Search results for: metabolic syndrome change

Authors: Lebogang Jane Msiza, Felix Dapare Dakora

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Photosynthesis is a process by which plants convert light energy to chemical energy for metabolic processes. Plants are known for converting inorganic CO₂ in the atmosphere to organic C by photosynthesis. A decrease in stomatal conductance causes a decrease in the transpiration rate of leaves, thus increasing the water-use efficiency of plants. Water-use efficiency in plants is conditioned by soil moisture availability and is enhanced under conditions of water deficit. This study evaluated leaf photosynthesis and water-use efficiency in 12 legume species inoculated with 26 rhizobial isolates from soybean, 15 from common bean, 10 from cowpea, 15 from Bambara groundnut, 7 from lessertia and 10 from Kersting bean. Gas-exchange studies were used to measure photosynthesis and water-use efficiency. The results revealed a much higher photosynthetic rate (20.95µmol CO₂ m-2s-1) induced by isolated tutpres to a lower rate (7.06 µmol CO₂ m-2s-1) by isolate mgsa 88. Stomatal conductance ranged from to 0.01 mmol m-2.s-1 by mgsa 88 to 0.12 mmol m-2.s-1 by isolate da-pua 128. Transpiration rate also ranged from 0.09 mmol m-2.s-1 induced by da-pua B2 to 3.28 mmol m-2.s-1 by da-pua 3, while water-use efficiency ranged from 91.32 µmol CO₂ m-1 H₂O elicited by mgsa 106 to 4655.50 µmol CO₂ m-1 H₂O by isolate tutswz 13. The results revealed the highest photosynthetic rate in soybean and the lowest in common bean, and also with higher stomatal conductance and transpiration rates in jack bean and Bambara groundnut. Pigeonpea exhibited much higher water-use efficiency than all the tested legumes. The findings showed significant differences between and among the test legume/rhizobia combinations. Leaf photosynthetic rates are reported to be higher in legumes with high stomatal conductance, which suggests that legume productivity can be improved by manipulating leaf stomatal conductance.

Keywords: legumes, photosynthetic rate, stomatal conductance, water-use efficiency

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Authors: Aneeqa Suhail, Shabana Naveed

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The public sector (in both developed and developing countries) has gone through various waves of radical reforms in recent decades. In Pakistan, under the influence of New Public Management(NPM) Reforms; best practices of private sector are introduced in the public sector to modernize public organizations. Human Resource Information System (HRIS) has been popular in the private sector and proven to be a successful system, therefore it is being adopted in the public sector too. However, implementation of private business practices in public organizations us very challenging due to differences in context. This implementation gets further critical in Pakistan due to a centralizing tendency and lack of autonomy in public organizations. Adoption of HRIS by public organizations in Pakistan raises several questions: What challenges are faced by public organizations in implementation of HRIS? Are benefits of HRIS such as efficiency, process integration and cost reduction achieved? How is the previous system improved with this change and what are the impacts? Yet, it is an under-researched topic, especially in public enterprises. This study contributes to the existing body of knowledge by empirically exploring benefits and challenges of implementation of HRIS in public organizations. The research adopts a case study approach and uses qualitative data based on in-depth interviews conducted at various levels in the hierarchy including top management, departmental heads and employees. The unit of analysis is LESCO, the Lahore Electric Supply Company, a state-owned entity that generates, transmits and distributes electricity to 4 big cities in Punjab, Pakistan. The findings of the study show that LESCO has not achieved the benefits of HRIS as established in literature. The implementation process remained quite slow and costly. Various functions of HR are still in isolation and integration is a big challenge for the organization. Although the data is automated, the previous system of manually record maintenance and paperwork is still in work, resulting in the presence of parallel practices. The findings also identified resistance to change from top management and labor workforce, lack of commitment and technical knowledge, and costly vendors as major barriers that affect the effective implementation of HRIS. The paper suggests some potential actions to overcome these barriers and to enhance effective implementation of HR-technology. The findings are explained in light of an institutional logics perspective. HRIS’ new logic of automated and integrated HR system is in sharp contrast with the prevailing logic of process-oriented manual data maintenance, leading to resistance to change and deadlock.

Keywords: human resource information system, technological changes, state-owned enterprise, implementation challenges

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: I. Boroňová, J.Bernasovská, J. Kľoc, Z. Tomková, E. Petrejčíková, D. Gabriková, S. Mačeková

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Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ2) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ2=0.270, p=0.605; χ2=0.250, p=0.616; G1181C: χ2= 1.730, p=0.188; χ2=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.

Keywords: osteoporosis, real-time PCR method, SNP polymorphisms

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Authors: Livia Herle

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A large part of the Principality of Liechtenstein is covered by forest. Three-quarters of this forest is defined as protective due to the alpine landscape of the country, which is deteriorating the quality of the wood. Nevertheless, the forest is one of the most important sources of raw material. However, out of the wood harvested annually in Liechtenstein, about two-thirds are used directly as an energy source, drastically shortening up the carbon storage cycle of wood. Furthermore, due to climate change, forest structures are changing. Predictions for the forest in Liechtenstein have stated that the spruce will mostly vanish in low altitudes, only being able to survive in the higher regions. In contrast, hardwood species will experience a rise, resulting in a more mixed forest. Thus, the main research focus will be put upon the potential of hardwood as well as prolonging the lifespan of a timber log before ending up as an energy source. An analysis of the local occurrence of hardwood species and their quality will serve as a tool to implement this knowledge upon constructional solutions. As a system that works with short spam timber and thus qualifies for the regional conditions of hardwood, reciprocal frame systems will be further investigated. These can be defined as load-bearing structures with only two beams connecting at a time, avoiding complex joining situations. Furthermore, every beam is mutually supporting. This allows the usage of short pieces of preferably massive wood. As a result, the system permits for an easy assembly but also disassembly. To promote a more circular application of wood, possible cascading scenarios of the structural solutions will be added. In a workshop at the School of Architecture of the University of Liechtenstein in the Sommer Semester 2024, prototypes in 1:1 of reciprocal frame systems using only local hardwood will help as a tool to further test the theoretical analyses.

Keywords: hardwood, cascading wood, reciprocal frames, crooked wood, forest structures, climate change

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Authors: Mahdieh Farzin Asanjan, Erkan Unal Mumcuoglu

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Mitochondria are cytoplasmic organelles of the cell, which have a significant role in the variety of cellular metabolic functions. Mitochondria act as the power plants of the cell and are surrounded by two membranes. Significant morphological alterations are often due to changes in mitochondrial functions. A powerful technique in order to study the three-dimensional (3D) structure of mitochondria and its alterations in disease states is Electron microscope tomography. Detection of mitochondria in electron microscopy images due to the presence of various subcellular structures and imaging artifacts is a challenging problem. Another challenge is that each image typically contains more than one mitochondrion. Hand segmentation of mitochondria is tedious and time-consuming and also special knowledge about the mitochondria is needed. Fully automatic segmentation methods lead to over-segmentation and mitochondria are not segmented properly. Therefore, semi-automatic segmentation methods with minimum manual effort are required to edit the results of fully automatic segmentation methods. Here two editing tools were implemented by applying spline surface dragging and interactive live-wire segmentation tools. These editing tools were applied separately to the results of fully automatic segmentation. 3D extension of these tools was also studied and tested. Dice coefficients of 2D and 3D for surface dragging using splines were 0.93 and 0.92. This metric for 2D and 3D for live-wire method were 0.94 and 0.91 respectively. The root mean square symmetric surface distance values of 2D and 3D for surface dragging was measured as 0.69, 0.93. The same metrics for live-wire tool were 0.60 and 2.11. Comparing the results of these editing tools with the results of automatic segmentation method, it shows that these editing tools, led to better results and these results were more similar to ground truth image but the required time was higher than hand-segmentation time

Keywords: medical image segmentation, semi-automatic methods, transmission electron microscopy, surface dragging using splines, live-wire

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Authors: S. A. Alotaibi, M. A. Al-Ajmi

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This work introduces a new concept for controlling the mechanical vibrations via variable stiffness coil spring. The concept relies on fitting a screw though the spring to change the number of active spring coils. A prototype has been built and tested with promising results toward an innovation in the field of vibration control.

Keywords: variable stiffness, coil spring, vibration control, computer science

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Authors: Ciaran Friel, Jerry Suls, Patrick Robles, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant response. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7, but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by the Fitbit for two weeks. Participants then engaged with a clinical research coordinator to review comprehension of the text message content and required actions for each of the BCTs to be tested. Participants then selected a consistent daily time in which they would receive their text message prompt. In the 8 week intervention phase of the study, participants received each of the four BCTs, in random order, for a two week period. Text message prompts were delivered daily at a time selected by the participant. All prompts required an interactive response from participants and may have included recording their detailed plan for walking or daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves with peers (self-monitoring, feedback). At the end of each two week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. Analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design, and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, 5 days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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Authors: Jeffreyson Wahlang

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The aim of this paper is to analyse the changes in the social status and role of Khasi women with the advent of modernisation and globalisation. Since all societies inevitably undergo social change, this paper will attempt to enquire about the path and direction to which women in Khasi Hills, Meghalaya is moving.

Keywords: status, role, women, Khasi Matriliny, gender

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Authors: M. Mulumpwa, W. W. L. Jere, M. Lazaro, A. H. N. Mtethiwa

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The study considered Seasonal Autoregressive Integrated Moving Average (SARIMA) processes to select an appropriate stochastic model to forecast the monthly data from the Lake Malawi water levels for the period 1986 through 2015. The appropriate model was chosen based on SARIMA (p, d, q) (P, D, Q)S. The Autocorrelation function (ACF), Partial autocorrelation (PACF), Akaike Information Criteria (AIC), Bayesian Information Criterion (BIC), Box–Ljung statistics, correlogram and distribution of residual errors were estimated. The SARIMA (1, 1, 0) (1, 1, 1)12 was selected to forecast the monthly data of the Lake Malawi water levels from August, 2015 to December, 2021. The plotted time series showed that the Lake Malawi water levels are decreasing since 2010 to date but not as much as was the case in 1995 through 1997. The future forecast of the Lake Malawi water levels until 2021 showed a mean of 474.47 m ranging from 473.93 to 475.02 meters with a confidence interval of 80% and 90% against registered mean of 473.398 m in 1997 and 475.475 m in 1989 which was the lowest and highest water levels in the lake respectively since 1986. The forecast also showed that the water levels of Lake Malawi will drop by 0.57 meters as compared to the mean water levels recorded in the previous years. These results suggest that the Lake Malawi water level may not likely go lower than that recorded in 1997. Therefore, utilisation and management of water-related activities and programs among others on the lake should provide room for such scenarios. The findings suggest a need to manage the Lake Malawi jointly and prudently with other stakeholders starting from the catchment area. This will reduce impacts of anthropogenic activities on the lake’s water quality, water level, aquatic and adjacent terrestrial ecosystems thereby ensuring its resilience to climate change impacts.

Keywords: forecasting, Lake Malawi, water levels, water level fluctuation, climate change, anthropogenic activities

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Authors: Maria Francesca Scannone, Martina Bochicchio

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One of the major environmental problems today is hydrocarbon contamination. The promising sustainable technologies for the treatment of these contaminated sites involves the use of biological organisms. In Agri Valley (Basilicata Region) there is a living laboratory (natural oil seeps) where the selective pressure has enriched the environmental matrices with microorganisms, fungi and plant species able to use the hydrocarbons as a source of metabolic energy, to degrade or tolerate hydrocarbons. Observers visiting this area are fascinated by its unspoiled nature, and the condition of the ecosystem does not appear to has been damaged. The amazing resiliency observed in Tramutola site is of key importance to try to bring green remediation technologies, but no research has been done to identify high-performing native species. The aim of this research was to study how natural processes affect the fate of released oil or how individual species or communities of plants and animals are capable of dealing with the burden of otherwise toxic chemicals. The survey of vegetation was carried out, more than 60 species have been identified and divided into tree, shrub and herb layer. Plant data sheets have been completed only for the species that showed the most appropriate properties for phytoremediation. In general, members of the Salicales, Cyperales, Poales, Fagales, Cornales, Equisetales orders were the most commonly identified orders. They are pioneer plants with high adaptive capacity and vegetative propagation. The literature review has highlighted the existence of rhizosphere effect and a green liver model on selected plants. The study provides significant information on the environmental stress adaptation processes of many indigenous plants that are living and growing on a natural leak of crude oil and gas that migrates up through subsurface.

Keywords: green liver, hydrocarbon degradation, oil seeps, phytoremediation

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Authors: Matthias Haerri, Tobias Huettche, Clemens Kustner

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This article discusses the impact of digitization on business valuation. In order to become and remain ‘digital’, investments are necessary whose return on investment (ROI) often remains vague. This uncertainty is contradictory for a valuation, that rely on predictable cash flows, fixed capital structures and the steady state. However digitisation does not make a company valuation impossible, but traditional approaches must be reconsidered. The authors identify four areas that are to be changing: (1) Tools instead of intuition - In the future, company valuation will neither be art nor science, but craft. This does not require intuition, but experience and good tools. Digital evaluation tools beyond Excel will therefore gain in importance. (2) Real-time instead of deadline - At present, company valuations are always carried out on a case-by-case basis and on a specific key date. This will change with the digitalization and the introduction of web-based valuation tools. Company valuations can thus not only be carried out faster and more efficiently, but can also be offered more frequently. Instead of calculating the value for a previous key date, current and real-time valuations can be carried out. (3) Predictive planning instead of analysis of the past - Past data will also be needed in the future, but its use will not be limited to monovalent time series or key figure analyses. With pictures of ‘black swans’ and the ‘turkey illusion’ it was made clear to us that we build forecasts on too few data points of the past and underestimate the power of chance. Predictive planning can help here. (4) Convergence instead of residual value - Digital transformation shortens the lifespan of viable business models. If companies want to live forever, they have to change forever. For the company valuation, this means that the business model valid on the valuation date only has a limited service life.

Keywords: business valuation, corporate finance, digitisation, disruption

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Authors: H. E. Amb. Terry Earthwind Nichols

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Over the years Ambassador Nichols observed that successful companies all have one thing in common - belief in people. His observations of people in many companies, industries, and countries have also concluded one thing - groups of achievers far exceed the expectations and timelines of their superiors. His experience with achieving this has brought forth a model for the 21st century that will not only exceed expectations of companies, but it will also set visions for the future of business globally. It is time for real discussion around the future of work and the business model that will set the example for the world. Methodologies: In-person observations over 40 years – Ambassador Nichols present during the observations. Audio-visual observations – TV, Cinema, social media (YouTube, etc.), various news outlet Reading the autobiography of some of successful leaders over the last 75 years that lead their companies from a distinct perspective your people are your commodity. Major findings: People who believe in the leader’s vision for the company so much so that they remain excited about the future of the company and want to do anything in their power to ethically achieve that vision. People who are achieving regularly in groups, division, companies, etcetera: Live more healthfully lowering both sick time off and on-the-job accidents. Cannot wait to physically get to work as much as they can to feed off the high energy present in these companies. They are fully respected and supported resulting in near zero attrition. Simply put – they do not “Burn Out”. Conclusion: To the author’s best knowledge, 20th century practices in business are no longer valid and people are not going to work in those environments any longer. The average worker in the post-covid world is better educated than 50 years ago and most importantly, they have real-time information about any subject and can stream injustices as they happen. The Consortium Model is just the model for the evolution of both humankind and business in the 21st century.

Keywords: business model, future of work, people, paradigm shift, business management

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Authors: Jinlu Sun, Shouxiang Lu, Siuming Lo

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Large passenger ship, especially luxury cruise, is one of the most prevalent means of marine transportation and tourism nowadays. In case of an accident, an effective evacuation would be the ultimate way to minimize the consequence. Ship heeling and trim has a considerable influence on passenger walking speed and posture during ship evacuation. To investigate passenger movement pattern under the combined effect of ship heeling and trim, a ship corridor simulator was developed. Both fast and freely individual walking experiments by male and female experimental subjects under heeling and trim conditions were conducted and recorded therein. It is found that routes of experimental subjects would change due to the heeling and trim angles, although they always walk along the right side because of cultural factors. Experimental subjects would also change their posture to adapt the combined heeling and trim conditions, such as leaning forward, adopting larger arm swaying, shorter and more frequent steps. While for individual walking speed, the speed would decrease with the increasing heeling and trim angles. But the maximum individual walking speed is achieved at heeling angle of 0° with trim angle ranging from -15° to -5 °, instead of on level ground, which may be attributable to the effect of the gravitational acceleration. Female is approximately 10% slower than male due to the discrepancy in physical quality. Besides, individual walking speed shows similar trends in both fast and freely walking modes, and the speed value in freely walking mode is about 78% of that in fast walking mode under each experimental condition. Furthermore, to designate the movement pattern of passengers in heeling and trim conditions, a model of the walking speed reduction was proposed. This work would provide guidance on the development of evacuation models and the design of evacuation facilities on board.

Keywords: evacuation, heeling, individual walking speed, ship corridor simulator, trim

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Authors: Chengliang Xie, Jinhyun Ryu, Hyun Joon Kim, Gyeong Jae Cho, Wan Sung Choi, Sang Soo Kang, Kye Man Cho, Dong Hoon Lee

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Obesity has become a global health problem and a source of major metabolic diseases like type-2 diabetes, hypertension, heart disease, nonalcoholic fatty liver and cancer. Synthetic anti-obesity drugs are effective but very costly and with undesirable side effects, so natural products such as soybean are needed as an alternative for obesity treatment. Lactobacillus Plantarum P1201is a probiotic bacterial strain reported to produce conjugated linoleic acid (CLA) and increase the ratio of aglycone-isoflavone of soybean, both of which have anti-obesity effect. In this study, the anti-obesity effect of the fermented soybean extract with P1201 (FSE) will be evaluated compared with that of the soybean extract (SE) by 3T3-L1 cells as an in vitro model of adipogenesis. 3T3-L1 cells were treated with SE and FSE during the nine days of the differentiation, lipid accumulation was evaluated by oil-red staining and triglyceride content and the mRNA expression level of adipogenic or lipogenic genes were analyzed by RT-PCR and qPCR. The results showed that formation of lipid droplets in differentiated 3T3-L1 cells was inhibited and triglyceride content was reduced by 23.1% after treated with 1000 μg/mL of FSE compared with control. For SE-treated groups, no delipidating effect was observed. The effect of FSE on adipogenesis inhibition can be attributed to the down-regulation of mRNA expressionof CCAAT/enhancer binding protein (C/EBP-α), lipoprotein lipase (LPL), adiponectin, adipocyte fatty acid-binding protein (aP2), fatty acid synthesis (FAS) and CoA carboxylase (ACC). Our results demonstrated that the anti-obesity effect of soybean can be improved by fermentation with P1201, and P1201can be used as a potential probiotic bacterial strain to produce natural anti-obesity food.

Keywords: fermentation, Lactobacillus plantarum P1201, obesity, soybean

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Authors: Angshuman Raha, Abesh Kumar Sanyal, Uttaran Bandyopadhyay, Kaushik Mallick, Kamalika Bhattacharyya, Subrata Gayen, Gaurab Nandi Das, Mohd. Ali, Kailash Chandra

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Indian Himalayan Region (IHR), due to its sheer latitudinal and altitudinal expanse, acts as a mixing ground for different zoogeographic faunal elements. The innumerable unique and distributional restricted rare species of IHR are constantly being threatened with extinction by the ongoing climate change scenario. Many of which might have faced extinction without even being noticed or discovered. Monitoring the community dynamics of a suitable taxon is indispensable to assess the effect of this global perturbation at micro-habitat level. Lepidoptera, particularly moths are suitable for this purpose due to their huge diversity and strict herbivorous nature. The present study aimed to collate scattered historical records of moths from IHR and spatially disseminate the same in Geographic Information System (GIS) domain. The study also intended to identify moth species with significant altitudinal shifts which could be prioritised for monitoring programme to assess the effect of climate change on biodiversity. A robust database on moths recorded from IHR was prepared from voluminous secondary literature and museum collections. Historical sampling points were transformed into richness grids which were spatially overlaid on altitude, annual precipitation and vegetation layers separately to show moth richness patterns along major environmental gradients. Primary samplings were done by setting standard light traps at 11 Protected Areas representing five Indian Himalayan biogeographic provinces. To identify significant altitudinal shifts, past and present altitudinal records of the identified species from primary samplings were compared. A consolidated list of 4107 species belonging to 1726 genera of 62 families of moths was prepared from a total of 10,685 historical records from IHR. Family-wise assemblage revealed Erebidae to be the most speciose family with 913 species under 348 genera, followed by Geometridae with 879 species under 309 genera and Noctuidae with 525 species under 207 genera. Among biogeographic provinces, Central Himalaya represented maximum records with 2248 species, followed by Western and North-western Himalaya with 1799 and 877 species, respectively. Spatial analysis revealed species richness was more or less uniform (up to 150 species record per cell) across IHR. Throughout IHR, the middle elevation zones between 1000-2000m encompassed high species richness. Temperate coniferous forest associated with 1500-2000mm rainfall zone showed maximum species richness. Total 752 species of moths were identified representing 23 families from the present sampling. 13 genera were identified which were restricted to specialized habitats of alpine meadows over 3500m. Five historical localities with high richness of >150 species were selected which could be considered for repeat sampling to assess climate change influence on moth assemblage. Of the 7 species exhibiting significant altitudinal ascend of >2000m, Trachea auriplena, Diphtherocome fasciata (Noctuidae) and Actias winbrechlini (Saturniidae) showed maximum range shift of >2500m, indicating intensive monitoring of these species. Great Himalayan National Park harbours most diverse assemblage of high-altitude restricted species and should be a priority site for habitat conservation. Among the 13 range restricted genera, Arichanna, Opisthograptis, Photoscotosia (Geometridae), Phlogophora, Anaplectoides and Paraxestia (Noctuidae) were dominant and require rigorous monitoring, as they are most susceptible to climatic perturbations.

Keywords: altitudinal shifts, climate change, historical records, Indian Himalayan region, Lepidoptera

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Authors: Khatia Tavidashvili, Nino Jamrishvili, Valerian Omsarashvili

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Studies of the vertical distribution of the air temperature in the atmosphere have great value for the solution of different problems of meteorology and climatology (meteorological forecast of showers, thunderstorms, and hail, weather modification, estimation of climate change, etc.). From the end of May 2015 in Kakheti after 25-year interruption, the work of anti-hail service was restored. Therefore, in connection with climate change, the need for the detailed study of the contemporary regime of the vertical distribution of the air temperature above this territory arose. In particular, the indicated information is necessary for the optimum selection of rocket means with the works on the weather modification (fight with the hail, the regulation of atmospheric precipitations, etc.). Construction of the detailed maps of the potential damage distribution of agricultural crops from the hail, etc. taking into account the dimensions of hailstones in the clouds according to the data of radar measurements and height of locality are the most important factors. For now, in Georgia, there is no aerological probing of atmosphere. To solve given problem we processed information about air temperature profiles above Telavi, at 27 km above earth's surface. Information was gathered during four observation time (4, 10, 16, 22 hours with local time. After research, we found vertical distribution of the average monthly values of the air temperature above Kakheti in ‎2012-2017 from January to December. Research was conducted from 0.543 to 27 km above sea level during four periods of research. In particular, it is obtained: -during January the monthly average air temperature linearly diminishes with 2.6 °C on the earth's surface to -57.1 °C at the height of 10 km, then little it changes up to the height of 26 km; the gradient of the air temperature in the layer of the atmosphere from 0.543 to 8 km - 6.3 °C/km; height of zero isotherm - is 1.33 km. -during July the air temperature linearly diminishes with 23.5 °C to -64.7 °C at the height of 17 km, then it grows to -47.5 °C at the height of 27 km; the gradient of the air temperature of - 6.1 °C/km; height of zero isotherm - is 4.39 km, which on 0.16 km is higher than in the sixties of past century.

Keywords: hail, Kakheti, meteorology, vertical distribution of the air temperature

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Bo-Jian Wu, Si-Heng Wu

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Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

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Authors: Eve-Andree Laramee

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The aesthetics and ethics of the Nuclear Anthropocene are explored through artists responses to the impact of radioactive materials on ecological systems, global issues, energy policies and ourselves. This presentation tracks and reveals the invisible traces of the nuclear weapons complex and the nuclear energy industry, in relation to environmental justice. Radioactive pollution transgresses international borders, boundaries between land and water, contaminating ecological systems. Radioactive waste is never disposed of; it is dispositioned, placed out of sight and out of mind. These materials leave behind an invisible toxic legacy lasting millions of years. As we are learning post-Fukushima, when climate change occurs and vulnerability spectrums shift, nuclear sites and the life forms surrounding them are at increased risk. By visualizing this contamination through art installations, videos, and social-sculpture interventions, information is shared with the public, raising awareness, and activating community participation in remediation and nonproliferation efforts. The emerging Ecological Art genre proposes paradigms sustainable with the life forms and resources of our planet. It is comprised of artists, scientists, philosophers and activists devoted to these. EcoArt is distinguished by a focus on systems and interrelationships within our environment: the ecological, geographic, political, biological and cultural. This presentation will cover artworks addressing the recent Fukushima meltdowns, weapons proliferation, climate change, radioactive waste disposal and environmental justice. Possibilities for art-and-science collaborations will be discussed as projects that sharpen our ethics and politics in our behaviors and social interactions. The presentation will consist of a PowerPoint talk (paper presentation) accompanied by images and video clips.

Keywords: art, ecology, environment, anthropocene, nuclear

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Authors: Temur Chilachava

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In work the new nonlinear mathematical model describing assimilation of the people (population) with some less widespread language by two states with two various widespread languages, taking into account demographic factor is offered. In model three subjects are considered: the population and government institutions with the widespread first language, influencing by means of state and administrative resources on the third population with some less widespread language for the purpose of their assimilation; the population and government institutions with the widespread second language, influencing by means of state and administrative resources on the third population with some less widespread language for the purpose of their assimilation; the third population (probably small state formation, an autonomy), exposed to bilateral assimilation from two rather powerful states. Earlier by us it was shown that in case of zero demographic factor of all three subjects, the population with less widespread language completely assimilates the states with two various widespread languages, and the result of assimilation (redistribution of the assimilated population) is connected with initial quantities, technological and economic capabilities of the assimilating states. In considered model taking into account demographic factor natural decrease in the population of the assimilating states and a natural increase of the population which has undergone bilateral assimilation is supposed. At some ratios between coefficients of natural change of the population of the assimilating states, and also assimilation coefficients, for nonlinear system of three differential equations are received the two first integral. Cases of two powerful states assimilating the population of small state formation (autonomy), with different number of the population, both with identical and with various economic and technological capabilities are considered. It is shown that in the first case the problem is actually reduced to nonlinear system of two differential equations describing the classical model "predator - the victim", thus, naturally a role of the victim plays the population which has undergone assimilation, and a predator role the population of one of the assimilating states. The population of the second assimilating state in the first case changes in proportion (the coefficient of proportionality is equal to the relation of the population of assimilators in an initial time point) to the population of the first assimilator. In the second case the problem is actually reduced to nonlinear system of two differential equations describing type model "a predator – the victim", with the closed integrated curves on the phase plane. In both cases there is no full assimilation of the population to less widespread language. Intervals of change of number of the population of all three objects of model are found. The considered mathematical models which in some approach can model real situations, with the real assimilating countries and the state formations (an autonomy or formation with the unrecognized status), undergone to bilateral assimilation, show that for them the only possibility to avoid from assimilation is the natural demographic increase in population and hope for natural decrease in the population of the assimilating states.

Keywords: nonlinear mathematical model, bilateral assimilation, demographic factor, first integrals, result of assimilation, intervals of change of number of the population

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Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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Authors: Ravi Kant Anand, Nikkey Keshri

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The Great Barrier Reef of Australia is known for its beautiful landscapes and seascapes with ecological importance. This site was selected as a World Heritage site in 1981 and popularized internationally for tourism, recreational activities and fishing. But the major environmental hazards such as climate change, pollution, overfishing and shipping are making worst the site of marine ecosystem. Climate change is directly hitting on Great Barrier Reef through increasing level of sea, acidification of ocean, increasing in temperature, uneven precipitation, changes in the El Nino and increasing level of cyclones and storms. Apart from that pollution is second biggest factor which vanishing the coral reef ecosystem. Pollution including over increasement of pesticides and chemicals, eutrophication, pollution through mining, sediment runoff, loss of coastal wetland and oil spills. Coral bleaching is the biggest problem because of the environmental threatening agents. Acidification of ocean water reduced the formation of calcium carbonate skeleton. The floral ecosystem (including sea grasses and mangroves) of ocean water is the key source of food for fishes and other faunal organisms but the powerful waves, extreme temperature, destructive storms and river run- off causing the threat for them. If one natural system is under threat, it means the whole marine food web is affected from algae to whale. Poisoning of marine water through different polluting agents have been affecting the production of corals, breeding of fishes, weakening of marine health and increased in death of fishes and corals. In lieu of World Heritage site, tourism sector is directly affected and causing increasement in unemployment. Fishing sector also affected. Fluctuation in the temperature of ocean water affects the production of corals because it needs desolate place, proper sunlight and temperature up to 21 degree centigrade. But storms, El Nino, rise in temperature and sea level are induced for continuous reduction of the coral production. If we do not restrict the environmental problems of Great Barrier Reef than the best known ecological beauty with coral reefs, pelagic environments, algal meadows, coasts and estuaries, mangroves forests and sea grasses, fish species, coral gardens and the one of the best tourist spots will lost in upcoming years. My research will focus on the different environmental threats, its socio-economic impacts and different conservative measures.

Keywords: climate change, overfishing, acidification, eutrophication

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Authors: Özge Selin Çevik, Leyla Şahin, Gülhan Örekeci Temel

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The early postnatal period is critical for the development of cognitive and emotional functions. Maternal separation is a detrimental postnatal influence, whereas environmental enrichment is a therapeutic and protective agent. It is unclear if long-term environmental enrichment can compensate for the effects of maternal separation stress on anxiety behavior. This study was designed to examine how environmental enrichment affects anxiety levels and corticosterone levels in maternally separated rats. There are six main groups in this study: control (C), maternal separation+standard cage (MS), maternal separation+enriched environment (MSE), enriched environment (E), the maternal separation that decapitated at postnatal (PN) 21 (MS21), and standard cage that decapitated at PN21 (STD21). The maternal separation procedure consisted of PN for 21 days (between 09:00 a.m and 12:00 a.m). Enriched (E, MSE) or standard cage environment rats (MS, C) spent PN (22-55) days in either enriched cages or standard cages. Anxiety and locomotor activity were examined with the open field and elevated plus-maze test. Blood corticosterone level was evaluated by the enzyme-linked immunosorbent assay (ELISA) method. Results showed that maternal separation (MS) increased locomotor activity and anxiety. An enriched environment (E) did not change the locomotor activity. MSE group’s anxiety and locomotor activity did not change. Corticosterone levels increased in the maternal separation group that decapitated at the PN 21 days. Maternal separation increases anxiety. Environmental enrichment alone was insufficient to cause alterations in the anxiety level. In addition, environmental enrichment did not ameliorate the anxiety level in maternally separated rats. However, environmental enrichment decreased the locomotor activity in the maternally separated rats.

Keywords: maternal separation, environment enrichment, stress, hippocampus, anxiety, memory, rat

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Authors: Bishal Saha, Musah Ahmed Rufai Muhyedeen, Jubeyer Hossain Joy, Muhammad Muhitur Rahman, Mohammad Shahedur Rahman, Md Arif Hasan, Syed Masiur Rahman

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Greenhouse gas (GHG) emission is one of the critical problems of today’s world. Many countries have been taking many short- and long-term plans to reduce climate change mitigation. However, the potential of behavioral changes in addressing this problem is promising, as reported by many researchers. This paper presents a comprehensive literature review that focuses on ways to influence people’s behavior in their homes, workplace, and transportation to mitigate the emission directly or indirectly. This study will investigate different theories pertinent to planned behavior and the key elements for modifying behavior like biophilia, reinforcement to use optimum energy and recyclable products, proper application of greenhouse tax, modern technology, and sustainable design adaptation, transportation sharing, social and community norms, proper education and information, and financial incentives. There is a number of challenges associated with behavioral changes. Behavioral interventions have different actions varied by their type and need to combine various policy tools and great social marketing. Many interventions can reduce GHG emissions without any compromise with household well-being. This study will develop a landscape of prevailing theories of environmental psychology by identifying and reviewing the key themes and findings of this field of study. It will support especially the developing countries to reduce GHG emissions without significant capital investment. It is also expected that the behavioral changes will lead to the successful adoption of climate-friendly policies easily. This study will also generate new research questions and directions.

Keywords: behavioral changes, climate change mitigation, environmental psychology, greenhouse gas emission

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Nwafia Ifeyinwa Nkeiruka, Nwafia Walter Chukwuma

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Since the early 1980’s fungi have emerged as major causes of human diseases, especially among immunocompromised. The most commonly isolated yeast is Candida albicans and constitutes the 4th most common nosocomial BSI in humans. It is progressive and cumulative and become more complex over time.It can even lead to leaky gut syndrome that causes food and environmental allergies. It is worthy of note that all the available data on oral Candida risk factors in humans were documented essentially using data from studies conducted in other areas, hence there is need for comparative and complementary information from the South eastern part of Nigeria. Method: 200 subjects of all age groups of both sexes were randomly examined,by swabbing their palatine mucosa and dorsal tongue with sterile cotton wool,then cultured into Sabouraud dextrose agar plates supplemented with antibiotics and incubated aerobically at 37 degree for 48 hrs. Identification of Candida albicans was done by germ tubes tests, chlamydospores production on cornmeal agar supplemented with 1% Tween 80.Sugar and nitrogen assimilation test using API 20C Auxanogram and potassium nitrate agar. Results: Out of 30 samples that were positive for candida, 15 (50%) were candida albicans. Using the anova test (P < 0.05) this variation is significant (P = 0016). followed by C. dublinensis 3 (13%), C. tropicalis 3 (10%), C. pseudotropicalis 3 (10%), C, glabrata 2 (7%), C. parapsilosis 2 (7%) and lastly C. krusei 1 (3%).However, 53% of the patients were female while 47% were male. Among the HIV positive isolates.67% were HIV isolates not on drugs while 33% positives isolates were on drugs and the percentages of candida species in these patients were as follows C. albicans were 45% followed by C. glabrata and C.tropicalis which were 17% each, C.parapsilosis, C.dubliensis and C.pseudotropicalis were all 8% each. Conclusion: Oral Candidiasis is a marker of systemic diseases and in some cases, it may be the first clinical presentation. There is need for more intensive clinical and laboratory monitoring and possible early intervention to prevent the reoccurrence and resistance to treatment.

Keywords: oral cavity, Candida species, oral Candidiasis, risk factors

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Authors: Akash Soogumbur

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Tourniquets are commonly used in orthopaedic surgery to provide hemostasis during procedures on the upper and lower limbs. However, there is a risk of complications associated with tourniquet use, such as nerve damage, skin necrosis, and compartment syndrome. The British Orthopaedic Association (BOAST) guidelines recommend the use of tourniquets at a pressure of 300 mmHg or less for a maximum of 2 hours. Research Aim: The aim of this study was to evaluate the effectiveness of a tourniquet checklist in improving compliance with the BOAST guidelines. Methodology: This was a retrospective study of all orthopaedic procedures performed at a single institution over a 12-month period. The study population included patients who had a tourniquet applied during surgery. Data were collected from the patients' medical records, including the duration of tourniquet use, the pressure used, and the method of exsanguination. Findings: The results showed that the use of the tourniquet checklist significantly improved compliance with the BOAST guidelines. Prior to the introduction of the checklist, compliance with the guidelines was 83% for the duration of tourniquet use and 73% for pressure used. After the introduction of the checklist, compliance increased to 100% for both duration of tourniquet use and pressure used. Theoretical Importance: The findings of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use. Data Collection: Data were collected from the patients' medical records. The data included the following information: Patient demographics, procedure performed, duration of tourniquet use, pressure used, method of exsanguination. Analysis Procedures: The data were analyzed using descriptive statistics. The compliance with the BOAST guidelines was calculated as the percentage of patients who met the guidelines for the duration of tourniquet use and pressure used. Question Addressed: The question addressed by this study was whether the use of a tourniquet checklist could improve compliance with the BOAST guidelines. Conclusion: The results of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use.

Keywords: tourniquet, pressure, duration, complications, surgery

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Authors: Asharaf Abdul Salam, Ibrahim Elsegaey, Rshood Khraif, Abdullah AlMutairi, Ali Aldosari

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Arab World that comprises of 22 member states of Arab League undergoes rapid transition in demographic front - fertility, mortality and migration. A distinctive geographic region spread across West Asia and North East Africa unified by Arabic language shares common values and characteristics even though diverse in economic and political conditions. Demographic lag that characterizes Arab World is unique but the present trend of declining fertility combined with the existing relatively low mortality undergoes significant changes in its population size. The current research aimed at (i) assessing the growth of population, over a period of 3 decades, (ii) exploring the components and (iii) understanding the public health impact. Based on International Data Base (IDB) of US Census Bureau, for 3 time periods – 1992, 2002 and 2012; 21 countries of Arab World have been analyzed by dividing them into four geographic sectors namely Gulf Cooperation Council (GCC), West Asia, Maghreb and Nile Valley African Horn. Population of Arab World grew widely during the past both through natural growth and migration. Immigrations pronounced especially in the resource intensive GCC nations not only from East Asian and central African countries but also from resource thrifty Arab nations. Migrations within the Arab World as well as outside of the Arab World remark an interesting demographic phenomenon that requires further research. But the transformations on public health statistics – impact of demographic change – depict a new era in the Arab World.

Keywords: demographic change, public health statistics, net migration, natural growth, geographic sectors, fertility and mortality, life expectancy

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Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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