Search results for: rain rates

Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Anna Rinaldi, Pierfrancesco Dellino

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COVID-19 vaccine hesitancy can be observed at different rates in different countries. In June 2021, 1,068 people were surveyed in France and Italy to inquire about individual potential acceptance, focusing on time preferences in a risk-return framework: having the vaccination today, in a month, and in 3 months; perceived risks of vaccination and COVID-19; and expected benefit of the vaccine. A randomized controlled trial was conducted to understand how everyday stimuli like fact-based news about vaccines impact an audience's acceptance of vaccination. The main experiment involved two groups of participants and two different articles about vaccine-related thrombosis taken from two Italian newspapers. One article used a more abstract description and language, and the other used a more anecdotal description and concrete language; each group read only one of these articles. Two other groups were assigned categorization tasks; one was asked to complete a concrete categorization task, and the other an abstract categorization task. Individual preferences for vaccination were found to be variable and unstable over time, and individual choices of accepting, refusing, or delaying could be affected by the way news is written. In order to understand these dynamic preferences, the present work proposes a new model based on seven categories of human behaviors that were validated by a neural network. A treatment effect was observed: participants who read the articles shifted to vaccine hesitancy categories more than participants assigned to other treatments and control. Furthermore, there was a significant gender effect, showing that the type of language leading to a lower hesitancy rate for men is correlated with a higher hesitancy rate for women and vice versa. This outcome should be taken into consideration for an appropriate gender-based communication campaign aimed at achieving herd immunity. The trial was registered at ClinicalTrials.gov NCT05582564 (17/10/2022).

Keywords: vaccine hesitancy, risk elicitation, neural network, covid19

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Authors: Majid Aldalbahi

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In 2009, over 3.4 billion people in the world resided in urban areas as a result of rapid urban growth. This figure is estimated to increase to 6.5 billion by 2050. This urban growth phenomenon has raised challenges for many countries in both the developing and developed worlds. Urban growth is a complicated process involving the spatiotemporal changes of all socio-economic and physical components at different scales. The socio-economic components of urban growth are related to urban population growth and economic growth, while physical components of urban growth and economic growth are related to spatial expansion, land cover change and land use change which are the focus of this research. The interactions between these components are complex and no-linear. Several factors and forces cause these complex interactions including transportation and communication, internal and international migrations, public policies, high natural growth rates of urban populations and public policies. Urban growth has positive and negative consequences. The positive effects relates to planned and orderly urban growth, while negative effects relate to unplanned and scattered growth, which is called sprawl. Although urban growth is considered as necessary for sustainable urbanization, uncontrolled and rapid growth cause various problems including consumption of precious rural land resources at urban fringe, landscape alteration, traffic congestion, infrastructure pressure, and neighborhood conflicts. Traditional urban planning approaches in fast growing cities cannot accommodate the negative consequences of rapid urban growth. Microsimulation programme, and modelling techniques are effective means to provide new urban development, management and planning methods and approaches. This paper aims to use these techniques to understand and analyse the complex interactions for the case study of Riyadh city, a fast growing city in Saudi Arabia.

Keywords: policy implications, urban planning, traffic congestion, urban growth, Suadi Arabia, Riyadh

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Authors: Livingstone Makondo

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This ongoing research explores what could be the components of a comprehensive First-Year Student Experience (FYSE) at the Durban University of Technology (DUT) and the preferred implementation modalities. In light of the Siyaphumelela project, this interrogation is premised on the need to glean data for the institution that could be used to ascertain the role of FYSE towards enhancing student success. The research proceeds by examining prevalent models from other South African Universities and beyond in its quest to get at pragmatic comprehensive FYSE programme for DUT. As DUT is a student centered institution and amidst the ever shrinking economy, this research would aid higher education practitioners to ascertain if the hard earned finances are being channelled to a worthy academic venture. This research seeks to get inputs from a) students who participated in FYSE and are now in second and third years at DUT b) students who are currently participating in FYSE c) former and present Tutors d) departmental coordinators e) academics and support staff working with the participating students. This exploratory approach is preferred since 2010 DUT has grappled with how to implement an integrated institution-wide FYSE. This findings of this research could provide the much-needed data to ascertain if the current FYSE package is pivotal towards attainment of DUT Strategic Focus Area 1: Building sustainable student communities of living and learning. The ideal is to have DUT FYSE programme become an institution-wide programme that lays the foundation for consolidated and focused student development programmes for subsequent undergraduate and postgraduate levels of study. Also, armed with data from this research, DUT could develop the capacity and systems to ensure that all students get diverse on-time support to enhance their retention and academic success in their tertiary studies. In essence, the preferred FYSE curriculum woven around DUT graduate attributes should contribute towards the reduction in the first-year students’ dropout rates and subsequently in undergraduate studies. Therefore, this on-going research will feed into Siyaphumelela project and would help position 2018-2020 FYSE initiatives at DUT.

Keywords: challenges, comprehensive, dropout, transition

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Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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Authors: Nizar Jawad Hadi, Sajad Abd Alabbas

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Because of their ability to encapsulate and release drugs in a controlled manner, microspheres fabricated from polymer emulsions using microfluidic devices have shown promise for drug delivery applications. In this study, the effects of velocity, density, viscosity, and surface tension, as well as channel diameter, on microsphere generation were investigated using Fluent Ansys software. The software was programmed with the physical properties of the polymer emulsion such as density, viscosity and surface tension. Simulation will then be performed to predict fluid flow and microsphere production and improve the design of drug delivery applications based on changes in these parameters. The effects of capillary and Weber numbers are also studied. The results of the study showed that the size of the microspheres can be controlled by adjusting the speed and diameter of the channel. Narrower microspheres resulted from narrower channel widths and higher flow rates, which could improve drug delivery efficiency, while smaller microspheres resulted from lower interfacial surface tension. The viscosity and density of the polymer emulsion significantly affected the size of the microspheres, ith higher viscosities and densities producing smaller microspheres. The loading and drug release properties of the microspheres created with the microfluidic technique were also predicted. The results showed that the microspheres can efficiently encapsulate drugs and release them in a controlled manner over a period of time. This is due to the high surface area to volume ratio of the microspheres, which allows for efficient drug diffusion. The ability to tune the manufacturing process using factors such as speed, density, viscosity, channel diameter, and surface tension offers a potential opportunity to design drug delivery systems with greater efficiency and fewer side effects.

Keywords: polymer emulsion, microspheres, numerical simulation, microfluidic device

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Authors: Rawan A. Abdelrazeq, Ahmed M. Khalafallah, Nabil A. Kartam

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Selection of competent contractors for construction projects is usually accomplished through competitive bidding or negotiated contracting in which the contract bid price is the basic criterion for selection. The evaluation of contractor’s safety performance is still not a typical criterion in the selection process, despite the existence of various safety prequalification procedures. There is a critical need for practical and automated systems that enable owners and decision makers to evaluate contractor safety performance, among other important contractor selection criteria. These systems should ultimately favor safety-conscious contractors to be selected by the virtue of their past good safety records and current safety programs. This paper presents an exploratory sequential mixed-methods approach to develop a framework for an automated decision support system that evaluates contractor safety performance based on a multitude of indicators and metrics that have been identified through a comprehensive review of construction safety research, and a survey distributed to domain experts. The framework is developed in three phases: (1) determining the indicators that depict contractor current and past safety performance; (2) soliciting input from construction safety experts regarding the identified indicators, their metrics, and relative significance; and (3) designing a decision support system using relational database models to integrate the identified indicators and metrics into a system that assesses and rates the safety performance of contractors. The proposed automated system is expected to hold several advantages including: (1) reducing the likelihood of selecting contractors with poor safety records; (2) enhancing the odds of completing the project safely; and (3) encouraging contractors to exert more efforts to improve their safety performance and practices in order to increase their bid winning opportunities which can lead to significant safety improvements in the construction industry. This should prove useful to decision makers and researchers, alike, and should help improve the safety record of the construction industry.

Keywords: construction safety, contractor selection, decision support system, relational database

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Authors: Yousef Reda

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Pancreatic cancer has an overall dismal prognosis. CT, MRI and Endoscopic Ultrasound are most often used to establish the diagnosis. We present a case of a patient found on abdominal CT and MRI to have an 8 mm cystic lesion within the head of the pancreas which was thought to be a benign intraductal papillary mucinous neoplasm (IPMN). Further evaluation by EUS demonstrated a 1 cm predominantly solid mass that was proven to be an adenocarcinoma by EUS-guided FNA. The patient underwent a Whipple procedure. The final pathology confirmed a 1 cm pT1 N0 pancreatic ductal adenocarcinoma. Case: A 63-year-old male presented with left upper quadrant pain and an abdominal CT demonstrated an 8 mm lesion within the head of the pancreas that was thought to represent a side branch IPMN. An MRI also showed similar findings. Four months later due to ongoing symptoms an EUS was performed to re-evaluate the pancreatic lesion. EUS revealed a predominantly solid hypoechoic, homogeneous mass measuring 12 mm x 9 mm. EUS-guided FNA was performed and was positive for adenocarcinoma. The patient underwent a Whipple procedure that confirmed it to be a ductal adenocarcinoma, pT1N0. The solid mass was noted to be adjacent to a cystic dilation with no papillary architecture and scant epithelium. The differential diagnosis resided between cystic degeneration of a primary pancreatic adenocarcinoma versus malignant degeneration within a side-branch IPMN. Discussion: The reported sensitivity of CT for pancreatic cancer is approximately 90%. For pancreatic tumors, less than 3 cm the sensitivity of CT is reduced ranging from 67-77%. MRI does not significantly improve overall detection rates compared to CT. EUS, however is superior to CT in the detection of pancreatic cancer, in particular among lesions smaller than 3 cm. EUS also outperforms CT and MRI in distinguishing neoplastic from non-neoplastic cysts. In this case, both MRI and CT failed to detect a small pancreatic adenocarcinoma. The addition of EUS and FNA to abdominal imaging can increase overall accuracy for the diagnosis of neoplastic pancreatic lesions. It may be prudent that when small lesions although appearing as a benign IPMN should further be evaluated by EUS as this would lead to potentially identifying earlier stage pancreatic cancers and improve survival in a disease which has a dismal prognosis.

Keywords: IPMN, MRI, EUS, CT

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Authors: Yimeng Zhang

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Major depressive disorder (MDD) is a prevalent mental health condition with a substantial economic impact and limited treatment options. Acupuncture has gained attention as a promising non-pharmacological intervention for alleviating depressive symptoms. However, its mechanisms and clinical effectiveness remain incompletely understood. This meta-analysis aims to (1) synthesize existing evidence on the mechanisms and clinical effectiveness of acupuncture for depression and (2) compare these findings with pharmacological interventions, providing insights for future research. Evidence from animal models and clinical studies indicates that acupuncture may enhance hippocampal and network neuroplasticity and reduce brain inflammation, potentially alleviating depressive disorders. Clinical studies suggest that acupuncture can effectively relieve primary depression, particularly in milder cases, and is beneficial in managing post-stroke depression, pain-related depression, and postpartum depression, both as a standalone and adjunctive treatment. Notably, combining acupuncture with antidepressant pharmacotherapy appears to enhance treatment outcomes and reduce medication side effects, addressing a critical issue in conventional drug therapy's high dropout rates. This meta-analysis, encompassing 12 studies and 710 participants, draws data from eight digital databases (PubMed, EMBASE, Web of Science, EBSCOhost, CNKI, CBM, Wangfang, and CQVIP) covering the period from 2012 to 2022. Utilizing Stata software 15.0, the meta-analysis employed random-effects and fixed-effects models to assess the distribution of depression in Traditional Chinese Medicine (TCM). The results underscore the substantial evidence supporting acupuncture's beneficial effects on depression. However, the small sample sizes of many clinical trials raise concerns about the generalizability of the findings, indicating a need for further research to validate these outcomes and optimize acupuncture's role in treating depression.

Keywords: Chinese medicine, acupuncture, depression, meta-analysis

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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Authors: McKenna Halverson, Allison Karpyn

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

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

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Authors: Vidya Badrinarayanan, Appa Iyer Sivakumar

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The coronavirus pandemic has sent an important message that future project teams need to be trained to work under virtual conditions, which has already become the new norm in organizations across the world. As organizations increasingly rely on virtual teams to achieve project objectives, it is essential to comprehend how leadership functions in virtual project teams. The purpose of this research is to analyze the leadership behaviors exhibited by project managers for building trust and managing conflicts effectively in virtual project teams. This convergent parallel mixed method research was conducted by surveying 185 virtual leaders and conducting a semi-structured interview with 13 senior virtual leaders involved in managing projects across the industry sectors. The research findings indicate that establishing trust and managing conflicts were ranked as significant challenges in leading virtual project teams in the post-pandemic era. In contrast to earlier findings, our research findings suggest that productivity was not ranked as a significant challenge in leading virtual project teams. This indeed is a positive finding for organizations to consider adopting virtual project teams in the long run. Additionally, the research findings recommend that virtual leaders need to strive to build a high-trust environment and develop effective conflict resolution skills to improve the effectiveness of virtual project teams. As the project management profession struggles with low project success rates, mixed-method research aims to contribute to the knowledge in the growing research area of virtual project leadership. This research contributes to the knowledge by offering first-person accounts from senior virtual leaders on the innovative strategies they had implemented for building trust and resolving conflicts effectively in the virtual project when there were limited opportunities for face-to-face interaction on account of the pandemic. In addition, the leadership framework created as a part of this research for trust development and conflict management in virtual project teams will guide project managers to improve virtual project team effectiveness.

Keywords: conflict management, trust building, virtual leadership, virtual teams

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Authors: Elise Machline

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Policy instruments have been developed worldwide to reduce the energy demand of buildings. Two types of such instruments have been green building rating systems and energy efficiency standards for buildings -such as Green Star (Australia), LEED (United States, Leadership in Energy and Environmental Design), Energy Star (United States), and BREEAM (United Kingdom, Building Research Establishment Environmental Assessment Method). The popularity of the idea of sustainable development has allowed the actors to consider the potential value generated by the environmental performance of buildings, labeled “green value” in the literature. Sustainable performances of buildings are expected to improve their attractiveness, increasing their value. A growing number of empirical studies demonstrate that green buildings yield rental/sale premia, as well as higher occupancy rates and thus higher asset values. The results suggest that green buildings are not affordable to all and that their construction tends to have a gentrifying effect. An increasing number of countries are institutionalizing green strategies for affordable housing. In that sense, making green buildings affordable to all will depend on government policies. That research aims to investigate whether green building fosters inequality in Israel, under the banner of sustainability. The method is comparison (of the market value). This method involves comparing the green buildings sale prices with non-certified buildings of the same type that have undergone recent transactions. The “market value” is deduced from those sources by analogy. The results show that, in Israel, green building projects are usually addressed to the middle to upper classes. The green apartment’s sale premium is about 19% (comparing to non-certified dwelling). There is a link between energy and/or environmental performance and the financial value of the dwellings. Moreover, price differential is much higher than the value of energy savings. This perpetuates socio-spatial and socio-economic inequality as well as ecological vulnerability for the poor and other socially marginal groups. Moreover, there are no green affordable housings and the authorities do not subsidy green building or retrofitting.

Keywords: green building, gentrification, social housing, green value, green building certification

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Authors: Bharath Kenchappa, Kunigal Shivakumar

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Lightweight, low thermal conductivity and high temperature resistant materials or the system with moderate mechanical properties and capable of taking high heating rates are needed in both commercial and military applications. A single material with these attributes is very difficult to find and one needs to come with innovative ideas to make such material system using what is available. To bring down the cost of the system, one has to be conscious about the cost of basic materials. Such a material system can be called as the thermal barrier system. This paper focuses on developing, testing and characterization of material system for thermal barrier applications. The material developed is porous, low density, low thermal conductivity of 0.1062 W/m C and glass transition temperature about 310 C. Also, the thermal properties of the developed material was measured in both longitudinal and thickness direction to highlight the fact that the material shows isotropic behavior. The material is called modified Eco-Core which uses only less than 9% weight of high-char resin in the composite. The filler (reinforcing material) is a component of fly ash called Cenosphere, they are hollow micro-bubbles made of ceramic materials. Special mixing-technique is used to surface coat the fillers with a thin layer of resin to develop a point-to-point contact of particles. One could use commercial ceramic micro-bubbles instead of Cenospheres, but it is expensive. The bulk density of Cenospheres is about 0.35 g/cc and we could accomplish the composite density of about 0.4 g/cc. One percent filler weight of 3mm length standard drywall grade fibers was used to bring the added toughness. Both thermal and mechanical characterization was performed and properties are documented. For higher temperature applications (up to 1,000 C), a hybrid system was developed using an aerogel mat. Properties of combined material was characterized and documented. Thermal tests were conducted on both the bare modified Eco-Core and hybrid materials to assess the suitability of the material to a thermal barrier application. The hybrid material system was found to meet the requirement of the application.

Keywords: aerogel, fly ash, porous material, thermal barrier

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Authors: M. Lobzhanidze, N. Damenia

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The article analyzes the current structural changes in the economy of Georgia, liberalization and integration processes of the economy. In accordance with this analysis, the peculiarities and the problems of youth employment are revealed. In the paper, the Georgian labor market and its contradictions are studied. Based on the analysis of materials, the socio-economic losses caused by the long-term and mass unemployment of young people are revealed, the objective and subjective circumstances of getting higher education are studied. The youth employment and unemployment rates are analyzed. Based on the research, the factors that increase unemployment are identified. According to the analysis of the youth employment, it has appeared that the unemployment share in the number of economically active population has increased in the younger age group. It demonstrates the high requirements of the labour market in terms of the quality of the workforce. Also, it is highlighted that young people are exposed to a highly paid job. The following research methods are applied in the presented paper: statistical (selection, grouping, observation, trend, etc.) and qualitative research (in-depth interview), as well as analysis, induction and comparison methods. The article presents the data by the National Statistics Office of Georgia and the Ministry of Agriculture of Georgia, policy documents of the Parliament of Georgia, scientific papers by Georgian and foreign scientists, analytical reports, publications and EU research materials on similar issues. The work estimates the students and graduates employment problems existing in the state development strategy and priorities. The measures to overcome the challenges are defined. The article describes the mechanisms of state regulation of youth employment and the ways of improving this regulatory base. As for major findings, it should be highlighted that the main problems are: lack of experience and incompatibility of youth qualification with the requirements of the labor market. Accordingly, it is concluded that the unemployment rate of young people in Georgia is increasing.

Keywords: migration of youth, youth employment, migration management, youth employment and unemployment

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Authors: Takaharu Hirai, Yuta Mitobe, Hiromi Hirai

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Introduction: Eating disorders (ED) are serious psychiatric disorders that affect individuals, especially adolescents. It has been suggested that nonclinical ED-like characteristics are related to sleep problems. However, studies exploring the association between potential ED and sleep disorders have primarily been conducted in Europe and the United States. We conducted a survey of Japanese adolescents to investigate this claim. Method: In this cross-sectional study, 398 school-aged adolescents, aged 12–18 years old, matched for gender ratio, responded to a self-administered questionnaire survey. We used the Eating Attitudes Test-26 (EAT-26) and the Athens Insomnia Scale (AIS) to measure potential ED and sleep problems, respectively. In this study, participants with an EAT-26 total score of 0–19 points were classified as non-ED, while those with scores of 20 points or higher were classified as potential ED. Result: Of the 398 participants, 17 (4.3%) had an EAT-26 total score of 20 or higher. Among boys, the rate was 6 of 199 participants (3%), and among girls, the rate was 11 of 182 participants (6%). There were 89 participants (22.4%) with an AIS score of 6 points or higher, of which 36 (17.6%) were boys, and 53 (27.5%) were girls. Adolescents with potential ED had significantly higher rates of daytime sleep problems than those without ED. Further, while examining the types of sleep problems, adolescents with potential ED had greater problems with a sense of well-being and physical and mental functioning during the day. In contrast, no significant associations were found between potential ED and sleep initiation, awakenings during the night, early morning awakening, total sleep duration, or overall quality of sleep. Finally, nocturnal and daytime sleep scores were significantly associated with dieting, bulimia, and oral control EAT-26 sub-scores. Discussion: While Japanese adolescents with possible ED do not experience nighttime sleep problems, they do experience problems related to well-being and mental and physical functioning, which are indicators of daytime sleep problems. This may assist with early detection of disordered eating in adolescents. The study suggested that professionals working towards adolescent mental health issues need an approach that comprehensively integrates both sleep problems and potential ED.

Keywords: adolescents, potential eating disorders, sleep problems, eating attitudes test-26

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Authors: Jane N. O'Sullivan

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In most studies relating change in fertility to potentially causal factors (such as girls’ educational attainment, infant mortality or urbanization), the presence or nature of family planning efforts are not examined, potentially misattributing their contributions. Modest impacts of voluntary family planning programs on fertility change have been claimed, citing the near-term effects of historical quasi-experimental projects – notably in Bangladesh and in Ghana – where recipients and non-recipients could be contrasted. By their nature, such experiments lacked the wider cultural impacts of national programs. Concurrently, analyses relating population growth with economic advancement have been equivocal, discrediting previous widespread concern which prevailed before the 1980s. This neutral view has been revised more recently with demographic dividend theory crediting higher working-age proportion with some economic stimulus if supported by sufficient institutional and human capacity. In this study of country-level data, cross-country comparisons spanning six decades relate fertility decline with family planning effort, GDP per capita and female education, finding that the timing of rapid fertility decline aligns with commencement of voluntary family planning programs, while economic betterment came after substantial fertility fall. The relationship between fertility and primary education completion was inconsistent, with potential channels of causation operating in both directions. GDP per capita was unrelated to rate of fertility decline, but total fertility rates above three children per woman strongly impeded enrichment. By synchronizing countries with respect to their fertility transition, strong relationships are revealed which suggest lower fertility enables economic betterment, rather than the other way around. These results argue in favour of elevating voluntary family planning as a development priority.

Keywords: economic advance, family planning effort, fertility decline, population growth rate

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Authors: Kana Matsuyanagi

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Anorexia Nervosa (AN) is a psychiatric disorder characterized by a relentless pursuit of thinness and strict restriction of food. The current therapeutic approaches for AN predominantly revolve around outpatient psychotherapies, which create significant financial barriers for the majority of affected patients, hindering their access to treatment. Nonetheless, AN exhibit one of the highest mortality and relapse rates among psychological disorders, underscoring the urgent need to provide patients with an affordable self-treatment tool, enabling those unable to access conventional medical intervention to address their condition autonomously. To this end, a neurofeedback software, termed RelaxNeuron, was developed with the objective of providing an economical and portable means to aid individuals in self-managing AN. Electroencephalography (EEG) was chosen as the preferred modality for RelaxNeuron, as it aligns with the study's goal of supplying a cost-effective and convenient solution for addressing AN. The primary aim of the software is to ameliorate the negative emotional responses towards food stimuli and the accompanying aberrant eye-tracking patterns observed in AN patient, ultimately alleviating the profound fear towards food an elemental symptom and, conceivably, the fundamental etiology of AN. The core functionality of RelaxNeuron hinges on the acquisition and analysis of EEG signals, alongside an electrocardiogram (ECG) signal, to infer the user's emotional state while viewing dynamic food-related imagery on the screen. Moreover, the software quantifies the user's performance in accurately tracking the moving food image. Subsequently, these two parameters undergo further processing in the subsequent algorithm, informing the delivery of either negative or positive feedback to the user. Preliminary test results have exhibited promising outcomes, suggesting the potential advantages of employing RelaxNeuron in the treatment of AN, as evidenced by its capacity to enhance emotional regulation and attentional processing through repetitive and persistent therapeutic interventions.

Keywords: Anorexia Nervosa, fear conditioning, neurofeedback, BCI

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Authors: Karen Miner-Romanoff

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Few art programs for incarcerated juveniles exist; however, evaluation results indicate decreased recidivism and behavior problems. This paper reports on an on-going study of a promising art program for incarcerated adolescents with community exhibits and charitable sale of their work. Voices from Inside, a partnership between Franklin University and the Ohio Department of Youth Services, sponsored three exhibits in 2012, 2013, and 2014. In 2013, youth exhibitor survey results (response rate 47%, 16 of 34) showed that 81% cited as benefits cooperation with others, task completion, and increased self-esteem from public recognition and art sales. Community attendee survey results (response rate 29.5%, 59 of 200) showed positive attitude changes toward juvenile offenders, from 40% to 53%. Qualitative responses were similarly positive. The 2014 youth exhibitor sample was larger (response rate 58%, 29 of 50) and showed that 93% cited positive benefits including increase in self-esteem, decrease in stress, pride or recognition of the ability to reach a goal from completing, exhibiting and selling their art to benefit a charity for at-risk youth. This year, the research was able to conduct ten one-on-one interviews inside of the youth facilities, and qualitative responses were even more positive with one youth explaining, “This art represents my joy, my tears, my pain and my hope.” Community attendee survey results (response rate 50%, 86 of 170) were transformative in that that they indicated significant impression on attitudes toward juvenile offenders and their rehabilitative needs with one attendee stating that the event had an, “Immense impact for me bringing into focus the humanity and value these youth still have for us and society.” Future research indicates a need for a correlation study to determine the extent to which these art programs reduce behavioral incidents inside of the facility and long-term reduction in reoffending rates. Generally, further study of juvenile offenders’ art for rehabilitation and restorative justice, the power of art to transform, and university-community partnerships implementing art programs for juvenile offenders should continue.

Keywords: art, juvenile, incarcerated, restorative justice

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Authors: Folong Tchoffo Marlyse Fabiola, Anaba Onana Achille Basile

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Located in the western region of Cameroon, in the BAMBOUTOS department, the city of Mbouda belongs to the Pan-African basement. The water resources exploited in this region consist of surface water and groundwater from weathered and fractured aquifers within the same basement. To study the factors determining the productivity of aquifers in the Mbouda area, we adopted a methodology based on collecting data from boreholes drilled in the region, identifying different types of rocks, analyzing structures, and conducting geophysical surveys in the field. The results obtained allowed us to distinguish two main types of rocks: metamorphic rocks composed of amphibolites and migmatitic gneisses and igneous rocks, namely granodiorites and granites. Several types of structures were also observed, including planar structures (foliation and schistosity), folded structures (folds), and brittle structures (fractures and lineaments). A structural synthesis combines all these elements into three major phases of deformation. Phase D1 is characterized by foliation and schistosity, phase D2 is marked by shear planes and phase D3 is characterized by open and sealed fractures. The analysis of structures (fractures in outcrops, Landsat lineaments, subsurface structures) shows a predominance of ENE-WSW and WNW-ESE directions. Through electrical surveys and borehole data, we were able to identify the sequence of different geological formations. Four geo-electric layers were identified, each with a different electrical conductivity: conductive, semi-resistive, or resistive. The last conductive layer is considered a potentially aquiferous zone. The flow rates of the boreholes ranged from 2.6 to 12 m3/h, classified as moderate to high according to the CIEH classification. The boreholes were mainly located in basalts, which are mineralogically rich in ferromagnesian minerals. This mineral composition contributes to their high productivity as they are more likely to be weathered. The boreholes were positioned along linear structures or at their intersections.

Keywords: Mbouda, Pan-African basement, productivity, west-Cameroon

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Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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Authors: Berk Ecer, Ebru Akcapinar Sezer

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Traditional management models of intersections, such as no-light intersections or signalized intersection, are not the most effective way of passing the intersections if the vehicles are intelligent. To this end, Dresner and Stone proposed a new intersection control model called Autonomous Intersection Management (AIM). In the AIM simulation, they were examining the problem from a multi-agent perspective, demonstrating that intelligent intersection control can be made more efficient than existing control mechanisms. In this study, autonomous intersection management has been investigated. We extended their works and added a potential-based lane organization layer. In order to distribute vehicles evenly to each lane, this layer triggers vehicles to analyze near lanes, and they change their lane if other lanes have an advantage. We can observe this behavior in real life, such as drivers, change their lane by considering their intuitions. Basic intuition on selecting the correct lane for traffic is selecting a less crowded lane in order to reduce delay. We model that behavior without any change in the AIM workflow. Experiment results show us that intersection performance is directly connected with the vehicle distribution in lanes of roads of intersections. We see the advantage of handling lane management with a potential approach in performance metrics such as average delay of intersection and average travel time. Therefore, lane management and intersection management are problems that need to be handled together. This study shows us that the lane through which vehicles enter the intersection is an effective parameter for intersection management. Our study draws attention to this parameter and suggested a solution for it. We observed that the regulation of AIM inputs, which are vehicles in lanes, was as effective as contributing to aim intersection management. PLO-AIM model outperforms AIM in evaluation metrics such as average delay of intersection and average travel time for reasonable traffic rates, which is in between 600 vehicle/hour per lane to 1300 vehicle/hour per lane. The proposed model reduced the average travel time reduced in between %0.2 - %17.3 and reduced the average delay of intersection in between %1.6 - %17.1 for 4-lane and 6-lane scenarios.

Keywords: AIM project, autonomous intersection management, lane organization, potential-based approach

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Authors: Monique Du Plessis, Anina Coetzee, Colleen L. Seymour, Claire N. Spottiswoode

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Artificial nectar feeders are used to attract nectarivorous birds to gardens and are increasing in popularity. The costs and benefits of these feeders remain controversial, however. Nectar feeders may have positive effects by attracting nectarivorous birds towards suburbia, facilitating their urban adaptation, and supplementing bird diets when floral resources are scarce. However, this may come at the cost of luring them away from the plants they pollinate in neighboring indigenous vegetation. This study investigated the effect of nectar feeders on an African pollinator-plant mutualism. Given that birds are important pollinators to many fynbos plant species, this study was conducted in gardens and natural vegetation along the urban edge of the Cape Peninsula. Feeding experiments were carried out to compare relative bird abundance and local distribution patterns for nectarivorous birds (i.e., sunbirds and sugarbirds) between feeder and control treatments. Resultant changes in their visitation rates to Erica flowers in the natural vegetation were tested by inspection of their anther ring status. Nectar feeders attracted higher densities of nectarivores to gardens relative to natural vegetation and decreased their densities in the neighboring fynbos, even when floral abundance in the neighboring vegetation was high. The consequent changes to their distribution patterns and foraging behavior decreased their visitation to at least Erica plukenetii flowers (but not to Erica abietina). This study provides evidence that nectar feeders may have positive effects for birds themselves by reducing their urban sensitivity but also highlights the unintended negative effects feeders may have on the surrounding fynbos ecosystem. Given that nectar feeders appear to compete with the flowers of Erica plukenetii, and perhaps those of other Erica species, artificial feeding may inadvertently threaten bird-plant pollination networks.

Keywords: avian nectarivores, bird feeders, bird pollination, indirect effects in human-wildlife interactions, sugar water feeders, supplementary feeding

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Authors: M. H. Moreira da Silva, L. Valadao, F. Moreira da Silva

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In the present study, the fertilizing capacity of bovine spermatozoa was evaluated before and after its cryopreservation. For this, the testicles of 100 bulls slaughtered on Terceira Island were dissected, the epididymal tails were separated, and semen was recovered by the flotation method and then evaluated by phase contrast microscopy and by flow cytometry. For phase contrast microscopy, a drop of semen was used to evaluate the percentage of motile spermatozoa (from 0 to 100%) and motility (from 0 to 5). After determining the concentration and the abnormal forms, semen was diluted to a final concentration of 50 x 106 spz/ml and evaluated by flow cytometer for membrane and acrosome integrity using the conjugation of fluorescent probes propidium iodide (PI) and Arachis hypogea agglutinin (FITC-PNA). Freezing was carried out in a programmable semen freezer, using 0.25 ml straws, in a total of 20 x 106 viable sperm per straw with glycerol as a cryoprotectant in a final concentration of 0.58 M. It was observed that, on average, a total of 7.25 ml of semen was collected from each bull. The viability and vitality rates were respectively 83.22 ± 7.52% and 3.8 ± 0.4 before freezing, decreasing to 58.81 ± 11.99% and 3.6 ± 0.6, respectively, after thawing. Regarding cytoplasmic droplets, it was observed that a high percentage of spermatozoa had medial cytoplasmic droplets (38.47%), with only 3.32% and 0.15% presenting proximal and distal cytoplasmic drops, respectively. By flow cytometry, it was observed that before freezing, the percentage of sperm with the damaged plasma membrane and intact acrosome was 3.61 ± 0.99%, increasing slightly to 4.21 ± 1.86% after cryopreservation (p<0.05). Regarding spermatozoa with damaged plasma membrane and acrosome, the percentage before freezing was 3.37±1.87%, increasing to 4.34 ±1.16% after thawing, and no significant differences were observed between these two values. For the percentage of sperm with the intact plasma membrane and damaged acrosome, this value was 2.04 ± 2.34% before freezing, decreasing to 0.89 ± 0.48% after thawing (p<0.05). The percentage of sperm with the intact plasma membrane and acrosome before freezing was 90.99±2.75%, with a slight decrease to 90.57±3.15% after thawing (p<0.05). From this study, it can be clearly concluded that, after the slaughtering of bulls, the spermatozoa can be recovered from the epididymis and cryopreserved, maintaining an excellent rate of sperm viability and quality after thawing.

Keywords: bovine semen, epididymis, cryopreservation, fertility assessment

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Authors: Abdul Fatah, Naveenchandra Acharya, Vamshi Krishna, T. Shivaprasad, Ramesh Ramayya

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Background: Significant number of patients with bladder outlet obstruction due to BPH are on anti-platelets and anticoagulants. Prostate surgery in this group of patients either in the form of TURP or Open prostatectomy is associated with increased risk of bleeding complications requiring transfusions, packing of the prostatic fossa or ligation or embolization of internal iliac arteries. Withholding of antiplatelets and anticoagulants may be associated with cardiac and other complications. Efficacy of Thulium Laser in the above group of patients was evaluated in terms of peri-operative, postoperative and delayed bleeding complications as well as cardiac events in peri-operative and immediate postoperative period. Methods: 217 patients with a mean age of 68.8 years were enrolled between March 2009 and March 2013 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), PSA values, urine analysis and urine culture, uroflowmetry. The post operative complications in the form of drop in hemoglobin level, transfusion rates, post –operative cardiac events within a period of 30 days, delayed hematuria and events like deep vein thrombosis and pulmonary embolism were noted. Results: Our data showed a better post-operative outcome in terms of, postoperative bleeding requiring intervention 7 (3.2%), transfusion rate 4 (1.8%) and cardiac events within a period of 30 days 4(1.8%), delayed hematuria within 6 months 2(0.9 %) compared other series of prostatectomies. Conclusion: The thulium LASER prostatectomy is a safe and effective option for patients with cardiac comorbidties and those patients who are on antiplatelet agents and anticoagulants. The complication rate is less as compared to larger series reported with open and transurethral prostatectomies.

Keywords: thulium laser, prostatectomy, antiplatelet agents, bleeding

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Authors: Elsayed A. Elkhatib, Ahmed M. Mahdy, Mohamed L. Moharem, Mohamed O. Mesalem

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Mercury (Hg) is one of the most toxic and bio-accumulative heavy metal in the environment. However, cheap and effective in situ remediation technology is lacking. In this study, the effects of water treatment residuals nanoparticles (nWTR) on mobility, fractionation and speciation of mercury in an arid zone soil from Egypt were evaluated. Water treatment residual nanoparticles with high surface area (129 m 2 g-1) were prepared using Fritsch planetary mono mill. Scanning and transmission electron microscopy revealed that the nanoparticles of WTR nanoparticles are spherical in shape, and single particle sizes are in the range of 45 to 96 nm. The x-ray diffraction (XRD) results ascertained that amorphous iron, aluminum (hydr)oxides and silicon oxide dominating all nWTR, with no apparent crystalline iron–Al (hydr)oxides. Addition of nWTR, greatly increased the Hg sorption capacities of studied soils and greatly reduced the cumulative Hg released from the soils. Application of nWTR at 0.10 and 0.30 % rates reduced the released Hg from the soil by 50 and 85 % respectively. The power function and first order kinetics models well described the desorption process from soils and nWTR amended soils as evidenced by high coefficient of determination (R2) and low SE values. Application of nWTR greatly increased the association of Hg with the residual fraction. Meanwhile, application of nWTR at a rate of 0.3% greatly increased the association of Hg with the residual fraction (>93%) and significantly increased the most stable Hg species (Hg(OH)2 amor) which in turn enhanced Hg immobilization in the studied soils. Fourier transmission infrared spectroscopy analysis indicated the involvement of nWTR in the retention of Hg (II) through OH groups which suggest inner-sphere adsorption of Hg ions to surface functional groups on nWTR. These results demonstrated the feasibility of using a low-cost nWTR as best management practice to immobilize excess Hg in contaminated soils.

Keywords: release kinetics, Fourier transmission infrared spectroscopy, Hg fractionation, Hg species

Procedia PDF Downloads 229

Authors: Fatma Koksal Cakirlar, Murat Gunaydin, Nevri̇ye Gonullu, Nuri Kiraz

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During the last few decades, the increasing prevalence of methicillin resistant-CoNS isolates has become a common problem worldwide. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are effectively used for the treatment of CoNS infections. However, resistance to MLSB antibiotics is prevalent among staphylococci. The aim of this study is to determine species distribution and the incidence of inducible clindamycin resistance in CoNS isolates caused nosocomial bacteremia in our hospital. Between January 2014 and October 2015, a total of 484 coagulase-negative CoNS isolates were isolated from blood samples of patients with true bacteremia who were hospitalized in intensive care units and in other departments of Istanbul University Cerrahpasa Medical Hospital. Blood cultures were analyzed with the BACTEC 9120 system (Becton Dickinson, USA). The identification and antimicrobial resistance of isolates were determined by Phoenix automated system (BD Diagnostic Systems, Sparks, MD). Inducible clindamycin resistance was detected using D-test. The species distribution was as follows: Staphylococcus epidermidis 211 (43%), S. hominis 154 (32%), S. haemolyticus 69 (14%), S. capitis 28 (6%), S. saprophyticus 11 (2%), S. warnerii 7 (1%), S. schleiferi 5 (1%) and S. lugdunensis 1 (0.2%). Resistance to methicillin was detected in 74.6% of CoNS isolates. Methicillin resistance was highest in S.hemoliticus isolates (89%). Resistance rates of CoNS strains to the antibacterial agents, respectively, were as follows: ampicillin 77%, gentamicin 20%, erythromycin 71%, clindamycin 22%, trimethoprim-sulfamethoxazole 45%, ciprofloxacin 52%, tetracycline 34%, rifampicin 20%, daptomycin 0.2% and linezolid 0.2%. None of the strains were resistant to vancomycin and teicoplanin. Fifteen (3%) CoNS isolates were D-test positive, inducible MLSB resistance type (iMLSB-phenotype), 94 (19%) were constitutively resistant (cMLSB -phenotype), and 237 (46,76%) isolates were found D-test negative, indicating truly clindamycin-susceptible MS phenotype (M-phenotype resistance). The incidence of iMLSB-phenotypes was higher in S. epidermidis isolates (4,7%) compared to other CoNS isolates.

Keywords: bacteremia, inducible MLSB resistance phenotype, methicillin-resistant, staphylococci

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Authors: Tim Giesen, Raphael Adamietz, Pablo Mayer, Philipp Stiefel, Patrick Alle, Dirk Schlenker

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The competitiveness and success of new electrical energy storages such as battery cells are significantly dependent on a short time-to-market. Producers who decide to supply new battery cells to the market need to be easily adaptable in manufacturing with respect to the early customers’ needs in terms of cell size, materials, delivery time and quantity. In the initial state, the required output rates do not yet allow the producers to have a fully automated manufacturing line nor to supply handmade battery cells. Yet there was no solution for manufacturing battery cells in low to medium volumes in a reproducible way. Thus, in terms of cell format and output quantity, a concept for the flexible assembly of battery cells was developed by the Fraunhofer-Institute for Manufacturing Engineering and Automation. Based on clustered processes, the modular system platform can be modified, enlarged or retrofitted in a short time frame according to the ordered product. The paper shows the analysis of the production steps from a conventional battery cell assembly line. Process solutions were found by using I/O-analysis, functional structures, and morphological boxes. The identified elementary functions were subsequently clustered by functional coherences for automation solutions and thus the single process cluster was generated. The result presented in this paper enables to manufacture different cell products on the same production system using seven process clusters. The paper shows the solution for a batch-wise flexible battery cell production using advanced process control. Further, the performed tests and benefits by using the process clusters as cyber-physical systems for an integrated production and value chain are discussed. The solution lowers the hurdles for SMEs to launch innovative cell products on the global market.

Keywords: automation, battery production, carrier, advanced process control, cyber-physical system

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Authors: Hala M. El-hanbuli, Mohammed F. Darweesh

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The incidence rates of any tumor vary hugely with geographical location. Basal Cell Carcinoma (BCC) is one of the most common skin cancer that has many histopathologic subtypes. Objective: The aim was to study the histopathological features of BCC cases that were received in the Pathology Department, Kasr El-Aini hospital, Cairo University, Egypt during the period from Jan 2004 to Dec 2013 and to evaluate the clinical characters through the patient data available in the request sheets. Methods: Slides and data of BCC cases were collected from the archives of the pathology department, Kasr El-Aini hospital. Revision of all available slides and histological classification of BCC according to WHO (2006) was done. Results: A total number of 310 cases of BCC representing about 65% from the total number of malignant skin tumors examined during the 10-years duration in the department. The age ranged from 8 to 84 years, the mean age was (55.7 ± 15.5). Most of the patients (85%) were above the age of 40 years. There was a slight male predominance (55%). Ulcerated BCC was the most common gross picture (60%), followed by nodular lesion (30%) and finally the ulcerated nodule (10%). Most of the lesions situated in the high-risk sites (77%) where the nose was the most common site (35%) followed by the periocular area (22%), then periauricular (15%) and finally perioral (5%). No lesion was reported outside the head. The tumor size was less than 2 centimeters in 65% of cases, and from 2-5 centimeters in the lesions' greatest dimension in the rest of cases. Histopathological reclassification revealed that the nodular BCC was the most common (68%) followed by the pigmented nodular (18.75%). The histologic high-risk groups represented (7.5%) about half of them (3.75%) being basosquamous carcinoma. The total incidence for multiple BCC and 2nd primary was 12%. Recurrent BCC represented 8%. All of the recurrent lesions of BCC belonged to the histologic high-risk group. Conclusion: Basal Cell Carcinoma is the most common skin cancer in the 10-year survey. Histopathological diagnosis and classification of BCC cases are essential for the determination of the tumor type and its biological behavior.

Keywords: basal cell carcinoma, high risk, histopathological features, statistical analysis

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Authors: Andrea Parisi, Samantha Vilkins, Luis Furuya-Kanamori, John A. Crump, Benjamin P. Howden, Darren Gray, Kathryn Glass, Martyn Kirk

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Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections.

Keywords: Antimicrobial Resistance, Bloodstream Infection, Health Outcomes, Hospitalisation, Invasive Disease, Multi-Drug Resistance (MDR), Mortality, Nontyphoidal Salmonella

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