Search results for: crystal report

Authors: Si Jack Chong, Chew Theng Yap, Wan Loong James Mok

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Introduction: Regional burn centres face the spectra of introduced multi-drug resistant organisms (MDRO) from transfer patients resident in MDRO endemic countries. MDRO can cause severe nosocomial infection, which in massive burn patients, will lead to greater morbidity and mortality and strain the institution financially. We aim to highlight 4 key measures that have effectively prevented transmission of imported MDRO. Methods: A case of Candida auris (C. auris) from a massive burn patient transferred from an MDRO endemic country is used to illustrate the measures. C. auris is a globally emerging multi-drug resistant fungal pathogen causing nosocomial transmission. Results: Infection control measures used to mitigate the risk of outbreak from transfer cases are: (1) Multidisciplinary team approach involving Infection Control and Infectious Disease specialists early to ensure appropriate antibiotics use and implementation of barrier measures, (2) aseptic procedures for dressing change with strict isolation and donning of personal protective equipment in the ward, (3) early screening of massive burn patient from MDRO endemic region, (4) hydrogen peroxide vaporization terminal cleaning for operating theatres and rooms. Conclusion: The prevalence of air travel and international transfer to regional burn centres will need effective infection control measures to reduce the risk of transmission from imported massive burn patients. In our centre, we have effectively implemented 4 measures which have reduced the risks of local contamination. We share a recent case report to illustrate successful management of a potential MDRO outbreak resulting from transfer of massive burn patient resident in an MDRO endemic area.

Keywords: burns, burn unit, cross infection, infection control

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Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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Authors: Ulriikka Savela-Huovinen, Hanni Muukkonen, Auli Toom

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The development of workplace as a learning environment has been emphasized in research field of workplace learning. The prior literature on sensory performance emphasized the individual’s competences as assessor, while the competences in the collaborative interactional and knowledge creation practices as workplace learning method are not often mentioned. In the present study aims to find out what kinds of competences and contexts are central when assessor conducts food sensory evaluation in authentic professional context. The aim was to answer the following questions: first, what kinds of competences does sensory evaluation require according to assessors? And second, what kinds of contexts for sensory evaluation do assessors report? Altogether thirteen assessors from three Finnish food companies were interviewed by using semi-structural thematic interviews to map practices and development intentions as well as to explicate already established practices. The qualitative data were analyzed by following the principles of abductive and inductive content analysis. Analysis phases were combined and their results were considered together as a cross-analysis. When evaluated independently required competences were perception, knowledge of specific domains and methods and cognitive skills e.g. memory. Altogether, 42% of analysis units described individual evaluation contexts, 53% of analysis units described collaborative interactional contexts, and 5% of analysis units described collaborative knowledge creation contexts. Related to collaboration, analysis reviewed learning, sharing and reviewing both external and in-house consumer feedback, developing methods to moderate small-panel evaluation and developing product vocabulary collectively between the assessors. Knowledge creation contexts individualized from daily practices especially in cases product defects were sought and discussed. The study findings contribute to the explanation that sensory assessors learn extensively from one another in the collaborative interactional and knowledge creation context. Assessors learning and abilities to work collaboratively in the interactional and knowledge creation contexts need to be ensured in the development of the expertise.

Keywords: assessor, collaboration, competences, contexts, learning and practices, sensory evaluation

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Authors: Khalid Iqbal, Saima Altaf, M. Akram, Muhammad Abdur Rafaye, Saeed Ahmad Buzdar

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Objective: Verification of patient-specific intensity modulated radiation therapy (IMRT) plans using different 2-D detectors has become increasingly popular due to their ease of use and immediate readout of the results. The purpose of this study was to test and compare various 2-D detectors for dosimetric quality assurance (QA) of intensity-modulated radiotherapy (IMRT) with the vision to find alternative QA methods. Material and Methods: Twenty IMRT patients (12 of brain and 8 of the prostate) were planned on Eclipse treatment planning system using Varian Clinac DHX on both energies 6MV and 15MV. Verification plans of all such patients were also made and delivered to Map check2, EPID (Electronic portal imaging device) and Gafchromic EBT3. Gamma index analyses were performed using different criteria to evaluate and compare the dosimetric results. Results: Statistical analysis shows the passing rate of 99.55%, 97.23% and 92.9% for 6MV and 99.53%, 98.3% and 94.85% for 15 MV energy using a criteria of ±5% of 3mm, ±3% of 3mm and ±3% of 2mm respectively for brain, whereas using ±5% of 3mm and ±3% of 3mm gamma evaluation criteria, the passing rate is 94.55% and 90.45% for 6MV and 95.25%9 and 95% for 15 MV energy for the case of prostate using EBT3 film. Map check 2 results shows the passing rates of 98.17%, 97.68% and 86.78% for 6MV energy and 94.87%,97.46% and 88.31% for 15 MV energy respectively for brain using a criteria of ±5% of 3mm, ±3% of 3mm and ±3% of 2mm, whereas using ±5% of 3mm and ±3% of 3mm gamma evaluation criteria gives the passing rate of 97.7% and 96.4% for 6MV and 98.75%9 and 98.05% for 15 MV energy for the case of prostate. EPID 6 MV and gamma analysis shows the passing rate of 99.56%, 98.63% and 98.4% for the brain, 100% and 99.9% for prostate using the same criteria as for map check 2 and EBT 3 film. Conclusion: The results demonstrate excellent passing rates were obtained for all dosimeter when compared with the planar dose distributions for 6 MV IMRT fields as well as for 15 MV. EPID results are better than EBT3 films and map check 2 because it is likely that part of this difference is real, and part is due to manhandling and different treatment set up verification which contributes dose distribution difference. Overall all three dosimeter exhibits results within limits according to AAPM report.120.

Keywords: gafchromic EBT3, radiochromic film dosimetry, IMRT verification, EPID

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Authors: Abdelkrim Khadir, Sina Kavalakatt, Preethi Cherian, Ali Tiss

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Soluble epoxide hydrolase (sEH) is an emerging therapeutic target in several chronic states that have inflammation as a common underlying cause such as immunometabolic diseases. Indeed, sEH is known to play a pro-inflammatory role by metabolizing anti-inflammatory, epoxyeicosatrienoic acids (EETs) to pro-inflammatory diols. Recently, it was shown sEH to be linked to diet and microbiota interaction in rat models of obesity. Nevertheless, the functional contribution of sEH and its anti-inflammatory substrates EETs in obesity remain poorly understood. In the current study, we compared the expression pattern of sEH between lean and obese nondiabetic human subjects using subcutaneous adipose tissue (SAT) and peripheral blood mononuclear cells (PBMCs). Using RT-PCR, western blot and immunofluorescence confocal microscopy, we show here that the level of sEH mRNA and protein to be significantly increased in obese subjects with concomitant increase in endoplasmic reticulum (ER) stress components (GRP78 and ATF6α) and inflammatory markers (TNF-α, IL-6) when compared to lean controls. The observation that sEH was overexpressed in obese subjects’ prompt us to investigate whether physical exercise could reduce its expression. In this study, we report here 3-months supervised physical exercise significantly attenuated the expression of sEH in both the SAT and PBMCs, with a parallel decrease in the expression of ER stress markers along with attenuated inflammatory response. On the other hand, homocysteine, a sulfur containing amino acid deriving from the essential amino acid methionine was shown to be directly associated with insulin resistance. When 3T3-L1 preadipocytes cells were treated with homocysteine our results show increased sEH levels along with ER stress markers. Collectively, our data suggest that sEH upregulation is strongly linked to ER stress in adiposity and that physical exercise modulates its expression. This gives further evidence that exercise might be useful as a strategy for managing obesity and preventing its associated complications.

Keywords: obesity, adipose tissue, epoxide hydrolase, ER stress

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

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Authors: Iryna P. Dzieciuch, Michael D. Putman

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Humidity is known to degrade Navy ship electronic equipment, especially in hot moist environments. If left untreated, it can cause significant and permanent damage. Even rigorous inspection and frequent clean-up would not prevent further equipment contamination and degradation because of the constant presence of favorable growth conditions for many microorganisms. Generally, relative humidity levels of less than 60% will inhibit corrosion in electronic equipment, but because NAVY electronics often operate in hot and humid environments, prevention via dehumidification is not always possible. Currently, there is no defined research that fully describes key mechanisms which cause electronics and its coating degradation. The corrosive action of most bacteria is mainly developed through (i) mycelium adherence to the metal plates, (ii) facilitation the formation of pitting areas, (iii) production of organic acids such as citric, iso-citric, cis-aconitic, alpha-ketoglutaric, which are corrosive to electronic equipment and its components. Our approach studies corrosive action in electronic equipment: circuit-board, wires and connections that are exposed in the humid environment that gets worse during condensation. In our new approach the technical task is built on work with the bacterial communities in public areas, bacterial genetics, bioinformatics, biostatistics and Scanning Electron Microscopy (SEM) of corroded circuit boards. Based on these methods, we collect and examine environmental samples from biofilms of the corroded and non-corroded sites, where bacterial contamination of electronic equipment, such as machine racks and shore boats, is an ongoing concern. Sample collection and sample analysis is focused on addressing the key questions identified above through the following tasks: laboratory sample processing and evaluation under scanning electron microscopy, initial sequencing and data evaluation; bioinformatics and data analysis. Preliminary results from scanning electron microscopy (SEM) have revealed that metal particulates and alloys in corroded samples consists mostly of Tin ( < 40%), Silicon ( < 4%), Sulfur ( < 1%), Aluminum ( < 2%), Magnesium ( < 2%), Copper ( < 1%), Bromine ( < 2%), Barium ( <1%) and Iron ( < 2%) elements. We have also performed X 12000 magnification of the same sites and that proved existence of undisrupted biofilm organelles and crystal structures. Non-corrosion sites have revealed high presence of copper ( < 47%); other metals remain at the comparable level as on the samples with corrosion. We have performed X 1000 magnification on the non-corroded at the sites and have documented formation of copper crystals. The next step of this study, is to perform metagenomics sequencing at all sites and to compare bacterial composition present in the environment. While copper is nontoxic to the living organisms, the process of bacterial adhesion creates acidic environment by releasing citric, iso-citric, cis-aconitic, alpha-ketoglutaric acidics, which in turn release copper ions Cu++, which that are highly toxic to the bacteria and higher order living organisms. This phenomenon, might explain natural “antibiotic” properties that are lacking in elements such as tin. To prove or deny this hypothesis we will use next - generation sequencing (NGS) methods to investigate types and growth cycles of bacteria that from bacterial biofilm the on corrosive and non-corrosive samples.

Keywords: bacteria, biofilm, circuit board, copper, corrosion, electronic equipment, organic acids, tin

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

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

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

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Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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Authors: Peifang Hsieh

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New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.

Keywords: cross department, high-risk families, public-private partnership, integrated safety net

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Authors: Ravi Kant, Banshi D. Gupta

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The unbridled application of insecticides to enhance agricultural yield has become a matter of grave concern to both the environment and the human health and, thus pose a potential threat to sustainable development. Fenitrothion is an extensively used organophosphate insecticide whose residues are reported to be extremely toxic for birds, humans and aquatic life. A sensitive, swift and accurate detection protocol for fenitrothion is, thus, highly demanded. In this work, we report an SPR based fiber optic sensor for the detection of fenitrothion, where a nanocomposite arrangement of Ta2O5 and reduced graphene oxide (rGO) (Ta₂O₅: rGO) decorated on silver coated unclad core region of an optical fiber forms the sensing channel. A nanocomposite arrangement synergistically integrates the properties of involved components and consequently furnishes a conducive framework for sensing applications. The modification of the dielectric function of the sensing layer on exposure to fenitrothion solutions of diverse concentration forms the sensing mechanism. This modification is reflected in terms of the shift in resonance wavelength. Experimental variables such as the concentration of rGO in the nanocomposite configuration, dip time of silver coated fiber optic probe for deposition of sensing layer and influence of pH on the performance of the sensor have been optimized to extract the best performance of the sensor. SPR studies on the optimized sensing probe reveal the high sensitivity, wide operating range and good reproducibility of the fabricated sensor, which unveil the promising utility of Ta₂O₅: rGO nanocomposite framework for developing an efficient detection methodology for fenitrothion. FOSPR approach in cooperation with nanomaterials projects the present work as a beneficial approach for fenitrothion detection by imparting numerous useful advantages such as sensitivity, selectivity, compactness and cost-effectiveness.

Keywords: surface plasmon resonance, optical fiber, sensor, fenitrothion

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Authors: Gunilla Dahlgren, Per Liv, Fredrik Öhberg, Lisbeth Slunga Järvholm, Mikael Forsman, Börje Rehn

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Background: Accuracy of risk assessment tools in hand-repetitive work is important. This can support precision in the risk management process and for a sustainable working life for women and men equally. Musculoskeletal disorders, MSDs, from the hand, wrist, and forearm, are common in the working population. Women report a higher prevalence of MSDs in these regions. Objective: The objective of this study was to compare if women and men who performed the identical hand-intensive work task were rated equally using the Hand Activity Threshold Limit Value® (HA-TLV) when self-rated and observer-rated. Method: Fifty-six workers from eight companies participated, with various intensities in hand-repetitive work tasks. In total, 18 unique identical hand-intensive work tasks were executed in 28 pairs of a woman and a man. Hand activity and force levels were assessed. Each worker executed the work task for 15 minutes, which was also video recorded. Data was collected on workers who self-rated directly after the execution of the work task. Also, experienced observers performed ratings from videos of the same work tasks. For comparing means between women and men, paired samples t-tests were used. Results: The main results showed that there was no difference in self-ratings of hand activity level and force by women and men who executed the same work task. Further, there was no difference between observer ratings of hand activity level. However, the observer force ratings of women and men differed significantly (p=0.01). Conclusion: Hand activity and force levels are rated equally in women and men when self-rated, also by observers for hand activity. However, it is an observandum that observer force rating is rated higher for women and lower for men. This indicates the need of comparing force ratings with technical measures.

Keywords: gender, equity, sex differences, repetitive strain injury, cumulative trauma disorders, upper extremity, exposure assessment, workload, health risk assessment, observation, psychophysics

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Authors: Nsikan Affiah, Kayode Osungbade, Williams Uzoma

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Malaria remains one of the major killers of humans worldwide, threatening the lives of more than one-third of the world’s population. Some people refers it to; a disease of poverty because it contributes towards national poverty through its impact on foreign direct investment, tourism, labour productivity, and trade. At the micro level, it may cause poverty through spending on health care, income losses, and premature deaths. Unfortunately, malaria is a disease that affects both low-income household and its high-income counterpart, but low-income households are still at greater risk because significant part of the available monthly income is dedicated to various preventive and treatment measures. The objective of this study is to estimate direct and indirect cost of malaria treatment in households in a section of South-South Region (Akwa Ibom State) of Nigeria. A cross-sectional study of Six Hundred and Forty (640) heads of households or any adult representative of households in three local government areas of Akwa Ibom State, Nigeria from May 1-31, 2015 were ascertained through interviewer-administered questionnaire adapted from Nigerian Malaria Indicator Survey Report. The clustering technique was used to select 640 households with the help of Primary Health Care (PHC) house numbering system. Using exchange rate of 197 Naira/USD, result shows that direct cost of malaria treatment was 8,894.44 USD while the indirect cost of malaria treatment was 11,012.81 USD. Total cost of treatment made up of 44.7% direct cost and 55.3% indirect cost, with average direct cost of malaria treatment per household estimated at 20.6 USD and the average indirect cost of treatment per household estimated at 25.1 USD. Average total cost for each episode (888) of malaria was estimated at 22.4 USD. While at household level, the average total cost was estimated at 45.5 USD. From the average total cost, low-income households would spend 36% of monthly household income on treating malaria and the impact could be said to be catastrophic, compared to high-income households where only 1.2% of monthly household income is spent on malaria treatment. It could be concluded that the cost of malaria treatment is well beyond the means of households and given the reality of repeated bouts of malaria and its contribution to the impoverishment of households, there is a need for urgent action.

Keywords: direct cost, indirect cost, low income households, malaria

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Authors: C. A. Bradley, D. Patsios, D. Berridge

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This paper presents evidence to better understand the risk and protective factors related to sibling conflict and the patterns of association between sibling conflict and negative adjustment outcomes by incorporating additional familial and societal factors within statistical models of risk and adjustment. It was conducted through the secondary analysis of a large representative cross-sectional dataset of children in the UK. The original study includes proxy interviews for young children and self-report interviews for adolescents. The study applies an ecological systems framework for the analyses. Hierarchical regression models assess risk and protective factors and adjustment outcomes associated with sibling conflict. Interactions reveal differential effect between contextual risk factors and the social context of influence. The general pattern of findings suggested that, although factors affecting likelihood of experiencing sibling conflict were often determined by child age, some remained consistent across childhood. These factors were often conditional on each other, reinforcing the importance of an ecological framework. Across both age-groups, sibling conflict was associated with siblings closer in age; male sibling groups; most advantaged socio-economic group; and exposure to community violence, such as witnessing violent assault or robbery. The study develops the evidence base on the influence of ethnicity and socio-economic group on sibling conflict by exploring interactions between social context. It also identifies key new areas of influence – such as family structure, disability, and community violence in exacerbating or reducing risk of conflict. The study found negative associations between sibling conflict and young children’s mental well-being and adolescents' mental well-being and anti-social behaviour, but also more context specific associations – such as sibling conflict moderating the negative impact of adversity and high risk experiences for young children such as parental violence toward the child.

Keywords: adjustment, conflict, ecological systems, family systems, risk and protective factors, sibling

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Authors: Manaf Bashir

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Corporate social responsibility (CSR) has become a tool for corporations to meet the expectations of different stakeholders about economic, social and environmental issues. It has become indispensable for an organization’s success, positive image and reputation. Equally important is how corporations communicate and report their CSR. Employing the stakeholder theory, the purpose of this research is to analyse CSR content of leading Kuwaiti corporations. No research analysis of CSR reporting has been conducted in Kuwait and this study is an attempt to redress in part this empirical deficit in the country and the region. It attempts to identify the issues and stakeholders of the CSR and if corporations are following CSR reporting standards. By analysing websites, annual and CSR reports of the top 100 Kuwaiti corporations, this study found low mentions of the CSR issues and even lower mentions of CSR stakeholders. Environmental issues were among the least mentioned despite an increasing global concern toward the environment. ‘Society’ was mentioned the most as a stakeholder and ‘The Environment’ was among the least mentioned. Cross-tabulations found few significant relationships between type of industry and the CSR issues and stakeholders. Independent sample t-tests found no significant difference between the issues and stakeholders that are mentioned on the websites and the reports. Only two companies from the sample followed reporting standards and both followed the Global Reporting Initiative. Successful corporations would be keen to identify the issues that meet the expectations of different stakeholders and address them through their corporate communication. Kuwaiti corporations did not show this keenness. As the stakeholder theory suggests, extending the spectrum of stakeholders beyond investors can open mutual dialogue and understanding between corporations and various stakeholders. However, Kuwaiti corporations focus on few CSR issues and even fewer CSR stakeholders. Kuwaiti corporations need to pay more attention to CSR and particularly toward environmental issues. They should adopt a strategic approach and allocate specialized personnel such as marketers and public relations practitioners to manage it. The government and non-profit organizations should encourage the private sector in Kuwait to do more CSR and meet the needs and expectations of different stakeholders and not only shareholders. This is in addition to reporting the CSR information professionally because of its benefits to corporate image, reputation, and transparency.

Keywords: corporate social responsibility, environmental responsibility, Kuwait, stakeholder theory

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Authors: Ji-Young Choi, Jungjin Kim, Sang-Sun Yun, Sangmee Ahn Jo

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Intracellular adhesion molecule1 (ICAM1) is a mediator of inflammation and involved in adhesion and transmigration of leukocytes to endothelial cells, resulting in enhancement of brain inflammation. We hypothesized that increase of ICAM1 expression in endothelial cells is an early step in the pathogenesis of brain diseases such as Alzheimer’s disease. Here, we report that ICAM1 expression is regulated by pro-inflammatory cytokine TNFa in human microvascular endothelial cell (HBMVEC). TNFa significantly increased ICAM1 mRNA and protein levels at the concentrations showing no cell toxicity. This increase was also shown in micro vessels of mouse brain 24 hours after treatment with TNFa (8 mg/kg, i.v). We then investigated the epigenetic mechanism involved in the induction of ICAM1 expression. Chromatin immunoprecipitation assay revealed that TNFa reduced methylation of histone3K9 (H3K9-2me) and histone3K27 (H3K27-3me), well-known modification as gene suppression, with in the ICAM1 promoter region. However, acetylation of H3K9 and H3K14, well-known modification as gene activation, was not changed by TNFa. Treatment of BIX01294, a specific inhibitor of histone methyltransferase G9a responsible for H3K9-2me, dramatically increased in ICAM1 mRNA and protein levels and overexpression of G9a gene suppressed TNFa-induced ICAM1 expression. In contrast, GSK126, an inhibitor of histone methyltransferase EZH2 responsible for H3K27-3me and valproic acid, an inhibitor of histone deacetylase (HDAC) did not affect ICAM1 expression. These results suggested that histone3 methylation is involved in ICAM1 repression. Moreover, TNFa or BIX01294-induced ICAM induction resulted in both enhancements in adhesion and transmigration of leukocyte on endothelial cell. This study demonstrates that TNFa upregulates ICAM1 expression through H3K9-2me and H3K27-3me within the ICAM1 promoter region, in which G9a is likely to play a pivotal role in ICAM1 transcription. Our study provides a novel mechanism for ICAM1 transcription regulation in HBMVEC.

Keywords: ICAM1, TNFa, HBMVEC, H3K9-2me

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Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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Authors: Sonam Chorol, Sharvan Kumar, Pritam Mukhopadhyay

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In biology, supramolecular systems require the use of chemical fuels to stay in sustained nonequilibrium steady states termed dissipative self-assembly in contrast to synthetic self-assembly. Biomimicking these natural dynamic systems, some studies have demonstrated artificial self-assembly under nonequilibrium utilizing various forms of energies (fuel) such as chemical, redox, and pH. Naphthalene diimides (NDIs) are well-known organic molecules in supramolecular architectures with high electron affinity and have applications in controlled electron transfer (ET) reactions, etc. Herein, we report the endergonic ET from tetraphenylborate to highly electron-deficient phosphonium NDI²+ dication to generate NDI•+ radical. The formation of radicals was confirmed by UV-Vis-NIR absorption spectroscopy. Electron-donor and electron-acceptor energy levels were calculated from experimental electrochemistry and theoretical DFT analysis. The HOMO of the electron donor locates below the LUMO of the electro-acceptor. This indicates that electron transfer is endergonic (ΔE°ET = negative). The endergonic ET from NaBPh₄ to NDI²+ dication was achieved thermodynamically by the formation of coupled biphenyl product confirmed by GC-MS analysis. NDI molecule bearing octyl phosphonium at the core and H-bond forming imide moieties at the axial position forms a gel. The rheological properties of purified radical ion NDI⦁+ gels were evaluated. The atomic force microscopy studies reveal the formation of large branching-type networks with a maximum height of 70-80 nm. The endergonic ET from NaBPh₄ to NDI²+ dication was used to design the assembly and disassembly redox reaction cycle using reducing (NaBPh₄) and oxidizing agents (Br₂) as chemical fuels. A part of NaBPh₄ is used to drive assembly, while a fraction of the NaBPh₄ is dissipated by forming a useful product. The system goes back to the disassembled NDI²+ dication state with the addition of Br₂. We think bioinspired dissipative self-assembly is the best approach to developing future lifelike materials with autonomous behavior.

Keywords: Ionic-gel, redox-cycle, self-assembly, useful product

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Authors: Calogero Lo Destro

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Numerous nations around the world are facing exceptional challenges in employing measures to stop the spread of COVID-19. Following the recommendations of the World Health Organization, a series of preventive measures have been adopted. However, individuals must comply with these rules and recommendations in order to make these measures effective. While COVID-19 was climaxing, it seemed of crucial importance to analyze which psychosocial factors contribute to the acceptance of such preventive behavior, thus favoring the management of COVID-19 worldwide health crisis. In particular, the identification of aspects related to obstacles and facilitation of adherence to social distancing has been considered crucial in the containment of the virus spread. Since the virus was firstly detected in China, Asian people could be considered a relevant outgroup targeted for exclusion. We also hypothesized social distance could be influenced by characteristics of the target, such as smiling or coughing. 260 participants participated in this research on a voluntary basis. They filled a survey designed to explore a series of COVID-19 measures (such as exposure to virus and fear of infection). We also assessed participants state and trait anxiety. The dependent variable was social distance, based on a measure of seating distance designed ad hoc for the present work. Our hypothesis that participants could report greater distance in response to Asian people was not confirmed. On the other hand, significantly lower distance in response to smiling compared to coughing targets was reported. Adopting a regression analysis model, we found that participants' social distance, in response to both coughing and smiling targets, was predicted by fear of infection and by the perception COVID-19 could become a pandemic. Social distance in response to the coughing target was also significantly and positively predicted by age and state anxiety. In summary, the present work has sought to identify a set of psychological variables, which may still be predictive of social distancing.

Keywords: COVID-19, social distancing, health, preventive behaviors, risk of infection

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Authors: Luciano Tarantino, Emanuele Balzano, Aurelio Nasto

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S.R. 53 years. January 2009: HCV-related cirrhosis, Child-Pugh A5 class, EGDS no aesophageal Varices. No important comorbidities. Treated with PEG-IFN+Ribavirin (march-november 2009) with subsequent sustained virologic response. HCVRNA absent overtime. October 2016 :CT detected small HCC nodule in the VIII segment (diam.=12 mm). Treated with US guided RF-ablation. November 2016 CT: complete necrosis. Unfortunately, the patient dropped out US and CT follow-up controls.September 2018: asthenia and weight loss. CT showed a large tumor infiltrating V-VII-VI segments and complete PVTT of right portal vein and its branches . Surgical Consultation excluded indication to Liver resection and OLT . 23 october 2018: ECT of a large peri-hilar area of the tumor including the PVTT. 1 and 3 months post-treatment CT showed complete necrosis and retraction of the thrombus and residual viable tumor in the peripheral portion of the right lobe . Therefor, the patient was reevaluated for OLT and considered eligible in waiting list . March 2019: CT showed no perihilar or portal vein recurrence and distant progression in the right lobe . March 2019 : Trans-arterial-Radio-therapy (TARE) of the right lobe. Post-treatment CT demonstrated no perihilar or portal vein recurrence and extensive necrosis of the residual tumor . December 2019: CT demonstrated several recurrences of HCC infiltrating the VI and VII segment . Howewer no recurrence was observed at hepatic hilum and in portal vessels . Therefore, on February 2020 the patient received OLT. At 44 months follow-up, no complication or recurrence or liver disfunction have been observed.

Keywords: hepatocellular carcinoma, portal vein tumor thrombosis, interventional ultrasound, liver tumor ablation, liver transplantation

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Authors: Prabesh Karki, Shyam Thapa Chettri, Bajarang Prasad Sah, Manoj Bhattarai, Sudeep Mishra

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Introduction: Frontal sinus is frequently described as the most difficult sinus to access surgically due to its proximity to the cribriform plate, orbit, and anterior ethmoid artery. Frontal sinus surgery requires a detailed understanding of the cellular structure and FSDP unique to each patient, making high-resolution CT scans an indispensable tool to assess the difficulty of planned sinus surgery. International Frontal Sinus Anatomy Classification (IFAC) was developed to provide a more precise nomenclature for cells in the frontal recess, classifying cells based on their anatomic origin. Objectives: To assess the proportion of frontal cell variants defined by IFAC, variation with respect to age and gender. Methods: 54 cases were enrolled after a detailed clinical history, thorough general and physical examinations, and CT a report ordered in a film. Assessment and tabulation of the presence of frontal cells according to the IFAC analyzed. The prevalence of each cell type was calculated, and data were entered in MS Excel and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and frequencies were defined for categorical and numerical variables. Frequency, percentage, the mean and standard deviation were calculated. Result: Among 54 patients, 30 (55.6%) were male and 24 (44.4%) were female. The patient enrolled ranged from 18 to 78 years. Majority33.3% (n=18) were in age group of >50 years.According to IFAC, Agger nasi cells (92.6%) were most common, whereas supraorbital ethmoidal cells were least common 16 (29.6%). Prevalence of other frontoethmoidal cells was SAC- 57.4%, SAFC- 38.9%, SBC- 74.1%, SBFC- 33.3%, FSC- 38.9% of 54 cases. Conclusion: IFAC is an international consensus document that describes an anatomically precise nomenclature for classifying frontoethmoidal cells' anatomy. This study has defined the prevalence, symmetry and reliability of frontoethmoidal cells as established by the IFAC system as in other parts of the world.

Keywords: frontal sinus, frontoethmoidal cells, international frontal sinus anatomy classification

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Authors: Wilfred Elliam

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Background: Pain is a prevalent and debilitating symptom among breast cancer patients, impacting their quality of life and overall well-being. The experience of pain in this population is multifaceted, influenced by a combination of disease-related factors, treatment side effects, and individual characteristics. Despite advancements in cancer treatment and pain management, many breast cancer patients continue to suffer from chronic pain, which can persist long after the completion of treatment. Understanding the progression of pain in breast cancer patients over time and identifying its correlates is crucial for effective pain management and supportive care strategies. The purpose of this research is to understand the patterns and progression of pain experienced by breast cancer survivors over time. Methods: Data were collected from breast cancer patients at Hartford Hospital at four time points: baseline, 3, 6 and 12 weeks. Key variables measured include pain, body mass index (BMI), fatigue, musculoskeletal pain, sleep disturbance, and demographic variables (age, employment status, cancer stage, and ethnicity). Binomial generalized linear mixed models were used to examine changes in pain and symptoms over time. Results: A total of 100 breast cancer patients aged  18 years old were included in the analysis. We found that the effect of time on pain (p = 0.024), musculoskeletal pain (p= <0.001), fatigue (p= <0.001), and sleep disturbance (p-value = 0.013) were statistically significant with pain progression in breast cancer patients. Patients using aromatase inhibitors have worse fatigue (<0.05) and musculoskeletal pain (<0.001) compared to patients with Tamoxifen. Patients who are obese (<0.001) and overweight (<0.001) are more likely to report pain compared to patients with normal weight. Conclusion: This study revealed the complex interplay between various factors such as time, pain, sleep disturbance in breast cancer patient. Specifically, pain, musculoskeletal pain, sleep disturbance, fatigue exhibited significant changes across the measured time points, indicating a dynamic pain progression in these patients. The findings provide a foundation for future research and targeted interventions aimed at improving pain in breast cancer patient outcomes.

Keywords: breast cancer, chronic pain, pain management, quality of life

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Authors: Elizabeth Perry, Jylana Sheats

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Scholars posit that there is an overlap between the fields of Behavioral Economics (BE) and Behavior Science (BSci)—and that consideration of concepts from both may facilitate a greater understanding of health decision-making processes. For example, the ‘intention-action gap’ is one BE concept to explain sup-optimal decision-making. It is described as having knowledge that does not translate into behavior. Complementary best BSci practices may provide insights into behavioral determinants and relevant behavior change techniques (BCT). Within the context of BSci, this exploratory study aimed to apply a BE concept with demonstrated effectiveness in financial decision-making to a health behavior: influenza (flu) vaccine uptake. Adults aged >18 years were recruited on Amazon’s Mechanical Turk, a digital labor market where anonymous users perform simple tasks at low cost. Eligible participants were randomized into 2 groups, reviewed a scenario, and then completed a survey on the likelihood of receiving a flu shot. The ‘usual care’ group’s scenario included standard CDC guidance that supported the behavior. The ‘intervention’ group’s scenario included messaging about people who did not receive the flu shot. The framing was such that participants could learn from others’ (strangers) mistakes and the subsequent health consequences: ‘Last year, other people who didn’t get the vaccine were about twice as likely to get the flu, and a number of them were hospitalized or even died. Don’t risk it.’ Descriptive statistics and chi-square analyses were performed on the sample. There were 648 participants (usual care, n=326; int., n=322). Among racial/ethnic minorities (n=169; 57% aged < 40), the intervention group was 22% more likely to report that they were ‘extremely’ or ‘moderately’ likely to get the flu vaccine (p = 0.11). While not statistically significant, findings suggest that framing messages from the perspective of learning from the mistakes of unknown others coupled with the BCT ‘knowledge about the health consequences’ may help influence flu vaccine uptake among the study population. With the widely documented disparities in vaccine uptake, exploration of the complementary application of these concepts and strategies may be critical.

Keywords: public health, decision-making, vaccination, behavioral science

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Authors: Tamseela Habib, Muhammad Amjad, Muhammad Edokali, Masome Moeni, Olivia Pickup, Ali Hassanpour

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Nanofluid-assisted steam generation is rapidly attracting attention amongst the scientific community since it can be applied in a wide range of industrial processes. Because of its high absorption rate of solar energy, nanoparticle-based solar steam generation could be a major contributor to many applications, including water desalination, sterilization and power generation. Lithium bromide-based iron oxide nanofluids have been previously studied in steam generation, which showed promising results. However, the efficiency of the system could be improved if a more heat-conductive nanofluid system could be utilised. In the current paper, we report on an experimental investigation of the photothermal conversion properties of functionalised Copper oxide (CuO) nanoparticles used in Lithium Bromide salt solutions. CuO binary nanofluid was prepared by chemical functionalization with polyethyleneimine (PEI). Long-term stability evaluation of prepared binary nanofluid was done by a high-speed centrifuge analyser which showed a 0.06 Instability index suggesting low agglomeration and sedimentation tendencies. This stability is also supported by the measurements from dynamic light scattering (DLS), transmission electron microscope (TEM), and ultraviolet-visible (UV-Vis) spectrophotometer. The fluid rheology is also characterised, which suggests the system exhibits a Newtonian fluid behavior. The photothermal conversion efficiency of different concentrations of CuO was experimentally investigated under a solar simulator. Experimental results reveal that the binary nanofluid in this study can remarkably increase the solar energy trapping efficiency and evaporation rate as compared to conventional fluids due to localized solar energy harvesting by the surface of the nanofluid. It was found that 0.1wt% CuO NP is the optimum nanofluid concentration for enhanced sensible and latent heat efficiencies.

Keywords: nanofluids, vapor absorption refrigeration system, steam generation, high salinity

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Authors: Liyun Chang, Cheng-Hsiang Tsai

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To ensure the radiation precisely delivering to the target of cancer patients, the linear accelerator equipped with the pretreatment on-board imaging system is introduced and through it the patient setup is verified before the daily treatment. New generation radiotherapy using beam-intensity modulation, usually associated the treatment with steep dose gradients, claimed to have achieved both a higher degree of dose conformation in the targets and a further reduction of toxicity in normal tissues. However, this benefit is counterproductive if the beam is delivered imprecisely. To avoid shooting critical organs or normal tissues rather than the target, it is very important to carry out the quality assurance (QA) of this on-board imaging system. The QA of the On-Board Imager® (OBI) system of one Varian Clinac-iX linear accelerator was performed through our procedures modified from a relevant report and AAPM TG142. Two image modalities, 2D radiography and 3D cone-beam computed tomography (CBCT), of the OBI system were examined. The daily and monthly QA was executed for five months in the categories of safety, geometrical accuracy and image quality. A marker phantom and a blade calibration plate were used for the QA of geometrical accuracy, while the Leeds phantom and Catphan 504 phantom were used in the QA of radiographic and CBCT image quality, respectively. The reference images were generated through a GE LightSpeed CT simulator with an ADAC Pinnacle treatment planning system. Finally, the image quality was analyzed via an OsiriX medical imaging system. For the geometrical accuracy test, the average deviations of the OBI isocenter in each direction are less than 0.6 mm with uncertainties less than 0.2 mm, while all the other items have the displacements less than 1 mm. For radiographic image quality, the spatial resolution is 1.6 lp/cm with contrasts less than 2.2%. The spatial resolution, low contrast, and HU homogenous of CBCT are larger than 6 lp/cm, less than 1% and within 20 HU, respectively. All tests are within the criteria, except the HU value of Teflon measured with the full fan mode exceeding the suggested value that could be due to itself high HU value and needed to be rechecked. The OBI system in our facility was then demonstrated to be reliable with stable image quality. The QA of OBI system is really necessary to achieve the best treatment for a patient.

Keywords: CBCT, image quality, quality assurance, OBI

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Authors: Pramika J. Muthya

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This paper investigates the impact of web graphics and interface design on building visitor trust in websites. A quantitative survey approach was used to examine how aesthetic and usability elements of website design influence user perceptions of trustworthiness. 133 participants aged 18-25 who live in urban Bangalore and engage in online transactions were recruited via convenience sampling. Data was collected through an online survey measuring trust levels based on website design, using validated constructs like the Visual Aesthetic of Websites Inventory (VisAWI). Statistical analysis, including ordinal regression, was conducted to analyze the results. The findings show a statistically significant relationship between web graphics and interface design and the level of trust visitors place in a website. The goodness-of-fit statistics and highly significant model fitting information provide strong evidence for rejecting the null hypothesis of no relationship. Well-designed visual aesthetics like simplicity, diversity, colorfulness, and craftsmanship are key drivers of perceived credibility. Intuitive navigation and usability also increase trust. The results emphasize the strategic importance for companies to invest in appealing graphic design, consistent with existing theoretical frameworks. There are also implications for taking a user-centric approach to web design and acknowledging the reciprocal link between pre-existing user trust and perception of visuals. While generalizable, limitations include possible sampling and self-report biases. Further research can build on these findings to deepen understanding of nuanced cultural and temporal factors influencing online trust. Overall, this study makes a significant contribution by providing empirical evidence that reinforces the crucial impact of thoughtful graphic design in fostering lasting user trust in websites.

Keywords: web graphics, interface design, visitor trust, website design, aesthetics, user experience, online trust, visual design, graphic design, user perceptions, user expectations

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: G. Venkatesha, Urs Samarth, H. K. Ramaraju, Arun Kumar Sharma

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The projection for Groundwater states that the total domestic water demand for greater Bangalore would increase from 1,170 MLD in 2010 to 1,336 MLD in 2016. Dependence on groundwater is ever increasing due to rapid Industrialization & Urbanization. It is estimated that almost 40% of the population of Bangalore is dependent on groundwater. Due to the unscientific disposal of domestic and industrial waste generated, groundwater is getting highly polluted in the city. The scale of this impact will depend mainly upon the water-service infrastructure, the superficial geology and the regional setting. The quality of ground water is equally important as that of quantity. Jointed and fractured granites and gneisses constitute the major aquifer system of BBMP area. Two new observatory Borewells were drilled and lithology report has been prepared. Petrographic Analysis (XRD/XRF) and Water quality Analysis were carried out as per the standard methods. Petrographic samples were analysed by collecting chip of rock from the borewell for every 20ft depth, most of the samples were similar and samples were identified as Biotite-Gneiss, Schistose Amphibolite. Water quality analysis was carried out for individual chemical parameters for two borewells drilled. 1st Borewell struck water at 150ft (Total depth-200ft) & 2nd struck at 740ft (Total depth-960ft). 5 water samples were collected till end of depth in each borewell. Chemical parameter values such as, Total Hardness (360-348, 280-320) mg/ltr, Nitrate (12.24-13.5, 45-48) mg/ltr, Chloride (104-90, 70-70)mg/ltr, Fe (0.75-0.09, 1.288-0.312)mg/ltr etc. are calculated respectively. Water samples were analysed from various parts of BBMP covering 750 sq kms, also thematic maps (IDW method) of water quality is generated for these samples for Post-Monsoon season. The study aims to explore the sub-surface Lithological layers and the thickness of weathered zone, which indirectly helps to know the Groundwater pollution source near surface water bodies, dug wells, etc. The above data are interpreted for future ground water resources planning and management.

Keywords: lithology, petrographic, pollution, urbanization

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Authors: Jessica Achebe, Susan Tighe

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The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

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Authors: Jason Clarke, Michaela Porubanova, Angela Mazzoli, Gulsah Kut

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What accounts for our perception that time inexorably passes in one direction, from the past to the future, the so-called arrow of time, given that the laws of physics permit motion in one temporal direction to also happen in the reverse temporal direction? Modern physics says that the reason for time’s unidirectional physical arrow is the relationship between time and entropy, the degree of disorder in the universe, which is evolving from low entropy (high order; thermal disequilibrium) toward high entropy (high disorder; thermal equilibrium), the second law of thermodynamics. Accordingly, our perception of the direction of time, from past to future, is believed to emanate as a result of the natural evolution of entropy from low to high, with low entropy defining our notion of ‘before’ and high entropy defining our notion of ‘after’. Here we explored this proposed relationship between entropy and the perception of time’s arrow. We predicted that if the brain has some mechanism for detecting entropy, whose output feeds into processes involved in constructing our perception of the direction of time, presentation of violations to the expectation that low entropy defines ‘before’ and high entropy defines ‘after’ would alert this mechanism, leading to measurable behavioral effects, namely a disruption in duration perception. To test this hypothesis, participants were shown briefly-presented (1000 ms or 500 ms) computer-generated visual dynamic events: novel 3D shapes that were seen either to evolve from whole figures into parts (low to high entropy condition) or were seen in the reverse direction: parts that coalesced into whole figures (high to low entropy condition). On each trial, participants were instructed to reproduce the duration of their visual experience of the stimulus by pressing and releasing the space bar. To ensure that attention was being deployed to the stimuli, a secondary task was to report the direction of the visual event (forward or reverse motion). Participants completed 60 trials. As predicted, we found that duration reproduction was significantly longer for the high to low entropy condition compared to the low to high entropy condition (p=.03). This preliminary data suggests the presence of a neural mechanism that detects entropy, which is used by other processes to construct our perception of the direction of time or time’s arrow.

Keywords: time perception, entropy, temporal illusions, duration perception

Procedia PDF Downloads 172