers, protect the victims and survivors, and partner with the other anti-trafficking advocates. Implications for researchers, administrators, and other stakeholders are discussed.

Keywords: pandemics, provisioning systems, sex trafficking, system dynamics modeling

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1004 Radical Scavenging Activity of Protein Extracts from Pulse and Oleaginous Seeds

Authors: Silvia Gastaldello, Maria Grillo, Luca Tassoni, Claudio Maran, Stefano Balbo

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Antioxidants are nowadays attractive not only for the countless benefits to the human and animal health, but also for the perspective of use as food preservative instead of synthetic chemical molecules. In this study, the radical scavenging activity of six protein extracts from pulse and oleaginous seeds was evaluated. The selected matrices are Pisum sativum (yellow pea from two different origins), Carthamus tinctorius (safflower), Helianthus annuus (sunflower), Lupinus luteus cv Mister (lupin) and Glycine max (soybean), since they are economically interesting for both human and animal nutrition. The seeds were grinded and proteins extracted from 20mg powder with a specific vegetal-extraction kit. Proteins have been quantified through Bradford protocol and scavenging activity was revealed using DPPH assay, based on radical DPPH (2,2-diphenyl-1-picrylhydrazyl) absorbance decrease in the presence of antioxidants molecules. Different concentrations of the protein extract (1, 5, 10, 50, 100, 500 µg/ml) were mixed with DPPH solution (DPPH 0,004% in ethanol 70% v/v). Ascorbic acid was used as a scavenging activity standard reference, at the same six concentrations of protein extracts, while DPPH solution was used as control. Samples and standard were prepared in triplicate and incubated for 30 minutes in dark at room temperature, the absorbance was read at 517nm (ABS30). Average and standard deviation of absorbance values were calculated for each concentration of samples and standard. Statistical analysis using t-students and p-value were performed to assess the statistical significance of the scavenging activity difference between the samples (or standard) and control (ABSctrl). The percentage of antioxidant activity has been calculated using the formula [(ABSctrl-ABS30)/ABSctrl]*100. The obtained results demonstrate that all matrices showed antioxidant activity. Ascorbic acid, used as standard, exhibits a 96% scavenging activity at the concentration of 500 µg/ml. At the same conditions, sunflower, safflower and yellow peas revealed the highest antioxidant performance among the matrices analyzed, with an activity of 74%, 68% and 70% respectively (p < 0.005). Although lupin and soybean exhibit a lower antioxidant activity compared to the other matrices, they showed a percentage of 46 and 36 respectively. All these data suggest the possibility to use undervalued edible matrices as antioxidants source. However, further studies are necessary to investigate a possible synergic effect of several matrices as well as the impact of industrial processes for a large-scale approach.

Keywords: antioxidants, DPPH assay, natural matrices, vegetal proteins

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1003 A Dynamic Curriculum as a Platform for Continuous Competence Development

Authors: Niina Jallinoja, Anu Moisio

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Focus on adult learning is vital to overcome economic challenges as well as to respond to the demand for new competencies and sustained productivity in the digitalized world economy. Employees of all ages must be able to carry on continuous professional development to remain competitive in the labor market. According to EU policies, countries should offer more flexible opportunities for adult learners who study online and in so-called ‘second chance’ qualification programmes. Traditionally, adult education in Finland has comprised of not only liberal adult education but also the government funding to study for Bachelor, Master's, and Ph.D. degrees in Finnish Universities and Universities of Applied Sciences (UAS). From the beginning of 2021, public funding is allocated not only to degrees but also to courses to achieve new competencies for adult learners in Finland. Consequently, there will be degree students (often younger of age) and adult learners studying in the same evening, online and blended courses. The question is thus: How are combined studies meeting the different needs of degree students and adult learners? Haaga-Helia University of Applied Sciences (UAS), located in the metropolitan area of Finland, is taking up the challenge of continuous learning for adult learners. Haaga-Helia has been reforming the bachelor level education and respective shorter courses from 2019 in the biggest project in its history. By the end of 2023, Haaga-Helia will have a flexible, modular curriculum for the bachelor's degrees of hospitality management, business administration, business information technology, journalism and sports management. Building on the shared key competencies, degree students will have the possibility to build individual study paths more flexibly, thanks to the new modular structure of the curriculum. They will be able to choose courses across all degrees, and thus, build their own unique competence combinations. All modules can also be offered as separate courses or learning paths to non-degree students, both publicly funded and as commercial services for employers. Consequently, there will be shared course implementations for degree studies and adult learners with various competence requirements. The newly designed courses are piloted in parallel of the designing of the curriculum in Haaga-Helia during 2020 and 2021. Semi-structured online surveys are composed among the participants for the key competence courses. The focus of the research is to understand how students in the bachelor programme and adult learners from Open UAE perceive the learning experience in such a diverse learning group. A comparison is also executed between learning methods of in-site teaching, online implementation, blended learning and virtual self-learning courses to understand how the pedagogy is meeting the learning objectives of these two different groups. The new flexible curricula and the study modules are to be designed to fill the most important competence gaps that exist in the Finnish labor markets. The new curriculum will be dynamic and constantly evolving over time according to the future competence needs in the labor market. This type of approach requires constant dialogue between Haaga-Helia and workplaces during and after designing of the shared curriculum.

Keywords: ccompetence development, continuous learning, curriculum, higher education

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1002 Effect of Sodium Arsenite Exposure on Pharmacodynamic of Meloxicam in Male Wistar Rats

Authors: Prashantkumar Waghe, N. Prakash, N. D. Prasada, L. V. Lokesh, M. Vijay Kumar, Vinay Tikare

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Arsenic is a naturally occurring metalloid with potent toxic effects. It is ubiquitous in the environment and released from both natural and anthropogenic sources. It has the potential to cause various health hazards in exposed populations. Arsenic exposure through drinking water is considered as one of the most serious global environmental threats including Southeast Asia. The aim of present study was to evaluate the modulatory role of subacute exposure to sodium (meta) arsenite on the antinociceptive, anti-inflammatory and antipyretic responses mediated by meloxicam in rats. Rats were exposed to arsenic as sodium arsenite through drinking water for 28 days. A single dose of meloxicam (2 mg/kg b. wt.) was administered by oral gavage on the 29th day. The exact time of meloxicam administration depended on the type of test. Rats were divided randomly into 5 groups (n=6). Group I served as normal control and received arsenic free drinking water, while rats in group II were maintained similar to Group I but received meloxicam on 29th day. Groups III, IV and V were pre-exposed to arsenic through drinking water at 0.5, 5.0 and 50 ppm, respectively, for 28 days and was administered meloxicam next day and; pain and inflammation carried out by using formalin-induced nociception and carrageenan-induced inflammatory model(s), respectively by using standard protocol. For assessment of antipyretic effects, one more additional group (Group VI) was taken and given LPS @ 1.8 mg/kg b. wt. for induction of pyrexia (LPS control). Higher dose of arsenic inhibited the meloxicam mediated antinociceptive, anti-inflammatory and antipyretic responses. Further, meloxicam inhibited the arsenic induced level of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 and COX2 mediated prostaglandin E2 in hind paw muscle. These results suggest a functional antagonism of meloxicam by arsenic. This may relate to arsenic mediated local release of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 releases COX2 mediated prostaglandin E2. Based on the experimental study, it is concluded that sub-acute exposure to arsenic through drinking water aggravate pyrexia, inflammation and pain at environment relevant concentration and decrease the therapeutic efficacy of meloxicam at higher level of arsenite exposure. Thus, the observation made has clinical relevance in situations where animals are exposed to arsenite epidemic geographical locations.

Keywords: arsenic, analgesic activity, meloxicam, Wistar rats

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1001 Risk Factors of Hospital Acquired Infection Mortality in a Tunisian Intensive Care Unit

Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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1000 Deterioration Prediction of Pavement Load Bearing Capacity from FWD Data

Authors: Kotaro Sasai, Daijiro Mizutani, Kiyoyuki Kaito

Abstract:

Expressways in Japan have been built in an accelerating manner since the 1960s with the aid of rapid economic growth. About 40 percent in length of expressways in Japan is now 30 years and older and has become superannuated. Time-related deterioration has therefore reached to a degree that administrators, from a standpoint of operation and maintenance, are forced to take prompt measures on a large scale aiming at repairing inner damage deep in pavements. These measures have already been performed for bridge management in Japan and are also expected to be embodied for pavement management. Thus, planning methods for the measures are increasingly demanded. Deterioration of layers around road surface such as surface course and binder course is brought about at the early stages of whole pavement deterioration process, around 10 to 30 years after construction. These layers have been repaired primarily because inner damage usually becomes significant after outer damage, and because surveys for measuring inner damage such as Falling Weight Deflectometer (FWD) survey and open-cut survey are costly and time-consuming process, which has made it difficult for administrators to focus on inner damage as much as they have been supposed to. As expressways today have serious time-related deterioration within them deriving from the long time span since they started to be used, it is obvious the idea of repairing layers deep in pavements such as base course and subgrade must be taken into consideration when planning maintenance on a large scale. This sort of maintenance requires precisely predicting degrees of deterioration as well as grasping the present situations of pavements. Methods for predicting deterioration are determined to be either mechanical or statistical. While few mechanical models have been presented, as far as the authors know of, previous studies have presented statistical methods for predicting deterioration in pavements. One describes deterioration process by estimating Markov deterioration hazard model, while another study illustrates it by estimating Proportional deterioration hazard model. Both of the studies analyze deflection data obtained from FWD surveys and present statistical methods for predicting deterioration process of layers around road surface. However, layers of base course and subgrade remain unanalyzed. In this study, data collected from FWD surveys are analyzed to predict deterioration process of layers deep in pavements in addition to surface layers by a means of estimating a deterioration hazard model using continuous indexes. This model can prevent the loss of information of data when setting rating categories in Markov deterioration hazard model when evaluating degrees of deterioration in roadbeds and subgrades. As a result of portraying continuous indexes, the model can predict deterioration in each layer of pavements and evaluate it quantitatively. Additionally, as the model can also depict probability distribution of the indexes at an arbitrary point and establish a risk control level arbitrarily, it is expected that this study will provide knowledge like life cycle cost and informative content during decision making process referring to where to do maintenance on as well as when.

Keywords: deterioration hazard model, falling weight deflectometer, inner damage, load bearing capacity, pavement

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999 Investigation of Processing Conditions on Rheological Features of Emulsion Gels and Oleogels Stabilized by Biopolymers

Authors: M. Sarraf, J. E. Moros, M. C. Sánchez

Abstract:

Oleogels are self-standing systems that are able to trap edible liquid oil into a tridimensional network and also help to use less fat by forming crystallization oleogelators. There are different ways to generate oleogelation and oil structuring, including direct dispersion, structured biphasic systems, oil sorption, and indirect method (emulsion-template). The selection of processing conditions as well as the composition of the oleogels is essential to obtain a stable oleogel with characteristics suitable for its purpose. In this sense, one of the ingredients widely used in food products to produce oleogels and emulsions is polysaccharides. Basil seed gum (BSG), with the scientific name Ocimum basilicum, is a new native polysaccharide with high viscosity and pseudoplastic behavior because of its high molecular weight in the food industry. Also, proteins can stabilize oil in water due to the presence of amino and carboxyl moieties that result in surface activity. Whey proteins are widely used in the food industry due to available, cheap ingredients, nutritional and functional characteristics such as emulsifier and a gelling agent, thickening, and water-binding capacity. In general, the interaction of protein and polysaccharides has a significant effect on the food structures and their stability, like the texture of dairy products, by controlling the interactions in macromolecular systems. Using edible oleogels as oil structuring helps for targeted delivery of a component trapped in a structural network. Therefore, the development of efficient oleogel is essential in the food industry. A complete understanding of the important points, such as the ratio oil phase, processing conditions, and concentrations of biopolymers that affect the formation and stability of the emulsion, can result in crucial information in the production of a suitable oleogel. In this research, the effects of oil concentration and pressure used in the manufacture of the emulsion prior to obtaining the oleogel have been evaluated through the analysis of droplet size and rheological properties of obtained emulsions and oleogels. The results show that the emulsion prepared in the high-pressure homogenizer (HPH) at higher pressure values has smaller droplet sizes and a higher uniformity in the size distribution curve. On the other hand, in relation to the rheological characteristics of the emulsions and oleogels obtained, the predominantly elastic character of the systems must be noted, as they present values of the storage modulus higher than those of losses, also showing an important plateau zone, typical of structured systems. In the same way, if steady-state viscous flow tests have been analyzed on both emulsions and oleogels, the result is that, once again, the pressure used in the homogenizer is an important factor for obtaining emulsions with adequate droplet size and the subsequent oleogel. Thus, various routes for trapping oil inside a biopolymer matrix with adjustable mechanical properties could be applied for the creation of the three-dimensional network in order to the oil absorption and creating oleogel.

Keywords: basil seed gum, particle size, viscoelastic properties, whey protein

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998 Seasonal Short-Term Effect of Air Pollution on Cardiovascular Mortality in Belgium

Authors: Natalia Bustos Sierra, Katrien Tersago

Abstract:

It is currently proven that both extremes of temperature are associated with increased mortality and that air pollution is associated with temperature. This relationship is complex, and in countries with important seasonal variations in weather such as Belgium, some effects can appear as non-significant when the analysis is done over the entire year. We, therefore, analyzed the effect of short-term outdoor air pollution exposure on cardiovascular mortality during the warmer and colder months separately. We used daily cardiovascular deaths from acute cardiovascular diagnostics according to the International Classification of Diseases, 10th Revision (ICD-10: I20-I24, I44-I49, I50, I60-I66) during the period 2008-2013. The environmental data were population-weighted concentrations of particulates with an aerodynamic diameter less than 10 µm (PM₁₀) and less than 2.5 µm (PM₂.₅) (daily average), nitrogen dioxide (NO₂) (daily maximum of the hourly average) and ozone (O₃) (daily maximum of the 8-hour running mean). A Generalized linear model was applied adjusting for the confounding effect of season, temperature, dew point temperature, the day of the week, public holidays and the incidence of influenza-like illness (ILI) per 100,000 inhabitants. The relative risks (RR) were calculated for an increase of one interquartile range (IQR) of the air pollutant (μg/m³). These were presented for the four hottest months (June, July, August, September) and coldest months (November, December, January, February) in Belgium. We applied both individual lag model and unconstrained distributed lag model methods. The cumulative effect of a four-day exposure (day of exposure and three consecutive days) was calculated from the unconstrained distributed lag model. The IQR for PM₁₀, PM₂.₅, NO₂, and O₃ were respectively 8.2, 6.9, 12.9 and 25.5 µg/m³ during warm months and 18.8, 17.6, 18.4 and 27.8 µg/m³ during cold months. The association with CV mortality was statistically significant for the four pollutants during warm months and only for NO₂ during cold months. During the warm months, the cumulative effect of an IQR increase of ozone for the age groups 25-64, 65-84 and 85+ was 1.066 (95%CI: 1.002-1.135), 1.041 (1.008-1.075) and 1.036 (1.013-1.058) respectively. The cumulative effect of an IQR increase of NO₂ for the age group 65-84 was 1.066 (1.020-1.114) during warm months and 1.096 (1.030-1.166) during cold months. The cumulative effect of an IQR increase of PM₁₀ during warm months reached 1.046 (1.011-1.082) and 1.038 (1.015-1.063) for the age groups 65-84 and 85+ respectively. Similar results were observed for PM₂.₅. The short-term effect of air pollution on cardiovascular mortality is greater during warm months for lower pollutant concentrations compared to cold months. Spending more time outside during warm months increases population exposure to air pollution and can, therefore, be a confounding factor for this association. Age can also affect the length of time spent outdoors and the type of physical activity exercised. This study supports the deleterious effect of air pollution on cardiovascular mortality (CV) which varies according to season and age groups in Belgium. Public health measures should, therefore, be adapted to seasonality.

Keywords: air pollution, cardiovascular, mortality, season

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997 Electronic Waste Analysis And Characterization Study: Management Input For Highly Urbanized Cities

Authors: Jilbert Novelero, Oliver Mariano

Abstract:

In a world where technological evolution and competition to create innovative products are at its peak, problems on Electronic Waste (E-Waste) are now becoming a global concern. E-waste is said to be any electrical or electronic devices that have reached the terminal of its useful life. The major issue are the volume and the raw materials used in crafting E-waste which is non-biodegradable and contains hazardous substances that are toxic to human health and the environment. The objective of this study is to gather baseline data in terms of the composition of E-waste in the solid waste stream and to determine the top 5 E-waste categories in a highly urbanized city. Recommendations in managing these wastes for its reduction were provided which may serve as a guide for acceptance and implementation in the locality. Pasig City was the chosen beneficiary of the research output and through the collaboration of the City Government of Pasig and its Solid Waste Management Office (SWMO); the researcher successfully conducted the Electronic Waste Analysis and Characterization Study (E-WACS) to achieve the objectives. E-WACS that was conducted on April 2019 showed that E-waste ranked 4th which comprises the 10.39% of the overall solid waste volume. Out of 345, 127.24kg which is the total daily domestic waste generation in the city, E-waste covers 35,858.72kg. Moreover, an average of 40 grams was determined to be the E-waste generation per person per day. The top 5 E-waste categories were then classified after the analysis. The category which ranked first is the office and telecommunications equipment that contained the 63.18% of the total generated E-waste. Second in ranking was the household appliances category with 21.13% composition. Third was the lighting devices category with 8.17%. Fourth on ranking was the consumer electronics and batteries category which was composed of 5.97% and fifth was the wires and cables category where it comprised the 1.41% of the average generated E-waste samples. One of the recommendations provided in this research is the implementation of the Pasig City Waste Advantage Card. The card can be used as a privilege card and earned points can be converted to avail of and enjoy services such as haircut, massage, dental services, medical check-up, and etc. Another recommendation raised is for the LGU to encourage a communication or dialogue with the technology and electronics manufacturers and distributors and international and local companies to plan the retrieval and disposal of the E-wastes in accordance with the Extended Producer Responsibility (EPR) policy where producers are given significant responsibilities for the treatment and disposal of post-consumer products.

Keywords: E-waste, E-WACS, E-waste characterization, electronic waste, electronic waste analysis

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996 The Display of Age-Period/Age-Cohort Mortality Trends Using 1-Year Intervals Reveals Period and Cohort Effects Coincident with Major Influenza A Events

Authors: Maria Ines Azambuja

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Graphic displays of Age-Period-Cohort (APC) mortality trends generally uses data aggregated within 5 or 10-year intervals. Technology allows one to increase the amount of processed data. Displaying occurrences by 1-year intervals is a logic first step in the direction of attaining higher quality landscapes of variations in temporal occurrences. Method: 1) Comparison of UK mortality trends plotted by 10-, 5- and 1-year intervals; 2) Comparison of UK and US mortality trends (period X age and cohort X age) displayed by 1-year intervals. Source: Mortality data (period, 1x1, males, 1933-1912) uploaded from the Human Mortality Database to Excel files, where Period X Age and Cohort X Age graphics were produced. The choice of transforming age-specific trends from calendar to birth-cohort years (cohort = period – age) (instead of using cohort 1x1 data available at the HMD resource) was taken to facilitate the comparison of age-specific trends when looking across calendar-years and birth-cohorts. Yearly live births, males, 1933 to 1912 (UK) were uploaded from the HFD. Influenza references are from the literature. Results: 1) The use of 1-year intervals unveiled previously unsuspected period, cohort and interacting period x cohort effects upon all-causes mortality. 2) The UK and US figures showed variations associated with particular calendar years (1936, 1940, 1951, 1957-68, 72) and, most surprisingly, with particular birth-cohorts (1889-90 in the US, and 1900, 1918-19, 1940-41 and 1946-47, in both countries. Also, the figures showed ups and downs in age-specific trends initiated at particular birth-cohorts (1900, 1918-19 and 1947-48) or a particular calendar-year (1968, 1972, 1977-78 in the US), variations at times restricted to just a range of ages (cohort x period interacting effects). Importantly, most of the identified “scars” (period and cohort) correlates with the record of occurrences of Influenza A epidemics since the late 19th Century. Conclusions: The use of 1-year intervals to describe APC mortality trends both increases the amount of information available, thus enhancing the opportunities for patterns’ recognition, and increases our capability of interpreting those patterns by describing trends across smaller intervals of time (period or birth-cohort). The US and the UK mortality landscapes share many but not all 'scars' and distortions suggested here to be associated with influenza epidemics. Different size-effects of wars are evident, both in mortality and in fertility. But it would also be realistic to suppose that the preponderant influenza A viruses circulating in UK and US at the beginning of the 20th Century might be different and the difference to have intergenerational long-term consequences. Compared with the live births trend (UK data), birth-cohort scars clearly depend on birth-cohort sizes relatives to neighbor ones, which, if causally associated with influenza, would result from influenza-related fetal outcomes/selection. Fetal selection could introduce continuing modifications on population patterns of immune-inflammatory phenotypes that might give rise to 'epidemic constitutions' favoring the occurrence of particular diseases. Comparative analysis of mortality landscapes may help us to straight our record of past circulation of Influenza viruses and document associations between influenza recycling and fertility changes.

Keywords: age-period-cohort trends, epidemic constitution, fertility, influenza, mortality

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