Search results for: human quality treatment

Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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Authors: Renuka G. Oka

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From chowks to streets to verandahs to courtyards; residential open spaces are very significantly placed in traditional urban neighborhoods of India. At various levels of intersection, the open spaces with their attributes like juxtaposition with the built fabric, scale, climate sensitivity and response, multi-functionality, etc. reflect and respond to the patterns of human interactions. Also, these spaces tend to be quite well utilized. On the other hand, it is a common specter to see an imbalanced utilization of open spaces in newly/recently planned residential clusters. This is maybe due to lack of activity generators around or wrong locations or excess provisions or improper incorporation of aforementioned design attributes. These casual observations suggest the necessity for a systematic study of current residential open spaces. The exploratory study thus attempts to draw lessons through a structured inspection of residential open spaces to understand the effective environment as revealed through their use patterns. Here, residential open spaces are considered in a wider sense to incorporate all the un-built fabric around. These thus, include both use spaces and access space. For the study, open spaces in ten exemplary housing clusters/societies built during the last ten years across India are studied. A threefold inquiry is attempted in this direction. The first relates to identifying and determining the effects of various physical functions like space organization, size, hierarchy, thermal and optical comfort, etc. on the performance of residential open spaces. The second part sets out to understand socio-cultural variations in values, lifestyle, and beliefs which determine activity choices and behavioral preferences of users for respective residential open spaces. The third inquiry further observes the application of these research findings to the design process to derive meaningful and qualitative design advice. However, the study also emphasizes to develop a suitable framework of analysis and to carve out appropriate methods and approaches to probe into these aspects of the inquiry. Given this emphasis, a considerable portion of the research details out the conceptual framework for the study. This framework is supported by an in-depth search of available literature. The findings are worked out for design solutions which integrate the open space systems with the overall design process for residential clusters. The open spaces in residential areas present great complexities both in terms of their use patterns and determinants of their functional responses. The broad aim of the study is, therefore, to arrive at reconsideration of standards and qualitative parameters used by designers – on the basis of more substantial inquiry into the use patterns of open spaces in residential areas.

Keywords: open spaces, physical and social determinants, residential clusters, use patterns

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Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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Authors: Mahboobe Daneshvar

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Introduction: Clinical studies on the effect of systemic conditions on periodontal diseases have shown that some systemic deficiencies may provide grounds for the onset of periodontal diseases. One of these systemic problems is osteoporosis, which may be a risk factor for the onset and exacerbation of periodontitis. This study tends to evaluate periodontal indices in osteoporotic menopausal women and compare them with healthy controls. Materials and Methods: In this case-control study, participants included 45-75-year-old menopausal women referred to rheumatology wards of the Khatamolanbia Clinic and Shahid Sadoughi Hospital in Yazd; Their bone density was determined by DEXA-scan and by imaging the femoral-lumbar bone. Thirty patients with osteoporosis and 30 subjects with normal BMD were selected. Then, informed consent was obtained for participation in the study. During the clinical examinations, tooth loss (TL), plaque index (PI), gingival recession, pocket probing depth (PPD), clinical attachment loss (CAL), and tooth mobility (TM) were measured to evaluate the periodontal status. These clinical examinations were performed to determine the periodontal status by catheter, mirror and probe. Results: During the evaluation, there was no significant difference in PPD, PI, TM, gingival recession, and CAL between case and control groups (P-value>0.05); that is, osteoporosis has no effect on the above factors. These periodontal factors are almost the same in both healthy and patient groups. In the case of missing teeth, the following results were obtained: the mean of missing teeth was 22.173% of the total teeth in the case group and 18.583% of the total teeth in the control group. In the study of the missing teeth in the case and control groups, there was a significant relationship between case and control groups (P-value = 0.025). Conclusion: In fact, since periodontal disease is multifactorial and microbial plaque is the main cause, osteoporosis is considered a predisposing factor in exacerbation or persistence of periodontal disease. In patients with osteoporosis, usually pathological fractures, hormonal changes, and aging lead to reduced physical activity and affect oral health, which leads to the manifestation of periodontal disease. But this disease increases tooth loss by changing the shape and structure of bone trabeculae and weakening them. Osteoporosis does not seem to be a deterministic factor in the incidence of periodontal disease, since it affects bone quality rather than bone quantity.

Keywords: plaque index, Osteoporosis, tooth mobility, periodontal packet

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Authors: Xuan Li, Weian Huang, Jinsheng Sun, Fuhao Zhao, Zhiyuan Wang, Jintang Wang

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Natural gas hydrates (NGHs) as promising alternative energy sources have gained increasing attention. Hydrate-bearing formation in marine areas is highly unconsolidated formation and is fragile, which is composed of weakly cemented sand-clay and silty sediments. During the drilling process, the invasion of drilling fluid can easily lead to excessive water content in the formation. It will change the soil liquid plastic limit index, which significantly affects the formation quality, leading to wellbore instability due to the metastable character of hydrate-bearing sediments. Therefore, controlling the filtrate loss into the formation in the drilling process has to be highly regarded for protecting the stability of the wellbore. In this study, the temperature-sensitive nanogel of P(NIPAM-co-AMPS-co-tBA) was prepared by soap-free emulsion polymerization, and the temperature-sensitive behavior was employed to achieve self-adaptive plugging in hydrate sediments. First, the effects of additional amounts of AMPS, tBA, and cross-linker MBA on the microgel synthesis process and temperature-sensitive behaviors were investigated. Results showed that, as a reactive emulsifier, AMPS can not only participate in the polymerization reaction but also act as an emulsifier to stabilize micelles and enhance the stability of nanoparticles. The volume phase transition temperature (VPTT) of nanogels gradually decreased with the increase of the contents of hydrophobic monomer tBA. An increase in the content of the cross-linking agent MBA can lead to a rise in the coagulum content and instability of the emulsion. The plugging performance of nanogel was evaluated in a core sample with a pore size distribution range of 100-1000nm. The temperature-sensitive nanogel can effectively improve the microfiltration performance of drilling fluid. Since a combination of a series of nanogels could have a wide particle size distribution at any temperature, around 200nm to 800nm, the self-adaptive plugging capacity of nanogels for the hydrate sediments was revealed. Thermosensitive nanogel is a potential intelligent plugging material for drilling operations in natural gas hydrate-bearing sediments.

Keywords: temperature-sensitive nanogel, NIPAM, self-adaptive plugging performance, drilling operations, hydrate-bearing sediments

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Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

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We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Hesam Gholami

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Elevated suspended sediment loads in riverine systems resulting from accelerated erosion due to human activities are a serious threat to the sustainable management of watersheds and ecosystem services therein worldwide. Therefore, mitigation of deleterious sediment effects as a distributed or non-point pollution source in the catchments requires reliable provenance information. Sediment tracing or sediment fingerprinting, as a combined process consisting of sampling, laboratory measurements, different statistical tests, and the application of mixing or unmixing models, is a useful technique for discriminating the sources of sediments. From 1996 to the present, different aspects of this technique, such as grouping the sources (spatial and individual sources), discriminating the potential sources by different statistical techniques, and modification of mixing and unmixing models, have been introduced and modified by many researchers worldwide, and have been applied to identify the provenance of fine materials in agricultural, rural, mountainous, and coastal catchments, and in large catchments with numerous lakes and reservoirs. In the last two decades, efforts exploring the uncertainties associated with sediment fingerprinting results have attracted increasing attention. The frameworks used to quantify the uncertainty associated with fingerprinting estimates can be divided into three groups comprising Monte Carlo simulation, Bayesian approaches and generalized likelihood uncertainty estimation (GLUE). Given the above background, the primary goal of this study was to apply geochemical fingerprinting within the GLUE framework in the estimation of sub-basin spatial sediment source contributions in the arid Mehran River catchment in southern Iran, which drains into the Persian Gulf. The accuracy of GLUE predictions generated using four different sets of statistical tests for discriminating three sub-basin spatial sources was evaluated using 10 virtual sediments (VS) samples with known source contributions using the root mean square error (RMSE) and mean absolute error (MAE). Based on the results, the contributions modeled by GLUE for the western, central and eastern sub-basins are 1-42% (overall mean 20%), 0.5-30% (overall mean 12%) and 55-84% (overall mean 68%), respectively. According to the mean absolute fit (MAF; ≥ 95% for all target sediment samples) and goodness-of-fit (GOF; ≥ 99% for all samples), our suggested modeling approach is an accurate technique to quantify the source of sediments in the catchments. Overall, the estimated source proportions can help watershed engineers plan the targeting of conservation programs for soil and water resources.

Keywords: sediment source tracing, generalized likelihood uncertainty estimation, virtual sediment mixtures, Iran

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Authors: Pauline Cuenin, Marcelo Leles Romarco Oliveira

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Based on their localities and following their ecological rationality, family-based farmers have experimented, adapted and innovated to improve their production systems continuously for millennia. With the technological package transfer processes of the so-called Green Revolution for agricultural holdings, farmers have become increasingly dependent on ready-made "recipes" built from so-called "universal" and global knowledge to face the problems that emerge in the management of local agroecosystems, thus reducing their creative and experiential capacities. However, the production of novelties within farms is fundamental to the transition to more sustainable agro food systems. In fact, as the fruits of local knowledge and / or the contextualization of exogenous knowledge, novelties are seen as seeds of transition. By presenting new techniques, new organizational forms and epistemological approaches, agroecology was pointed out as a way to encourage and promote the creative capacity of farmers. From this perspective, this theoretical work aims to analyze how agroecology encourages the innovative capacity of farmers, and in general, the production of novelties. For this, an analysis was made of the theoretical and methodological bases of agroecology through a literature review, specifically looking for the way in which it articulates the local with the global, complemented by an analysis of agro ecological Brazilian experiences. It was emphasized that, based on the peasant way of doing agriculture, that is, on ecological / social co-evolution or still called co-production (interaction between human beings and living nature), agroecology recognizes and revalues peasant involves the deep interactions of the farmer with his site (bio-physical and social). As a "place science," practice and movement, it specifically takes into consideration the local and empirical knowledge of farmers, which allows questioning and modifying the paradigms that underpin the current agriculture that have disintegrated farmers' creative processes. In addition to upgrade the local, agroecology allows the dialogue of local knowledge with global knowledge, essential in the process of changes to get out of the dominant logic of thought and give shape to new experiences. In order to reach this articulation, agroecology involves new methodological focuses seeking participatory methods of study and intervention that express themselves in the form of horizontal spaces of socialization and collective learning that involve several actors with different knowledge. These processes promoted by agroecology favor the production of novelties at local levels for expansion at other levels, such as the global, through trans local agro ecological networks.

Keywords: agroecology, creativity, global, local, novelty

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Authors: Natasha Gabriella, Josef-Peter Schöggl, Alfred Posch

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Being a mature industry, pulp and paper industry (PPI) possess strength points coming from its existing infrastructure, technology know-how, and abundant availability of biomass. However, the declining trend of the wood-based products sales sends a clear signal to the industry to transform its business model in order to increase its profitability. With the emerging global attention on bio-based economy and circular economy, coupled with the low price of fossil feedstock, the PPI starts to integrate biorefinery as a value-added business model to keep the industry’s competitiveness. Nonetheless, biorefinery as an innovation exposes the PPI with some barriers, of which the uncertainty of the promising product becomes one of the major hurdles. This study aims to assess factors that affect the diffusion and development of forest biorefinery in the PPI, including drivers, barriers, advantages, disadvantages, as well as the most promising bio-based products of forest biorefinery. The study examines the identified factors according to the layer of business environment, being the macro-environment, industry, and strategic group level. Besides, an overview of future state of the identified factors is elaborated as to map necessary improvements for implementing forest biorefinery. A two-phase Delphi method is used to collect the empirical data for the study, comprising of an online-based survey and interviews. Delphi method is an effective communication tools to elicit ideas from a group of experts to further reach a consensus of forecasting future trends. Collaborating a total of 50 experts in the panel, the study reveals that influential factors are found in every layers of business of the PPI. The politic dimension is apparent to have a significant influence for tackling the economy barrier while reinforcing the environmental and social benefits in the macro-environment. In the industry level, the biomass availability appears to be a strength point of the PPI while the knowledge gap on technology and market seem to be barriers. Consequently, cooperation with academia and the chemical industry has to be improved. Human resources issue is indicated as one important premise behind the preceding barrier, along with the indication of the PPI’s resistance towards biorefinery implementation as an innovation. Further, cellulose-based products are acknowledged for near-term product development whereas lignin-based products are emphasized to gain importance in the long-term future.

Keywords: forest biorefinery, pulp and paper, bio-based product, Delphi method

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Authors: Samaneh Mashayekhi

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Cream (whipped cream) is one of the dairy products that can be used in desserts, pastries, cakes, and ice creams. In this product, some parameters such as taste and flavor, quality stability, whipping ability, and stability of foam after whipping are very important. The objective of this study is applicable of Farsi gum and sodium caseinate in 3 biopolymer ratios (1:1, 1:2, and 2:1) and 0.15, 0.30, and 0.45 %wt. concentrations in whipped cream formulation. Sample without hydrocolloids was considered as a control. Before whipping, viscosity of all creams was increased continuously with increasing shear rate. In addition, the viscosity was increased with the increasing hydrocolloids addition (in constant shear rate). Microscopic observations showed that polydispersity of systems before whipping. Overrun of F, FC11, and FC21 samples were increased (with increasing total hydrocollid concentration 0.15 to 0.30 % wt.); then decreased this parameter with increasing to 0.45 % wt. concentration. However, mean comparison of FC12 samples overrun showed that this value was increased with increasing total hydrocolloids concentration. 0.45FC21 sample had significantly (P<0.05) highest overrun (118.44±9.11). Synersis of whipped cream samples are reduced with hydrocolloid addition. B sample had significantly (P<0.05) highest serum separation (16.66±0.80%), and 0.45FC12 had a low one (5.94±0.19%) in compered with others synersis. Mean comparison of hardness and adhesiveness of whipped cream revealed that Farsi gum addition alone and in combination with sodium caseinate increased the previous textural characteristics. Results exhibited that 0.4FG12 had significantly (P<0.05) highest hardness (267.00±18.38 g).Mean comparison of droplet size of cream sample before whipping displaced that hydrocolloid addition had no significant effect (P>0.05), and mean droplet size of the samples ranged between 1.93-2.16 µm. Generally, the mean droplet size of whipped cream increased after whipping with increasing hydrocolloid concentration (0.15-0.45 % wt.). Color parameter analysis showed that Farsi gum addition alone and in combination with sodium caseinate had no significant effect (P>0.05) on these parameters (Lightness, Redness, and Yellowness). Based on sensory evaluation results, appearance, color, flavor, and taste of whipped creams not influenced by hydrocolloids addition; but 0.45FC12 sample had higher value. Based on the above results, Farsi gum had suggested to potential application in a whipped cream formulation; however, further research need to foundingof their functionality.

Keywords: whipped cream, farsi gum, sodium caseinate, overrun, droplet size, texture analysis, sensory evaluation

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Authors: Ombir Singh

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In spite of the religious and cultural pre-dominance of the river Ganga in the Indian ethos, fragmentation and degradation of the river continued down the ages. Recognizing the national concern on environmental degradation of the river and its basin, Ministry of Water Resources, River Development & Ganga Rejuvenation (MoWR,RD&GR), Government of India has initiated a number of pilot schemes for the rejuvenation of river Ganga under the ‘Namami Gange’ Programme. Considering the diversity, complexity, and intricacies of forest ecosystems and pivotal multiple functions performed by them and their inter-connectedness with highly dynamic river ecosystems, forestry interventions all along the river Ganga from its origin at Gaumukh, Uttarakhand to its mouth at Ganga Sagar, West Bengal has been planned by the ministry. For that Forest Research Institute (FRI) in collaboration with National Mission for Clean Ganga (NMCG) has prepared a Detailed Project Report (DPR) on Forestry Interventions for Ganga. The Institute has adopted an extensive consultative process at the national and state levels involving various stakeholders relevant in the context of river Ganga and employed a science-based methodology including use of remote sensing and GIS technologies for geo-spatial analysis, modeling and prioritization of sites for proposed forestation and conservation interventions. Four sets of field data formats were designed to obtain the field based information for forestry interventions, mainly plantations and conservation measures along the river course. In response, five stakeholder State Forest Departments had submitted more than 8,000 data sheets to the Institute. In order to analyze a voluminous field data received from five participating states, the Institute also developed a software to collate, analyze and generation of reports on proposed sites in Ganga basin. FRI has developed potential plantation and treatment models for the proposed forestry and other conservation measures in major three types of landscape components visualized in the Ganga riverscape. These are: (i) Natural, (ii) Agriculture, and (iii) Urban Landscapes. Suggested plantation models broadly varied for the Uttarakhand Himalayas and the Ganga Plains in five participating states. Besides extensive plantations in three type of landscapes within the riverscape, various conservation measures such as soil and water conservation, riparian wildlife management, wetland management, bioremediation and bio-filtration and supporting activities such as policy and law intervention, concurrent research, monitoring and evaluation, and mass awareness campaigns have been envisioned in the DPR. The DPR also incorporates the details of the implementation mechanism, budget provisioned for different components of the project besides allocation of budget state-wise to five implementing agencies, national partner organizations and the Nodal Ministry.

Keywords: conservation, Ganga, river, water, forestry interventions

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Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: water and sanitation, emergency response, education and training, building resilience

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Authors: Sabyasachi Mukhopadhyay, Joseph Ogutu, Gundula Bartzke, Hans-Peter Piepho

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Rainfall is a critical component of climate governing vegetation growth and production, forage availability and quality for herbivores. However, reliable rainfall measurements are not always available, making it necessary to predict rainfall values for particular locations through time. Predicting rainfall in space and time can be a complex and challenging task, especially where the rain gauge network is sparse and measurements are not recorded consistently for all rain gauges, leading to many missing values. Here, we develop a flexible Bayesian model for predicting rainfall in space and time and apply it to Narok County, situated in southwestern Kenya, using data collected at 23 rain gauges from 1965 to 2015. Narok County encompasses the Maasai Mara ecosystem, the northern-most section of the Mara-Serengeti ecosystem, famous for its diverse and abundant large mammal populations and spectacular migration of enormous herds of wildebeest, zebra and Thomson's gazelle. The model incorporates geographical and meteorological predictor variables, including elevation, distance to Lake Victoria and minimum temperature. We assess the efficiency of the model by comparing it empirically with the established Gaussian process, Kriging, simple linear and Bayesian linear models. We use the model to predict total monthly rainfall and its standard error for all 5 * 5 km grid cells in Narok County. Using the Monte Carlo integration method, we estimate seasonal and annual rainfall and their standard errors for 29 sub-regions in Narok. Finally, we use the predicted rainfall to predict large herbivore biomass in the Maasai Mara ecosystem on a 5 * 5 km grid for both the wet and dry seasons. We show that herbivore biomass increases with rainfall in both seasons. The model can handle data from a sparse network of observations with many missing values and performs at least as well as or better than four established and widely used models, on the Narok data set. The model produces rainfall predictions consistent with expectation and in good agreement with the blended station and satellite rainfall values. The predictions are precise enough for most practical purposes. The model is very general and applicable to other variables besides rainfall.

Keywords: non-stationary covariance function, gaussian process, ungulate biomass, MCMC, maasai mara ecosystem

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Authors: D. S. N. K. Liyanagamage, V. Karunaratne, A. P. Attanayake, S. Jayasinghe

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Diabetes mellitus is an ever increasing global health problem which causes disability and untimely death. Current treatments using synthetic drugs have caused numerous adverse effects as well as complications, leading research efforts in search of safe and effective alternative treatments for diabetes mellitus. Even though there are traditional Ayurvedic remedies which are effective, due to a lack of scientific exploration, they have not been proven to be beneficial for common use. Hence the aim of this study is to evaluate the traditional remedy made of mixture of plant components, namely leaves of Murraya koenigii L. Spreng (Rutaceae), cloves of Allium sativum L. (Amaryllidaceae), fruits of Garcinia queasita Pierre (Clusiaceae) and seeds of Piper nigrum L. (Piperaceae) used for the treatment of diabetes. We report herein the preliminary results for the in vivo study of the anti-hyperglycaemic activity of the extracts of the above plant mixture in Wistar rats. A mixture made out of equal weights (100 g) of the above mentioned medicinal plant parts were extracted into cold water, hot water (3 h reflux) and water: acetone mixture (1:1) separately. Male wistar rats were divided into six groups that received different treatments. Diabetes mellitus was induced by intraperitoneal administration of streptozotocin at a dose of 70 mg/ kg in male Wistar rats in group two, three, four, five and six. Group one (N=6) served as the healthy untreated and group two (N=6) served as diabetic untreated control and both groups received distilled water. Cold water, hot water, and water: acetone plant extracts were orally administered in diabetic rats in groups three, four and five, respectively at different doses of 0.5 g/kg (n=6), 1.0 g/kg(n=6) and 1.5 g/kg(n=6) for each group. Glibenclamide (0.5 mg/kg) was administered to diabetic rats in group six (N=6) served as the positive control. The acute anti-hyperglycemic effect was evaluated over a four hour period using the total area under the curve (TAUC) method. The results of the test group of rats were compared with the diabetic untreated control. The TAUC of healthy and diabetic rats were 23.16 ±2.5 mmol/L.h and 58.31±3.0 mmol/L.h, respectively. A significant dose dependent improvement in acute anti-hyperglycaemic activity was observed in water: acetone extract (25%), hot water extract ( 20 %), and cold water extract (15 %) compared to the diabetic untreated control rats in terms of glucose tolerance (P < 0.05). Therefore, the results suggest that the plant mixture has a potent antihyperglycemic effect and thus validating their used in Ayurvedic medicine for the management of diabetes mellitus. Future studies will be focused on the determination of the long term in vivo anti-diabetic mechanisms and isolation of bioactive compounds responsible for the anti-diabetic activity.

Keywords: acute antihyperglycemic activity, herbal mixture, oral glucose tolerance test, Sri Lankan medicinal plant extracts

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Authors: Nadezhda Kvatashidze, Elena Kharabadze

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It is broadly known that lease is a flexible means of funding enterprises. Lease reduces the risk related to access and possession of assets, as well as obtainment of funding. Therefore, it is important to refine lease accounting. The lease accounting regulations under the applicable standard (International Accounting Standards 17) make concealment of liabilities possible. As a result, the information users get inaccurate and incomprehensive information and have to resort to an additional assessment of the off-balance sheet lease liabilities. In order to address the problem, the International Financial Reporting Standards Board decided to change the approach to lease accounting. With the deficiencies of the applicable standard taken into account, the new standard (IFRS 16 ‘Leases’) aims at supplying appropriate and fair lease-related information to the users. Save certain exclusions; the lessee is obliged to recognize all the lease agreements in its financial report. The approach was determined by the fact that under the lease agreement, rights and obligations arise by way of assets and liabilities. Immediately upon conclusion of the lease agreement, the lessee takes an asset into its disposal and assumes the obligation to effect the lease-related payments in order to meet the recognition criteria defined by the Conceptual Framework for Financial Reporting. The payments are to be entered into the financial report. The new lease accounting standard secures supply of quality and comparable information to the financial information users. The International Accounting Standards Board and the US Financial Accounting Standards Board jointly developed IFRS 15: ‘Revenue from Contracts with Customers’. The standard allows the establishment of detailed revenue recognition practical criteria such as identification of the performance obligations in the contract, determination of the transaction price and its components, especially price variable considerations and other important components, as well as passage of control over the asset to the customer. IFRS 15: ‘Revenue from Contracts with Customers’ is very similar to the relevant US standards and includes requirements more specific and consistent than those of the standards in place. The new standard is going to change the recognition terms and techniques in the industries, such as construction, telecommunications (mobile and cable networks), licensing (media, science, franchising), real property, software etc.

Keywords: assessment of the lease assets and liabilities, contractual liability, division of contract, identification of contracts, contract price, lease identification, lease liabilities, off-balance sheet, transaction value

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Authors: Huixia Shi, Can Hu, Jun Zhu, Hongling Guo, Haiyan Li, Hongyan Du

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The identification of human body fluids during forensic investigations is a critical step to determine key details, and present strong evidence to testify criminal in a case. With the popularity of DNA and improved detection technology, the potential question must be revolved that whether the suspect’s DNA derived from saliva or semen, menstrual or peripheral blood, how to identify the red substance or aged blood traces on the spot is blood; How to determine who contribute the right one in mixed stains. In recent years, molecular approaches have been developing increasingly on mRNA, miRNA, DNA methylation and microbial markers, but appear expensive, time-consuming, and destructive disadvantages. Physicochemical methods are utilized frequently such us scanning electron microscopy/energy spectroscopy and X-ray fluorescence and so on, but results only showing one or two characteristics of body fluid itself and that out of working in unknown or mixed body fluid stains. This paper focuses on using chemistry methods Raman spectroscopy and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to discriminate species of peripheral blood, menstrual blood, semen, saliva, vaginal secretions, urine or sweat. Firstly, non-destructive, confirmatory, convenient and fast Raman spectroscopy method combined with more accurate matrix-assisted laser desorption/ionization time-of-flight mass spectrometry method can totally distinguish one from other body fluids. Secondly, 11 spectral signatures and specific metabolic molecules have been obtained by analysis results after 70 samples detected. Thirdly, Raman results showed peripheral and menstrual blood, saliva and vaginal have highly similar spectroscopic features. Advanced statistical analysis of the multiple Raman spectra must be requested to classify one to another. On the other hand, it seems that the lactic acid can differentiate peripheral and menstrual blood detected by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, but that is not a specific metabolic molecule, more sensitivity ones will be analyzed in a forward study. These results demonstrate the great potential of the developed chemistry methods for forensic applications, although more work is needed for method validation.

Keywords: body fluids, identification, Raman spectroscopy, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry

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Authors: Nan Wu, Peng Liu

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As a morphological element reflecting the land property rights structure, the plot pattern plays a crucial role in shaping the form and quality of the built environment. Therefore, it is one of the core control elements of urban regeneration. As China's urban development mode is shifting from growth-based development to urban regeneration, it is urgent to explore a more refined way for the planning control of the plot pattern, which further promotes the optimization of urban form and land property structure. European and American countries such as Germany and the United States began to deal with the planning control of plot patterns in urban regeneration earlier and established relatively mature methods and mechanisms. Therefore, this paper summarizes two typical scenarios of plot pattern regeneration in old cities in China: the first one is "limited scale plot pattern rezoning", which mainly deals with the regeneration scenario of tearing down the old and building the new, and the focus of its control is to establish an adaptive plot pattern rezoning methodology and mechanism; The second is "localized parcel regeneration under the existing property rights," which mainly deals with the renewal scenario of alteration and addition, and its control focuses on the establishment of control rules for individual plot regeneration. For the two typical plot pattern regeneration scenarios, Germany (Berlin) and the United States (New York) are selected as two international cases with reference significance, and the framework of plot pattern form and property rights control elements of urban regeneration is established from four latitudes, namely, the overall operation mode, form control methods, property rights control methods, and effective implementation prerequisites, so as to compare and analyze the plot pattern control methods of the two countries under different land systems and regeneration backgrounds. Among them, the German construction planning system has formed a more complete technical methodology for block-scale rezoning, and together with the overall urban design, it has created a practical example in the critical redevelopment of the inner city of Berlin. In the United States (New York), the zoning method establishes fine zoning regulations and rules for adjusting development rights based on the morphological indicators plots so as to realize effective control over the regeneration of local plots under the existing property rights pattern. On the basis of summarizing the international experience, we put forward the proposal of plot pattern and property rights control for the organic regeneration of old cities in China.

Keywords: plot pattern, urban regeneration, urban morphology, property rights, regulatory planning

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Authors: Olivine Lo

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Small- and Medium-Sized Enterprises (SMEs) consist of a broad variety of businesses, ranging from small grocery shops to manufacturing concerns. Some are dynamic and innovative, while others are more traditional. The definition of SMEs varies by country but is most determined by the number of employees, though business assets and sales revenues are alternative measures. There are eight main types of SME industries in Hong Kong: garment, electronics, plastics, metal and machinery, trading and logistics, building, manufacturing, and service industries. Information exchange is a key goal of human communication, and communicators have used a variety of media to maintain relationships through traditional face-to-face interactions and written forms like letters and faxes. With the advancement of mediated-interpersonal communication media from telephone to synchronic online tools like email, instant messaging, voice messaging, and video conferencing for sustaining relationships, particularly enabling geographically distanced relationships. Although these synchronous tools are gaining popularity, they are facilitating relationship maintenance in everyday life and complementing rather than replacing the more conventional face-to-face interactions. This study will test if there are any variances in effects by industry type among Hong Kong SMEs. The competitiveness of the business environment refers to the competition faced by a business within its particular industry. The more intense the competition in a given sector, the greater the potential for strategic uses of specific needs in a business. Both internal organization characteristics and external environments may affect firm performance and financial resources. The level of competitiveness within an industry will be a more reliable indicator to show how Hong Kong SMEs are striving to achieve their business goals using different techniques in their communication media preferences, rather than mere classification by industry type. This study thus divides the competitiveness of the business environment into internal and external: (1) the internal environment competition is the inherent competitiveness of the products or services provided by the SMEs, whereas (2) the external environment competition includes the economic and political realities and competitors joining the market. This study will test various organizational characteristics and competitiveness of the business environment to predict entrepreneurs’ communication media preferences.

Keywords: competitiveness of business environment, small- and medium-sized enterprises, organizational characteristics, communication media preference

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: Nur Hidayah Iwani Mohd Kamal

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The higher education institutions in Malaysia is challenged with a more socially and culturally diverse student population than ever before, especially with the increasing number of international students studying in Malaysia in the recent years. First year university is a critical time in students’ lives. Students are not only developing intelectually, they are also establishing and maintaining personal relationships, developing an identity, deciding about career and lifestyle, maintaining personal health and wellness, and developing an integrated philosohy of life. The higher education institutions work as a diverse community of learners to provide a supportive environment for these first year students in assisting them in their transition from high school to university. Although many universities are taking steps to improve the first year experience for their new local and international students, efforts must be taken to ensure organized and coordinated manner in order for the initiatives to be successful. The objectives of the study are to examine the international students’ perceptions and interpretation of their first year experiences in shaping and determining their attitudes toward study and the quality of their entire undergraduate academic career; and identify an appropriate mechanism to encounter the international students’ adjustment in the new environment in order to facilitate cross-functional communication and create a coherent and meaningful first year experience. A key construct in this study is that if universities wish to recruiting and retaining international students, it is their ethical responsibility to determine how they can best meet their needs at the academic and social level, create a supportive ‘learning community’ as a foundation of their educational experience, hence facilitate cross-cultural communication and create a coherent and meaningful first year experience. This study is simultaneously frames in relation to focus on the factors that influence a successful and satisfying transition to university life by the first year international students. The study employs a mixed-method data collection involving semi-structured interviews, questionnaire, classroom observation and document analysis. This study provides valuable insight into the struggles that many international students face as they attempt to make the adjustment not only to a new educational system but factors such as psychosocial and cultural problems. It would discuss some of the factors that impact the international students during their first year in university in their quest to be academically successful. It concludes with some recommendations on how Malaysian universities provide these students with a good first year experience based on some the best practices of universities around the world.

Keywords: first year experience, Malaysian universities, international students, education

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Authors: Aime P. Lampad-Dela Pena, Rhodora V. Azanza, Cesar L. Villanoy, Ephrime B. Metillo, Aletta T. Yniguez

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Phytoplankton community changes in relation to environmental parameters were compared between and within, the three interconnected basins. Phytoplankton samples were collected from thirteen stations of Baler Bay and Casiguran Sound, Aurora last May 2013 by filtering 10 L buckets of surface water and 5 L Niskin samples at 20 meters and at 30 to 40 meters depths through a 20um sieve. Duplicate samples per station were preserved, counted, and identified up to genus level, in order to determine the horizontal and vertical spatial variation of different phytoplankton functional groups during the summer ebb and flood flow. Baler Bay, Outer and Inner Casiguran Sound had a total of 89 genera from four phytoplankton groups: Diatom (62), Dinoflagellate (25), Silicoflagellate (1) and Cyanobacteria (1). Non-toxic diatom Chaetoceros spp. bloom (averaged 2.0 x 105 to 2.73 x 106 cells L⁻¹) co-existed with Bacteriastrum spp. at surface waters in Inner and Outer Casiguran. Pseudonitzschia spp. (1.73 x 106 cells L⁻¹) bloomed at bottom waters of the innermost embayment near Casiguran mangrove estuary. Cyanobacteria Trichodesmium spp. significantly increased during ebb tide at the mid-water layers (20 meters depth) in the three basins (ranged from 6, 900 to 15, 125 filaments L⁻¹), forming another bloom. Gonyaulax spp. - dominated dinoflagellate did not significantly change with depth across the three basins. Overall, diatoms and dinoflagellates community assemblages significantly changed between sites (p < 0.001) while diatoms and cyanobacteria varied within Casiguran outer and inner sites (p < 0.001) only. Tidal fluctuations significantly affected dinoflagellates and diatom groups (p < 0.001) in inner and baler sites. Chlorophyll significantly varied between (KW, p < 0.001) and within each basins (KW, p < 0.05), no tidal influence, with the highest value at inner Casiguran and at deeper waters indicating deep chlorophyll maxima. Aurora’s distinct shelf morphology favoring counterclockwise circulation pattern, advective transport, and continuous stratification of the water column could basically affect the phytoplankton assemblages and water quality of Baler Bay and Casiguran inner and outer basins. Observed spatial phytoplankton community changes with multi-species diatom and cyanobacteria bloom at different water layers of the three inter-connected embayments would be vital for any environmental management initiatives in Aurora.

Keywords: aurora fronting Philippines Rise, intermonsoon, multi-species diatom bloom, spatial variability

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Authors: Yasser O. Abualnaja1, Alexandra Pavlidou2, Taha Boksmati3, Ahmad Alharbi3, Hammad Alsulmi3, Saleh Omar Maghrabi3, Hassan Mowalad3, Rayan Mutwalli3, James H. Churchill4, Afroditi Androni2, Dionysios Ballas2, Ioannis Hatzianestis2, Harilaos Kontoyiannis2, Angeliki Konstantinopoulou2, Georgios Krokkos1, 5, Georgios Pappas2, Vassilis P. Papadopoulos2, Konstantinos Parinos2, Elvira Plakidi2, Eleni Rousselaki2, Dimitris Velaoras2, Panagiota Zachioti2, Theodore Zoulias2, Ibrahim Hoteit5.

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The coastal areas along the Kingdom of Saudi Arabia on both the Red Sea and Arabian Gulf have been witnessing in the past decades an unprecedented economic growth and a rapid increase in anthropogenic activities. Therefore, the Saudi Arabian government has decided to frame a strategy for sustainable development of the coastal and marine environments, which comes in the context of the Vision 2030, aimed at providing the first comprehensive ‘Status Quo Assessment’ of the Kingdom’s coastal and marine environments. This strategy will serve as a baseline assessment for future monitoring activities; this baseline is relied on scientific evidence of the drivers, pressures, and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressures of the hotspots analysis, which was developed following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. Ten hotspot sites were identified, eight in the Red Sea and two in the Arabian Gulf. Thus, multidisciplinary research cruises were conducted throughout the Red Sea and the Arabian Gulf coastal and marine environments in June/July 2021 and September 2021, respectively, in order to understand the relative impact of hydrography and the various pressures on the quality of seawater and sediments. The main objective was to record the physical and biogeochemical parameters along the coastal waters of the Kingdom, tracing the dispersion of contaminants related to specific pressures. The assessment revealed the effect of hydrography on the trophic status of the southern marine coastal areas of the Red Sea. Jeddah Lagoon system seems to face significant eutrophication and pollution challenges, whereas sediments are enriched in some heavy metals in many areas of the Red Sea and the Arabian Gulf. This multidisciplinary research in the Red Sea and the Arabian Gulf coastal waters will pave the way for future detailed environmental monitoring strategies for the Saudi Arabian marine environment.

Keywords: arabian gulf, contaminants, hotspot, red sea

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Authors: Charles Ruffner, Michael Manton, Gintautas Kibirkstis, Gediminas Brazaitas, Vitas Marozas, Ekaterine Makrickiene, Rutile Pukiene, Per Angelstam

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In dynamic boreal forests, fire is an important natural disturbance, which drives regeneration and mortality of living and dead trees, and thus successional trajectories. However, current forest management practices focusing on wood production only have effectively eliminated fire as a stand-level disturbance. While this is generally well studied across much of Europe, in Lithuania, little is known about the historic fire regime and the role fire plays as a management tool towards the sustainable management of future landscapes. Focusing on Scots pine forests, we explore; i) the relevance of fire disturbance regimes on forestlands of Lithuania; ii) fire occurrence in the Dzukija landscape for dry upland and peatland forest sites, and iii) correlate tree-ring data with climate variables to ascertain climatic influences on growth and fire occurrence. We sampled and cross-dated 132 Scots pine samples with fire scars from 4 dry pine forest stands and 4 peatland forest stands, respectively. The fire history of each sample was analyzed using standard dendrochronological methods and presented in FHAES format. Analyses of soil moisture and nutrient conditions revealed a strong probability of finding forests that have a high fire frequency in Scots pine forests (59%), which cover 34.5% of Lithuania’s current forestland. The fire history analysis revealed 455 fire scars and 213 fire events during the period 1742-2019. Within the Dzukija landscape, the mean fire interval was 4.3 years for the dry Scots pine forest and 8.7 years for the peatland Scots pine forest. However, our comparison of fire frequency before and after 1950 shows a marked decrease in mean fire interval. Our data suggest that hemi-boreal forest landscapes of Lithuania provide strong evidence that fire, both human and lightning-ignited fires, has been and should be a natural phenomenon and that the examination of biological archives can be used to guide sustainable forest management into the future. Currently, fire use is prohibited by law as a tool for forest management in Lithuania. We recommend introducing trials that use low-intensity prescribed burning of Scots pine stands as a regeneration tool towards mimicking natural forest disturbance regimes.

Keywords: biodiversity conservation, cultural burning, dendrochronology, forest dynamics, forest management, succession

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Authors: Ying Shi, June Zhang, Lu Shao, Xiyan Xie, Aidi Lao, Zhangan Wang

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Background: Low levels of physical activity are associated with poorer health outcomes, and this situation is more critical in older adults living in long‐term care facilities. Objectives: To systematically identify, appraise, and synthesize current qualitative research evidence regarding the barriers and facilitators to physical activity as reported by older adults and care staff in long‐term care facilities. Design: This is a systematic review with qualitative evidence synthesis adhering to PRISMA guidelines. Methods: We conducted a systematic search on PubMed, Science Citation Index Expanded, Social Sciences Citation Index, EMBASE, CINAHL, and PsychInfo databases from inception until 30 June 2023. Thematic synthesis was undertaken to identify the barriers and facilitators relating to physical activity. Then, we mapped them onto the Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and confidence in review findings was assessed using the GRADE-CERQual approach. Results: We included 32 studies after screening 10496 citations and 177 full texts. Seven themes and 17 subthemes were identified relating to barriers and facilitators influencing physical activity in elderly residents. The main themes were mapped onto COM-B) model-Capability (physical activity knowledge gaps and individual health issues), Opportunity (social support and macro-level resources) and Motivation (health beliefs, fear of falling or injury, and personal and social incentives to physical activity). Most subthemes were graded as high (n = 9) or moderate (n = 3) confidence. Conclusions and Implications: Our comprehensive synthesis of 32 studies provides a wealth of knowledge of barriers and facilitators to physical activity from both residents and care staff’s perspectives. Intervention components were also suggested within the context of long‐term care facilities. End users such as older residents, care staff, and researchers can have confidence in our findings when formulating policies and guidance on promoting physical activity among elderly residents in long‐term care facilities.

Keywords: long‐term care, older adults, physical activity, qualitative, systematic review

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Authors: Aoxue Yang, Weili Tian, Haikun Liu

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Brain tumor stem cells (BTSCs) are resistant to therapy and give rise to recurrent tumors. These rare and elusive cells are likely to disseminate during cancer progression, and some may enter dormancy, remaining viable but not increasing. The identification of dormant BTSCs is thus necessary to design effective therapies for glioblastoma (GBM) patients. Glucocorticoids (GCs) are used to treat GBM-associated edema. However, glucocorticoids participate in the physiological response to psychosocial stress, linked to poor cancer prognosis. This raises concern that glucocorticoids affect the tumor and BTSCs. Identifying markers specifically expressed by brain tumor stem cells (BTSCs) may enable specific therapies that spare their regular tissue-resident counterparts. By ribosome profiling analysis, we have identified that glycerol-3-phosphate dehydrogenase 1 (GPD1) is expressed by dormant BTSCs but not by NSCs. Through different stress-induced experiments in vitro, we found that only dexamethasone (DEXA) can significantly increase the expression of GPD1 in NSCs. Adversely, mifepristone (MIFE) which is classified as glucocorticoid receptors antagonists, could decrease GPD1 protein level and weaken the proliferation and stemness in BTSCs. Furthermore, DEXA can induce GPD1 expression in tumor-bearing mice brains and shorten animal survival, whereas MIFE has a distinct adverse effect that prolonged mice lifespan. Knocking out GR in NSC can block the upregulation of GPD1 inducing by DEXA, and we find the specific sequences on GPD1 promotor combined with GR, thus improving the efficiency of GPD1 transcription from CHIP-Seq. Moreover, GR and GPD1 are highly co-stained on GBM sections obtained from patients and mice. All these findings confirmed that GR could regulate GPD1 and loss of GPD1 Impairs Multiple Pathways Important for BTSCs Maintenance GPD1 is also a critical enzyme regulating glycolysis and lipid synthesis. We observed that DEXA and MIFE could change the metabolic profiles of BTSCs by regulating GPD1 to shift the transition of cell dormancy. Our transcriptome and lipidomics analysis demonstrated that cell cycle signaling and phosphoglycerides synthesis pathways contributed a lot to the inhibition of GPD1 caused by MIFE. In conclusion, our findings raise concern that treatment of GBM with GCs may compromise the efficacy of chemotherapy and contribute to BTSC dormancy. Inhibition of GR can dramatically reduce GPD1 and extend the survival duration of GBM-bearing mice. The molecular link between GPD1 and GR may give us an attractive therapeutic target for glioblastoma.

Keywords: cancer stem cell, dormancy, glioblastoma, glycerol-3-phosphate dehydrogenase 1, glucocorticoid receptor, dexamethasone, RNA-sequencing, phosphoglycerides

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Authors: Elisabeth Mamani-Mategula

Abstract:

Background: Anaemia has significant consequences on both the mother and child's health as it results in maternal haemorrhage, low childbirth weight, premature delivery, poor organ development, and infections at birth and hence the need for treatment. In low-middle income countries, anaemic pregnant women are recommended to take 30 mg to 60 mg of elemental iron daily throughout pregnancy which are often poorly tolerated and adhered to. A potential alternative to oral iron is intravenous (IV) iron which allows the saturation of the body’s iron stores quickly. Currently, a randomised controlled trial on the Effect of intravenous iron on Anaemia in Malawian Pregnant women (REVAMP) is underway. Since this is new in Africa and Malawi is the second country to implement it, its acceptability to both the providers and end-users is not known. Suppose the use of IV iron during pregnancy would be acceptable in Malawi, it could change how we treat and manage pregnant women with anaemia and be scaled up throughout Malawi to improve maternal and child health. Objectives: To identify the barriers and facilitators of implementing IV iron in the Malawian healthcare system and identify ‘touchpoints’ and co-develop strategies to support and inform the implementation of the trial Methodology: A qualitative study was conducted with policymakers, government partners, and health managers through in-depth interviews to identify barriers and facilitators relating to the implementation of IV iron in the health system of Malawi. From the interviews, touchpoints were identified that formed the basis of the discussion in further discussing the barriers and suggested solutions in the co-design workshops with the community members and the health workers, respectively. We purposively recruited 20 health workers (10 male, 10 Female). 20 community members (10 male, 10 female) were recruited randomly. Data was collected through group discussions and interactive sessions and was recorded through audios, flip charts, and sticky notes. We familiarized ourselves with the data and identified themes. Results: Two co-design workshops were conducted with different community members and different health worker carders. Identified individual factors included lack of knowledge about anaemia, lack of male involvement, the attitude of health workers and patient non-compliance with appointments. Community factors included myths and misconceptions about IV iron, including associating the use of IV iron with vampirism and covid 19 vaccination. Health system factors identified were a shortage of staff and equipment, unfamiliarity with IV iron and its cost. Discussion: The use of IV iron, as suggested by the community members and health workers, demands civic education through bringing awareness to end-users and training to providers. Through these co-design workshops, community sensitization and awareness, briefing and training of health workers and creation of educational materials were done.

Keywords: acceptability, IV iron, barriers, facilitators, co-design

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Authors: Moshiur Rahman, Tahmida Jakia

Abstract:

Bangladesh, a densely populated South Asian country is home to more than 160 million people. In two decades ago, the people of this developing nation drank heavily contaminated surface water. Over the past thirty years, the country, and its development partners, has undertaken extensive efforts to provide microbiologically safe groundwater based drinking water through the use of tube-wells. About 85% of the people now drink tube-well water from about 11 million tube-wells/hand pumps. However, diarrhoeal and other water-related diseases are still reported among the major causes of morbidity and mortality among Bangladeshi children. This implies that the mode of transmission of pathogens through water and/or other modes continue. In addition, massive scale arsenic contamination has been recently reported in the ground water. Thirty five million people may be at risk of consuming arsenic contaminated water exceeding 0.05 mg/l in Bangladesh. Drinking of arsenic contaminated water has been linked with skin problems, cancer, cardiovascular diseases, neurological diseases, eye problems, cancer of the internal organs, and other diseases. In the study area, Narail district, recent investigations about existing water quality situations indicated presence of low to high levels of arsenic, salinity, iron, manganese and bacteriological contamination risks. As challenges for safe water exist; it is likely that sanitation and food hygiene practices are poor which lead threat to ensure food security.The main attempt of this study is to find out the challenges to ensure food security andprovide probable solutions to ensure food safety towards 0.7 million of people in study area. A survey has been conducted at Lohagara and Kalia sub district of Narail district with a pretested questionnaire. Primary data are collected through a questionnaire, while secondary data are collected from pertinent offices as well as academic journals. FGD has also been done to know the knowledge regarding water, sanitation as well as food preparation and consumption practice of community people in study area. The major focus of this study is to assess the state of sanitation and food hygiene condition of rural people. It is found that most of the villagers have lack of knowledge about food safety. Open defecation rate is high which lead threat to ensure food security.

Keywords: food safety, challenges, hygiene, Bangladesh

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Authors: B. B. S. Pereira, M. O. Souza, L. P. Zanetti, L. C. S. Oliveira, J. R. P. Moreno, M. P. Souza, V. R. Colturato, C. M. Machado

Abstract:

Background: The introduction of prophylactic or preemptive therapies has effectively decreased the CMV mortality rates after hematopoietic stem cell transplantation (HSCT). CMV antigenemia (pp65) or quantitative PCR are methods currently approved for CMV surveillance in pre-emptive strategies. Commercial assays are preferred as cut-off levels defined by in-house assays may vary among different protocols and in general show low reproducibility. Moreover, comparison of published data among different centers is only possible if international standards of quantification are included in the assays. Recently, the World Health Organization (WHO) established the first international standard for CMV detection. The real time PCR COBAS Ampliprep/ CobasTaqMan (CAP/CTM) (Roche®) was developed using the WHO standard for CMV quantification. However, the cut-off for the introduction of antiviral has not been determined yet. Methods: We conducted a retrospective study to determine: 1) the sensitivity and specificity of the new CMV CAP/CTM test in comparison with pp65 antigenemia to detect episodes of CMV infection/reactivation, and 2) the cut-off of viral load for introduction of ganciclovir (GCV). Pp65 antigenemia was performed and the corresponding plasma samples were stored at -20°C for further CMV detection by CAP/CTM. Comparison of tests was performed by kappa index. The appearance of positive antigenemia was considered the state variable to determine the cut-off of CMV viral load by ROC curve. Statistical analysis was performed using SPSS software version 19 (SPSS, Chicago, IL, USA.). Results: Thirty-eight patients were included and followed from August 2014 through May 2015. The antigenemia test detected 53 episodes of CMV infection in 34 patients (89.5%), while CAP/CTM detected 37 episodes in 33 patients (86.8%). AG and PCR results were compared in 431 samples and Kappa index was 30.9%. The median time for first AG detection was 42 (28-140) days, while CAP/CTM detected at a median of 7 days earlier (34 days, ranging from 7 to 110 days). The optimum cut-off value of CMV DNA was 34.25 IU/mL to detect positive antigenemia with 88.2% of sensibility, 100% of specificity and AUC of 0.91. This cut-off value is below the limit of detection and quantification of the equipment which is 56 IU/mL. According to CMV recurrence definition, 16 episodes of CMV recurrence were detected by antigenemia (47.1%) and 4 (12.1%) by CAP/CTM. The duration of viremia as detected by antigenemia was shorter (60.5% of the episodes lasted ≤ 7 days) in comparison to CAP/CTM (57.9% of the episodes lasting 15 days or more). This data suggests that the use of antigenemia to define the duration of GCV therapy might prompt early interruption of antiviral, which may favor CMV reactivation. The CAP/CTM PCR could possibly provide a safer information concerning the duration of GCV therapy. As prolonged treatment may increase the risk of toxicity, this hypothesis should be confirmed in prospective trials. Conclusions: Even though CAP/CTM by ROCHE showed great qualitative correlation with the antigenemia technique, the fully automated CAP/CTM did not demonstrate increased sensitivity. The cut-off value below the limit of detection and quantification may result in delayed introduction of pre-emptive therapy.

Keywords: antigenemia, CMV COBAS/TAQMAN, cytomegalovirus, antiviral cut-off

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