Search results for: post stroke survivors

Authors: Chiara Cosentino, Carlo Pruneti, Carla Merisio, Domenico Sgromo

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Introduction – Psychoneuroimmunology as approach clearly showed how psychological features can influence health through specific physiological pathways linked to the stress reaction. This can be true also in cancer, in its latter conceptualization seen as a chronic disease. Therefore, it is still not clear how the psychological features can combine with a physiological specific path, for a better adjustment to cancer. The aim of this study is identifying how in Italian survivors, perceived social support, body image, coping and quality of life correlate with or influence Heart Rate Variability (HRV), the physiological parameter that can mirror a condition of chronic stress or a good relaxing capability. Method - The study had an exploratory transversal design. The final sample was made of 38 ovarian cancer survivors aged from 29 to 80 (M= 56,08; SD=12,76) following a program for Ovarian Cancer at the Oncological Clinic, University Hospital of Parma, Italy. Participants were asked to fill: Multidimensional Scale of Perceived Social Support (MSPSS); Derridford Appearance Scale-59 (DAS-59); Mental Adjustment to Cancer (MAC); Quality of Life Questionnaire (EORTC). For each participant was recorded Short-Term HRV (5 minutes) using emWavePro. Results– Data showed many interesting correlations within the psychological features. EORTC scores have a significant correlation with DAS-59 (r =-.327 p <.05), MSPSS (r =.411 p<.05), and MAC scores, in particular with the strategy Fatalism (r =.364 p<.05). A good social support improves HRV (F(1,33)= 4.27 p<.05). Perceiving themselves as effective in their environment, preserving a good role functioning (EORTC), positively affects HRV (F(1,33)=9.810 p<.001). Women admitting concerns towards body image seem prone to emotive disclosure, reducing emotional distress and improving HRV (β=.453); emotional avoidance worsens HRV (β=-.391). Discussion and conclusion - Results showed a strong relationship between body image and Quality of Life. These data suggest that higher concerns on body image, in particular, the negative self-concept linked to appearance, was linked to the worst functioning in everyday life. The relation between the negative self-concept and a reduction in emotional functioning is understandable in terms of possible distress deriving from the perception of body appearance. The relationship between a high perceived social support and a better functioning in everyday life was also confirmed. In this sample fatalism, was associated with a better physical, role and emotional functioning. In these women, the presence of a good support may activate the physiological Social Engagement System improving their HRV. Perceiving themselves effective in their environment, preserving a good role functioning, also positively affects HRV, probably following the same physiological pathway. A higher presence of concerns about appearance contributes to a higher HRV. Probably women admitting more body concerns are prone to a better emotive disclosure. This could reduce emotional distress improving HRV and global health. This study reached preliminary demonstration of an ‘Integrated Model of Defense’ in these cancer survivors. In these model, psychological features interact building a better quality of life and a condition of psychological well-being that is associated and influence HRV, then the physiological condition.

Keywords: cancer survivors, heart rate variability, ovarian cancer, psychophysiological adjustment

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Authors: Tytus Tulwin, Rafal Sochaczewski, Ksenia Siadkowska

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Designing a new engine requires a large number of different cases to be considered. Especially different injector parameters and combustion chamber geometries. This is essential when developing an engine with unconventional build – compression ignition, two-stroke operating with direct side injection. Computational Fluid Dynamics modelling allows to test those different conditions and seek for the best conditions with correct combustion. This research presents the combustion results for different injector and combustion chamber cases. The shape of combustion chamber is different than for conventional engines as it requires side injection. This completely changes the optimal shape for the given condition compared to standard automotive heart shaped combustion chamber. Because the injection is not symmetrical there is a strong influence of cylinder swirl and piston motion on the injected fuel stream. The results present the fuel injection phenomena allowing to predict the right injection parameters for a maximum combustion efficiency and minimum piston heat loads. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: CFD, combustion, injection, opposed piston

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Authors: Mubarak S. Aldosari

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Transition of adolescents with mild intellectual disabilities (ID) from secondary level to post-school employment level is a critical step for them and their families. Transition of adolescents with mild ID to post secondary levels faces serious difficulties and challenges. The current research highlighted the important factors related to the success of transition of students with mild ID to post-school employment such as vocational training, Self-determination skills, Social skills, and family involvement.

Keywords: adolescents with mild intellectual disabilities, post-school employment, vocational training, self-determination skills, social skills, family involvement

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Authors: B. V. Lande, Suhas Kongare

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Fuel blend of alcohol and conventional hydrocarbon fuels for a spark ignition engine can increase the fuel octane rating and the power for a given engine displacement and compression ratio. The greatest advantage of ethanol as a fuel in SI Engines is its high octane number. The efficiency of an SI engine that is the ability to convert fuel energy to mechanical energy, mainly depends on the compression ratio. It is, therefore, an advantage to increase this as much as possible. The major restraint is the fuel octane number – high octane fuels can be used with high compression ratios, thus yielding higher energy efficiency. This work investigates to suggest suitable ethanol gasoline blend and compression ratio for single cylinder four strokes SI Engine on the basis of performance and exhaust emissions. A single cylinder four stroke SI Engine was tested with different blend of ethanol – gasoline like E5 (5% ethanol +95% gasoline), E10 (10% ethanol + 90% gasoline) E15 (15% ethanol + 85% petrol) and E20 ( 20% + 80% gasoline) with Variable compression ratio. The performance parameter evaluated BSFC, Brake thermal efficiency and also exhaust emission CO2, Co & HC%. The result showed that higher compression ratio improved engine Performance and reduction in exhaust emission.

Keywords: blend, compression ratio, ethanol, performance, blend

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Authors: Natalie Thorburn

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New Zealand legalised and regulated prostitution 13 years ago with the hope of eradicating unsafe or exploitative practices in the sex trade, but the extent to which this has been successful has been hotly contested, with the New Zealand Government denying any existence of sex trafficking and evidence generally indicating the success of the 2004 reform. The aim of the research was therefore to establish the circumstances in which sex trafficking may be occurring without using any previously instrumental gatekeepers of the New Zealand sex industry. 14 survivors of gang, family, or intimate partner trafficking (all of whom had first been trafficked prior to the age of 16) were interviewed, as well as several key informants. It was found that there was a perceived lack of commitment by Police to investigate instances of trafficking, and this was considered to be linked to the legal status of prostitution. The lack of recognition at both community and political levels of the existence and prevalence of trafficking also meant that medical and social service practitioners were unaware trafficking was occurring, and would not know who to refer to if it was disclosed. Participants commonly normalised coercion into sex, seeing this as a continuation of prior sexually abusive experiences that were prevalent in their childhood and early adolescent environments. Their experiences with the helping services were typically either negative or non-existent, and they expressed frustration regarding the absence of justice, the lack of awareness, and health and outcomes they suffered in relation to their experiences of having been trafficked. Barriers to engagement and strategies to facilitate meaningful and sustainable engagement with this population group are therefore presented.

Keywords: legalisation, regulation, service access, socio-political context

Procedia PDF Downloads 216

Authors: Mahyar Maali, Merve Sagiroglu, Mahmut Kilic, Abdulkadir Cuneyt Aydin

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In order to evaluate the residual strength of S235 (St37) steel structures after the fire, an experimental program was undertaken to investigate the post-fire mechanical properties. Tensile coupons taken from S235 sheets were exposed to varying temperatures as 200°C, 400°C, 600°C, and 800 °C. The samples were then allowed to cool down to ambient temperature before they were tested to failure. To obtain the mechanical properties of steels; tensile tests are performed, and the post-fire stress-strain curves are evaluated. The microstructures of the heat-treated specimens were examined by Scanning Electron Microscope (SEM). It is seen that morphology and size of the precipitates in the specimens change, as the heat increases. The modulus of elasticity decreases, and deformation increases with temperature. Energy dissipation decreases due to lower stress according to the stress-strain curves of the specimens. Especially, the mechanical properties were decreased compared with the pre-fire ones. As a result of the post-fire and pre-fire behavior of S235, a set of equations is evaluated to predict the mechanical properties after the fire. These types of equations may allow the structural and/or fire engineers to predict accurately the post-fire behavior of the buildings constructed with S235 type steel.

Keywords: post-fire behavior, stress-strain curves, experimental study, S235 steel

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Authors: Mohammad Mehdizadeh

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COVID-19 forced marketers to change their marketing strategies, focusing less on reactive approaches and more on proactive approaches, primarily social media. The next few years will be dominated by employee engagement and customer experience, leading to businesses focusing more on "long-term customer relationships." A large number of marketing strategies need to be employed in an ever-evolving online environment, which is both filled with opportunities and dangers, as well as being an intimidating platform to use, incorporating new and exciting opportunities for businesses and organizations as it constantly evolves. In this article, we examine the effect of social networks on marketing in post-pandemic environments. A descriptive survey is used as the research method. The results show that social networks have a positive and significant impact on marketing in a post-pandemic environment. Among the social networks studied, Instagram, Facebook, and Twitter have the most positive effect on marketing advancement.

Keywords: COVID-19, customers, marketing, post-pandemic

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Authors: Mohammad Q. M. Momani

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The objective of this study is to examine whether the value relevance of ownership structure changed as the Amman Stock Exchange market conditions changed. Using data from 2005 to 2014, the study finds that the performance of portfolios that contain firms with concentrated ownership structure declines significantly during the post-crisis period. These portfolios exhibit poor performance relative to portfolios that contain firms with dispersed ownership structure during the post-crisis period. The results argue that uninspired performance of the Amman Stock Exchange during the post-crisis period, increased the incentives for controlling shareholders to expropriate. Investors recognized these incentives and discounted firms that were more likely to expropriate.

Keywords: value relevance, ownership structure, portfolio performance, Jordan, ASE

Procedia PDF Downloads 124

Authors: Munenari Inoguchi, Keiko Tamura

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In Japan, we were suffered by earthquake, typhoon, and flood disaster in 2019. Especially, 38 of 47 prefectures were affected by typhoon #1919 occurred in October 2019. By this disaster, 99 people were dead, three people were missing, and 484 people were injured as human damage. Furthermore, 3,081 buildings were totally collapsed, 24,998 buildings were half-collapsed. Once disaster occurs, local responders have to inspect damage level of each building by themselves in order to certificate building damage for survivors for starting their life reconstruction process. At that disaster, the total number to be inspected was so high. Based on this situation, Cabinet Office of Japan approved the way to detect building damage level efficiently, that is collectively detection. However, they proposed a just guideline, and local responders had to establish the concrete and infallible method by themselves. Against this issue, we decided to establish the effective and efficient methodology to detect building damage level collectively with flood depth. Besides, we thought that the flood depth was relied on the land height, and we decided to utilize GIS (Geographic Information System) for analyzing the elevation spatially. We focused on the analyzing tool of spatial interpolation, which is utilized to survey the ground water level usually. In establishing the methodology, we considered 4 key-points: 1) how to satisfy the condition defined in the guideline approved by Cabinet Office for detecting building damage level, 2) how to satisfy survivors for the result of building damage level, 3) how to keep equitability and fairness because the detection of building damage level was executed by public institution, 4) how to reduce cost of time and human-resource because they do not have enough time and human-resource for disaster response. Then, we proposed a methodology for detecting building damage level collectively with flood depth utilizing GIS with five steps. First is to obtain the boundary of flooded area. Second is to collect the actual flood depth as sampling over flooded area. Third is to execute spatial analysis of interpolation with sampled flood depth to detect two-dimensional flood depth extent. Fourth is to divide to blocks by four categories of flood depth (non-flooded, over the floor to 100 cm, 100 cm to 180 cm and over 180 cm) following lines of roads for getting satisfaction from survivors. Fifth is to put flood depth level to each building. In Koriyama city of Fukushima prefecture, we proposed the methodology of collectively detection for building damage level as described above, and local responders decided to adopt our methodology at typhoon #1919 in 2019. Then, we and local responders detect building damage level collectively to over 1,000 buildings. We have received good feedback that the methodology was so simple, and it reduced cost of time and human-resources.

Keywords: building damage inspection, flood, geographic information system, spatial interpolation

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Authors: Suwarno, D. Jongudomkarn

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Family Health Assessment (FHA) is a key process to identify the family health needs, family health problems, and family health history. Assessing the family health is not only from the assessment tool but also from health care provider especially Nurse. Nurses’ have duties to assess the family as holistic view and they have to increase their capacities (knowledge, skills and experiences) in FHA. Thus, the continuing nursing education-training program on using the KKU FHA Tool was aimed to enhance the participant nurses’ capacities in (FHA) based on such tool. The aim of this study was to evaluate the KKU FHA Tool training program on PCU nurses’ capacity before and after training program in Primary Care Unit Bantul, Yogyakarta. The Quasi-Experiment with one group pre-, post-test design as a research design with convenient sampling technique and one group pre- post test formula for Nurses who work in Six PCU Bantul, Yogyakarta as much as fourteen respondents. The research processes were used training program with module, video and handbook KKU FHA Tool, KKU FHA tool form and capacities questionnaires. It was analyzed by descriptive data, Kolmogorov-Smirnov and Paired Sample t-test. The overall comparing analysis of paired sample t-test revealed that the mean values of pre-test were 3.35 with SD 0.417, post-test was 3.86 with SD 0.154 and post-test in later two weeks was 4.00 with SD 0.243. It was found that the p value of among the pre-test, the intermediate post-test and the post–test in later two weeks were 0.000. The p value of the intermediate post-test and post-test in later two weeks was 0.053. KKU FHA Tool training program in PCU Bantul Yogyakarta was enhanced the participant nurses’ capacities significantly. In conclusion, we are recommending KKU FHA Tool forms have to develop and implement with qualitative research as complementary data in PCU Bantul Yogyakarta by Focus Group Discussion.

Keywords: family health assessment, KKU FHA tool, training program, nurses capacities

Procedia PDF Downloads 378

Authors: Sujith Rajashekar Swamy, Meghana Rajashekara Swamy

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Although T1-weighted gadolinium-enhanced imaging (T1-Gd) has its established clinical role in diagnosing brain lesions of infectious and metastatic origins, the use of post-contrast susceptibility-weighted imaging (SWI) has been understudied. This observational study aims to explore and compare the prominence of brain parenchymal lesions between T1-Gd and SWI-Gd images. A cross-sectional study design was utilized to analyze 58 patients with brain parenchymal lesions using T1-Gd and SWI-Gd scanning techniques. Our results indicated that SWI-Gd enhanced the conspicuity of metastatic as well as infectious brain lesions when compared to T1-Gd. Consequently, it can be used as an adjunct to T1-Gd for post-contrast imaging, thereby avoiding additional contrast administration. Improved conspicuity of brain lesions translates directly to enhanced patient outcomes, and hence SWI-Gd imaging proves useful to meet that endpoint.

Keywords: susceptibility weighted, T1 weighted, brain lesions, gadolinium contrast

Procedia PDF Downloads 128

Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

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Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

Procedia PDF Downloads 319

Authors: Sujayeva V. A., Karpova I. S., Koslataya O. V., Kolyadko M. G., Russkikh I. I., Vankovich E. A.

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Objective: The goal of this study is to develop a method for the prevention of the progression of heart failure (HF) in patients with post-infarction cardiosclerosis who have suffered coronavirus infection. Methods: 135 patients with post-infarction cardiosclerosis were divided into 2 groups: Group I - patients who had suffered COVID-19 - 85 people, and Group II - patients who had not suffered COVID-19 - 50 people. Patients of group I, depending on the level of N-terminal fragment of natriuretic peptide (NTproBNP), were divided into 2 subgroups - subgroup A - with HF - 40 people, subgroup B - without HF - 45 people. All patients underwent a clinical examination, echocardiography, electrocardiotopography in 60 leads, computed angiography of the coronary arteries, heart magnetic resonance imaging, NTproBNP. Results: In the post-Covid period, in patients with post-infarction cardiosclerosis, remodeling of the left ventricle and right parts of the heart, deterioration of the systolic-diastolic function of both ventricles, increased pressure in the pulmonary artery, progression of coronary artery atherosclerosis, and an increase in the size of myocardial fibrosis were revealed. The consequence of these changes was the progression of heart failure. The developed method of medical prevention made it possible to improve the clinical course of coronary artery disease and prevent the progression of chronic heart failure in patients with post-infarction cardiosclerosis. Conclusions: In patients with post-infarction cardiosclerosis who initially had HF, after 1 year, according to laboratory and instrumental data, a slight decrease in its severity was revealed. In patients with post-infarction cardiosclerosis who did not have HF before COVID-19, HF developed 1 year after the coronavirus disease, which may be due to the identified process of myocardial fibrosis, which dictates the need to prevent the development of HF in patients with post-infarction cardiosclerosis, even those who did not initially have HF. The proposed method of medical prevention made it possible to improve the clinical course of coronary artery disease in patients with post-infarction cardiosclerosis after COVID-19, both in persons with and without HF, when included in the study. A method of medical prevention in people with post-infarction cardiosclerosis after COVID-19 infection, including spironolactone, loop diuretics, empagliflozin, sacubitril/valsartan, helped prevent the progression of HF.

Keywords: elderly, myocardial infarction, COVID-19, prevention

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Authors: Rafal Sochaczewski, Marcin Szlachetka, Miroslaw Wendeker

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Increasing requirements to reduce exhaust emissions and fuel consumption while increasing the power factor is increasingly becoming applicable to internal combustion engines intended for aircraft applications. As a result, intensive research work is underway to develop a diesel-powered unit for aircraft propulsion. Due to a number of advantages, such as lack of the head (lower heat loss) and timing system, opposite movement of pistons conducive to balancing the engine, the two-stroke compression-ignition engine with the opposite pistons has been developed and upgraded. Of course, such construction also has drawbacks. The main one is the necessity of using a gear connecting two crankshafts or a complicated crank system with one shaft. The peculiarity of the arrangement of pistons with sleeves, as well as the fulfillment of rigorous requirements, makes it necessary to apply the most modern technologies and constructional solutions. In the case of the fuel supply system, it was decided to use common rail system elements. The paper presents an analysis of the possibility of using a common rail pump to supply an aircraft compression-ignition engine. It is an engine with a two-stroke cycle, three cylinders, opposing pistons, and 100 kW power. Each combustion chamber is powered by two injectors controlled by electromagnetic valves. In order to assess the possibility of using a common rail pump, four high-pressure pumps were tested on a bench. They are piston pumps differing in the number and geometry of the pumping sections. The analysis included the torque on the pump drive shaft and the power needed to drive the pump depending on the rotational speed, pumping pressure and fuel dispenser settings. The research allowed to optimize the engine power supply system depending on the fuel demand and the way the pump is mounted on the engine. Acknowledgment: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish Nation-al Centre for Research and Development.

Keywords: diesel engine, fuel pump, opposing pistons, two-stroke

Procedia PDF Downloads 141

Authors: Huda Al-Awisi, Mohammed Al-Azri, Samira Al-Rasbi, Mansour Al-Moundhri

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Cancer diagnosis is invariably a profound and catastrophic life-changing experience for individuals and their families. It has been found that cancer patients and survivors are distressed with the fragility of their life and their mortality. Based on the literature, cancer patients /survivors value their spiritual experience and connecting with unknown power either related to religious belief or not as an important coping mechanism. Health care professionals including nurses are expected to provide spiritual care for cancer patients as holistic care. Yet, nurses face many challenges in providing such care mainly due to lack of clear definition of spirituality. This study aims to explore coping mechanisms of Omani women diagnosed with breast cancer throughout their cancer journey including spirituality using a qualitative approach. A purposive sample of 19 Omani women diagnosed with breast cancer at different stages of cancer treatment modalities were interviewed. Interviews were tape recorded and transcribed verbatim. The framework approach was used to analyze the data. One main theme related to spirituality was identified and called “The power of faith”. For the majority of participants, faith in God (the will of God) was most important in coping with all stages of their breast cancer experience. Some participants thought that the breast cancer is a test from God which they have to accept. Participants also expressed acceptance of death as the eventual end and reward from God. This belief gives them the strength to cope with cancer and seek medical treatment. In conclusion, women participated in this study believed faith in God imposed spiritual power for them to cope with cancer. They connected spirituality with religious beliefs. Therefore, regardless of nurses’ faith in spirituality, the spiritual care needs to be tailored and provided according to each patient individual need.

Keywords: breast cancer, spiritual, religion, coping, diagnosis, oman, women

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Authors: Karen Armstrong

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This paper considers the importance of acquiring, cultivating, and protecting one’s personal online reputation in a post-truth era. Although the idea of the individual is essential psychological construct, the concept necessarily now includes our online reputation. The idea of this online reputation has expanded to become almost more important than any other factor in terms of our professional, social and psychological development. The discussion will first consider philosophical ideas of the self, followed by an examination of underlying concepts of perception and interpretation in a post-truth world. Then, the idea of the recent shift to a consideration of posted images, through words and photos, in the construction of self, will be discussed. Next, the relation between private personal life and exterior social life, including our reputation in a variety of realms will be addressed. This will include the adoption of specific strategies and behaviors, which facilitate accuracy, currency and necessary modifications with regard to our online reputation. Finally, specific ways in which we can negotiate the fluid dynamic between reputation, and inner and outer selves to optimum effect will conclude the discussion.

Keywords: image, post-truth, privacy, reputation, surveillance

Procedia PDF Downloads 254

Authors: Brian J. Biroscak

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

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

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Authors: Pavel Bulai, Taras Pitlik, Tatsiana Kulahava, Timofei Lipski

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The method of Electrocardiography (ECG) interpretation for post-exercise recovery tracking was developed. Metabolic indices (aerobic and anaerobic) were designed using ECG-derived features. This study reports the associations between aerobic and anaerobic indices and classical parameters of the person’s physiological state, including blood biochemistry, glycogen concentration and VO2max changes. During the study 9 participants, healthy, physically active medium trained men and women, which trained 2-4 times per week for at least 9 weeks, fulfilled (i) ECG monitoring using Apple Watch Series 4 (AWS4); (ii) blood biochemical analysis; (iii) maximal oxygen consumption (VO2max) test, (iv) bioimpedance analysis (BIA). ECG signals from a single-lead wrist-wearable device were processed with detection of QRS-complex. Aerobic index (AI) was derived as the normalized slope of QR segment. Anaerobic index (ANI) was derived as the normalized slope of SJ segment. Biochemical parameters, glycogen content and VO2max were evaluated eight times within 3-60 hours after training. ECGs were recorded 5 times per day, plus before and after training, cycloergometry and BIA. The negative correlation between AI and blood markers of the muscles functional status including creatine phosphokinase (r=-0.238, p < 0.008), aspartate aminotransferase (r=-0.249, p < 0.004) and uric acid (r = -0.293, p<0.004) were observed. ANI was also correlated with creatine phosphokinase (r= -0.265, p < 0.003), aspartate aminotransferase (r = -0.292, p < 0.001), lactate dehydrogenase (LDH) (r = -0.190, p < 0.050). So, when the level of muscular enzymes increases during post-exercise fatigue, AI and ANI decrease. During recovery, the level of metabolites is restored, and metabolic indices rising is registered. It can be concluded that AI and ANI adequately reflect the physiology of the muscles during recovery. One of the markers of an athlete’s physiological state is the ratio between testosterone and cortisol (TCR). TCR provides a relative indication of anabolic-catabolic balance and is considered to be more sensitive to training stress than measuring testosterone and cortisol separately. AI shows a strong negative correlation with TCR (r=-0.437, p < 0.001) and correctly represents post-exercise physiology. In order to reveal the relation between the ECG-derived metabolic indices and the state of the cardiorespiratory system, direct measurements of VO2max were carried out at various time points after training sessions. The negative correlation between AI and VO2max (r = -0.342, p < 0.001) was obtained. These data testifying VO2max rising during fatigue are controversial. However, some studies have revealed increased stroke volume after training, that agrees with findings. It is important to note that post-exercise increase in VO2max does not mean an athlete’s readiness for the next training session, because the recovery of the cardiovascular system occurs over a substantially longer period. Negative correlations registered for ANI with glycogen (r = -0.303, p < 0.001), albumin (r = -0.205, p < 0.021) and creatinine (r = -0.268, p < 0.002) reflect the dehydration status of participants after training. Correlations between designed metabolic indices and physiological parameters revealed in this study can be considered as the sufficient evidence to use these indices for assessing the state of person’s aerobic and anaerobic metabolic systems after training during fatigue, recovery and supercompensation.

Keywords: aerobic index, anaerobic index, electrocardiography, supercompensation

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Authors: Sahil Kapahi

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A Formula SAE competition is characterized by typical track layouts having slaloms, tight corners and short straights, which favor a particular range of engine speed for a given set of gear ratios. Therefore, it is imperative that the power-train is optimized for the corresponding engine rpm band. This paper describes the process of designing, simulating and validating an air intake manifold for an inline four cylinder four-stroke internal combustion gasoline engine based on analysis of required vehicle performance. The requirements for the design of subject intake were set considering the rules of FSAE competitions and analysis of engine performance patterns for typical competition scenarios, carried out using OPTIMUMLAP software. Manifold geometry was optimized using results of air flow simulations performed on ANSYS CFX, and subsequent effect of this geometry on the engine was modeled using 1D simulation on Ricardo WAVE. A design was developed to meet the targeted performance standards in terms of engine torque output and volumetric efficiency. Finally, the intake manifold was manufactured and assembled onto the vehicle, and the engine output of the vehicle with the designed intake was studied using a dynamometer. The results of the dynamometer testing were then validated against predicted values derived from the Ricardo WAVE modeling and benefits to performance of the vehicle were established.

Keywords: 1 D Simulation, air flow simulation, ANSYS CFX, four-stroke engine, OPTIMUM LAP, Ricardo WAVE

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Authors: Li-Ting Chen, Chih-Tao Cheng, I-Ping Huang, Jen-Ho Chang, Nien-Tzu Chang, Fei-Hsiu Hsiao

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Background: Insecurity adult attachment style may be triggered by cancer threat, which in turn influences depression symptoms. Dispositional mindfulness may have benefits of insecure attachment on depression for colorectal patient transfer to survivor. Objective: This study examined the mediating and moderating effects of quality of life (QOL) and dispositional mindfulness on the relationship between insecure attachment style and depression symptoms. Methods: A cross-sectional study design was used. Data were collected using the QOL functional and symptoms (EORTC-C30 and EORTC CR29), dispositional mindfulness (FFMQ), Short form of Experience in Close Relationships Revised Questionnaire (SF-ECRRQ), and depressive symptoms (BDI-II scale). Results: Of the 90 CRC survivors who participated, the indirect effect of both ECR anxiety (β=0.23, CI=0.05-0.44) and ECR avoidance (β=0.12, CI=0.02-0.24) on depression were significantly mediated through EORTC-C29 colorectal symptoms. Three components of dispositional mindfulness (i.e., acting of awareness, non-judging, non-reactivity) as the moderator in the relationship between ECR anxiety and depressive symptoms. Acting of awareness was a moderator in the relationship between ECR avoidance and depressive symptoms. Conclusions: There are two pathways from insecure attachment to depression: through the mediator of colorectal symptoms and the moderator of dispositional mindfulness. Cancer symptom management and mindfulness practices could improve the impact of insecure attachment on depression among CRC patients in a post-treatment transition period.

Keywords: acting of awareness, attachment style, colorectal cancer, disposisitonal mindfulness, depression

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Authors: Khushboo Verma

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The use of rape as a weapon of war has been in existence for as early as the middle ages. Women, during the conflict, have been treated as the spoils of war, a reward for the conquering soldiers granted to them by their superiors which is, arguably, most often overlooked as part of the collateral damage that is unavoidable in conflict zones. Korean-born Therese Park’s first novel, A Gift of the Emperor (1997), describes one such atrocious incidence wherein she highlights the active role the Japanese military played in procuring and condoning trafficking of women, who were euphemistically referred to as ‘comfort women’, for prostitution during World War II. This paper thus aims to look at the remembering and reckonings of these women, which fueled a range of creative gestures in the artistic representations and knowledge production by Korean American artists and writers. The essay divides into three parts wherein first it tries to highlight the relationship of the state and the self in relation to the ‘comfort women’ as to who bears the onus of the exploitation of these women, or the responsibility for the redressal with the present-day notions of human rights as studied through Ueno Chizuko’s ‘The Politics of Memory: Nation, Individual and Self’ (1999). There are several narratological elements of the text that are of interest here which shall be viewed and analysed throughout the paper as well. The second part of the paper talks about the aesthetics of rape and sexual violence as represented or (mis)represented by Park in her novel as she attempts to give voice to the victim and retain her and her suffering as the central focus of the narrative. Finally, the third part of the novel explores as well as places the novel in the context of debates over the highly contested issue of ‘comfort women’ and the actual ‘comfort women’ survivors’ testimonies. For this purpose, the present study focuses on Dori Laub’s ‘Truth and Testimony: The Process and the Struggle’ (1991).

Keywords: Korean comfort women, survivors’ testimonies, sexual slavery, aesthetics of sexual violence, horrible memories

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Authors: Ashenafi Ayele, Shewit Haftu, Tesfalem Araya

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Background: “Post-psychotic depression”, “post schizophrenic depression”, and “secondary depression” have been used to describe the occurrence of depressive symptoms during the chronic phase of schizophrenia. Post-psychotic depression is the most common cause of death due to suicide in schizophrenia patients. Overall lifetime risk for patients with schizophrenia is 50% for suicide attempts and 9-13% lifetime risk for completed suicide and also it is associated with poor prognosis and poor quality of life. Objective: To assess determinant of post psychotic depression in schizophrenia patients ACSH and Mekelle General Hospital, Tigray Ethiopia 2019. Methods: An institutional based unmatched case control study was conducted among 69 cases and 138 controls with the ratio of case to control 1 ratio 2. The sample is calculated using epi-info 3.1 to assess the determinant factors of post-psychotic depression in schizophrenia patients. The cases were schizophrenia patients who have been diagnosed at least for more than one-year stable for two months, and the controls are any patients who are diagnosed as schizophrenia patients. Study subjects were selected using a consecutive sampling technique. The Calgary depression scale for schizophrenia self-administered questionnaire was used. Before the interview, it was assessed the client’s capacity to give intended information using a scale called the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Bivariant and multiple Logistic regression analysis was performed to determine between the independent and dependent variables. The significant independent predictor was declared at 95% confidence interval and P-value of less than 0.05. Result: Females were affected by post psychotic depression with the (AOR=2.01, 95%CI: 1.003- 4.012, P= 0.49).Patients who have mild form of positive symptom of schizophrenia affected by post psychotic depression with (AOR =4.05, 95%CI: 1.888- 8.7.8, P=0001).Patients who have minimal form of negative symptom of schizophrenia are affected by post psychotic depression with (AOR =4.23, 95%CI: 1.081-17.092, P=.038). Conclusion: In this study, sex (female) and presence of positive and negative symptoms of schizophrenia were significantly associated. It is recommended that the post psychotic depression should be assessed in every schizophrenia patient to decrease the severity of illness, and to improve patient’s quality of life.

Keywords: determinants, post-psychotic depression, Mekelle city

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Authors: Xiaolian Jiang, Dongling Liu, Kun Liu

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Aims: To examine the prevalence of POST-TRAUMATIC STRESS DISORDER (PTSD) symptoms among Tibetan adolescents in heavily-hit disaster area three years after Yushu earthquake, and to explore the interactions of the psycho-social-genetic risk factors. Methods: This was a three-stage study. Firstly, demographic variables，PTSD Checklist-Civilian Version （PCL-C），the Internality、Powerful other、Chance Scale，（IPC），Coping Style Scale（CSS），and the Social Support Appraisal（SSA）were used to explore the psychosocial factors of PTSD symptoms among adolescent survivors. PCL-C was used to examine the PTSD symptoms among 4072 Tibetan adolescents，and the Structured Clinical Interview for DSM-IV Disorders（SCID）was used by psychiatrists to make the diagnosis precisely. Secondly，a case-control trial was used to explore the relationship between PTSD and gene polymorphisms. 287adolescents diagnosed with PTSD were recruited in study group, and 280 adolescents without PTSD in control group. Polymerase chain reaction-restriction fragment length polymorphism technology（PCR-RFLP）was used to test gene polymorphisms. Thirdly，SPSS 22.0 was used to explore the interactions of the psycho-social-genetic risk factors of PTSD on the basis of the above results. Results and conclusions: 1．The prevalence of PTSD was 9.70%. 2．The predictive psychosocial factors of PTSD included earthquake exposure, support from others, imagine, abreact, tolerant, powerful others and family support. 3．Synergistic interactions between A1 gene of DRD2 TaqIA and the external locus of control, negative coping style, severe earthquake exposure were found. Antagonism interactions between A1 gene of DRD2 TaqIA and poor social support was found. Synergistic interactions between A1/A1 genotype and the external locus of control, negative coping style were found. Synergistic interactions between 12 gene of 5-HTTVNTR and the external locus of control, negative coping style, severe earthquake exposure were found. Synergistic interactions between 12/12 genotype and the external locus of control, negative coping style, severe earthquake exposure were also found.

Keywords: adolescents, earthquake, PTSD, risk factors

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Ahmed R. Z. Baghdadi,  Mona H. Gamal Eldein

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel unsatisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for group I, II, and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed-Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months post-operatively in group I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months post-operatively in group I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: dynamic balance, functional performance, knee arthroplasty, long-term

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Authors: Firmanda Taufiq

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Turkey as a country with great political power and political dynamics that occurred in Turkey shows symptoms that make this country interesting enough to be studied. In addition, there is also Post-Islamism phenomenon that causes fluctuations and changes in Turkish politics. In this regard, Turkey carved out history by holding a referendum that changed the state system from a parliamentary system with a presidential system. This change has major implications in the life of Turkish society and politics. The condition is not only influenced by the government of Recep Tayyib Erdogan alone, but actually there is also anxiety middle class Turkish (Middle Class Anatolia). So there was a Turkish referendum held on 16 April 2017. This research using descriptive-analysis method to analyzing problems of research, that's how the post-Islamism situation in Turkey and Anatolian Middle Class impact to Turkish referendum. Actually, the political process that took place in Turkey is inseparable from Post-Islamism which became an important part in the change and transition of government system. The AKP Party as the basis of the Erdogan government movement became an important actor in the political and policy dynamics produced by the Erdogan government. It is then why the Turkish referendum took place.

Keywords: post-Islamism, Turkish politic, AKP, middle class Anatolia

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Authors: Vinay Choudhary, Ibakordor Patlong

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This study investigates and evaluates pre and post competitive anxiety, self-confidence, and performance of the athletes. The Cognitive State Anxiety Inventory-2 was administered to collect data from 73 athletes, both men, and women, before and after the competition, who participated in the Reliance Foundation Youth Sports (RFYS)-Athletics, held at Gachibowli Stadium, Hyderabad. A paired t-test was used to find the significant difference between the pre and post-competition. Results showed that the levels of cognitive state anxiety before the competition was low as compared after the competition and the levels of somatic state anxiety before the competition was high as compared after the competition whereas the levels of self-confidence before the competition was high as compared after the competition. This study concludes that the levels of cognitive state anxiety increases after the competition as athletes could not perform according to the performance expectations, on the contrary, the levels of somatic anxiety decrease as there was no pressure of performance on the athletes after the competition and the levels of self-confidence decreases after the competition as athletes could not reach their desired performance levels.

Keywords: anxiety, athletes, pre and post, CSAI-2, self-confidence, performance

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Authors: Sweta Kandari

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Predominantly, the conventional role of an architect is to design and construct. However, in a post-disaster scenario, the prevalent role expands and includes many other responsibilities. Agencies collaborating in post-disaster reconstruction face the challenge of building back quickly while requiring them to listen, reflect, develop and deliver as per the needs and requirements of the people. The question of the role of an architect has been extensively discussed in the reconstruction field. Discourses about the role of an architect in post-disaster scenario revolve around the ignorance by the profession, their professional abilities and inabilities. Within this domain, this paper aims at analyzing and recognizing the roles, responsibilities, scope, limitations, skillsets applied and required by an architect while working in a post-disaster situation. Four projects rebuilt after the 2001 Bhuj earthquake in Gujarat, India were examined for this research. Based on the analysis of the case study, areas of intervention of an architect in the various stages of rebuilding were identified. It was reinforced that within the areas of intervention identified, there is a vast gap between the prescribed, the prevalent notion and the performed responsibilities of an architect. This paper brings forth the specific gaps in the rebuilding process while exploring and understanding the relationship between various stakeholders that influence the role of an architect.

Keywords: rebuilding, role of an architect, Bhuj, post-disaster

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Authors: Sally Salah El Menshawy, Ghada M. Ahmed GabAllah, Doaa Khedr M. Khedr

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Background: Our study aims to detect the diagnostic role of DTI in the differentiation of salivary glands benign and malignant lesions. Results: Our study included 50 patients (25males and 25 females) divided into 4 groups (benign lesions n=20, malignant tumors n=13, post-operative changes n=10 and normal n=7). 28 patients were with parotid gland lesions, 4 patients were with submandibular gland lesions and only 1 case with sublingual gland affection. The mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of malignant salivary gland tumors (n = 13) (0.380±0.082 and 0.877±0.234× 10⁻³ mm² s⁻¹) were significantly different (P<0.001) than that of benign tumors (n = 20) (0.147±0.03 and 1.47±0.605 × 10⁻³ mm² s⁻¹), respectively. The mean FA and ADC of post-operative changes (n = 10) were (0.211±0.069 and 1.63±0.20× 10⁻³ mm² s⁻¹) while that of normal glands (n =7) was (0.251±0.034and 1.54±0.29× 10⁻³ mm² s⁻¹), respectively. Using ADC to differentiate malignant lesions from benign lesions has an (AUC) of 0.810, with an accuracy of 69.7%. ADC used to differentiate malignant lesions from post-operative changes has (AUC) of 1.0, and an accuracy of 95.7%. FA used to discriminate malignant from benign lesions has (AUC) of 1.0, and an accuracy of 93.9%. FA used to differentiate malignant from post-operative changes has (AUC) of 0.923, and an accuracy of 95.7%. Combined FA and ADC used to differentiate malignant from benign lesions has (AUC) of 1.0, and an accuracy of 100%. Combined FA and ADC used to differentiate malignant from post-operative changes has (AUC) of 1.0, and an accuracy of 100%. Conclusion: Combined FA and ADC can differentiate malignant tumors from benign salivary gland lesions.

Keywords: diffusion tensor imaging, MRI, salivary gland, tumors

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