Search results for: universal events

Authors: Christina Largent, Tazley Hobbs

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Objective: A literature review was performed to examine the existing research on COVID-19 lockdown as it relates to ADHD child/adolescent individuals, media use, and impact on educational performance/learning. It was surmised that with the COVID-19 shut-down and transition to remote learning, a less structured learning environment, increased screen time, in addition to potential difficulty accessing school resources would impair ADHD individuals’ performance and learning. A resulting increase in the number of youths diagnosed and treated for ADHD would be expected. As of yet, there has been little to no published data on the incidence of ADHD as it relates to COVID-19 outside of reports from several nonprofit agencies such as CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder ), who reported an increased number of calls to their helpline, The New York based Child Mind Institute, who reported an increased number of appointments to discuss medications, and research released from Athenahealth showing an increase in the number of patients receiving new diagnosis of ADHD and new prescriptions for ADHD medications. Methods: A literature search for articles published between 2020 and 2021 from Pubmed, Google Scholar, PsychInfo, was performed. Search phrases and keywords included “covid, adhd, child, impact, remote learning, media, screen”. Results: Studies primarily utilized parental reports, with very few from the perspective of the ADHD individuals themselves. Most findings thus far show that with the COVID-19 quarantine and transition to online learning, ADHD individuals’ experienced decreased ability to keep focused or adhere to the daily routine, as well as increased inattention-related problems, such as careless mistakes or lack of completion in homework, which in turn translated into overall more difficulty with remote learning. To add further injury, one study showed (just on evaluation of two different sites within the US) that school based services for these individuals decreased with the shift to online-learning. Increased screen time, television, social media, and gaming were noted amongst ADHD individuals. One study further differentiated the degree of digital media, identifying individuals with “problematic “ or “non-problematic” use. ADHD children with problematic digital media use suffered from more severe core symptoms of ADHD, negative emotions, executive function deficits, damage to family environment, pressure from life events, and a lower motivation to learn. Conclusions and Future Considerations: Studies found not only was online learning difficult for ADHD individuals but it, in addition to greater use of digital media, was associated with worsening ADHD symptoms impairing schoolwork, in addition to secondary findings of worsening mood and behavior. Currently, data on the number of new ADHD cases, in addition to data on the prescription and usage of stimulants during COVID-19, has not been well documented or studied; this would be well-warranted out of concern for over diagnosing or over-prescribing our youth. It would also be well-worth studying how reversible or long-lasting these negative impacts may be.

Keywords: COVID-19, remote learning, media use, ADHD, child, adolescent

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Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel

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Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.

Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite

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Authors: Ani Kojoyan

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The Syrian refugee crisis has been a matter of worldwide concern during the recent years. And though refugees’ problems are contextualized in terms of time and space, the refugee crisis still remains a global issue to discuss. Since the start of the conflict, Armenia has welcomed thousands of Syrian refugees too. Taking into consideration Armenia’s current socio-economic and geopolitical situation, the flow of refugees is a challenge both for the country and for refugees themselves. However, these people are not simply refugees from Syria, they are Syrian-Armenian refugees; people whose ancestors were survivals of the Armenian Genocide, perpetrated by the Ottoman Turks in 1915, people whose ancestors became refugees a century ago in Syria and now, ironically, a century later they follow their ancestors’ paths, turning into refugees themselves in their historical homeland, facing various difficulties, among them socio-economic, socio-ideological, and identity and gender issues, the latter being the main topic of discussion in the present paper. The situation presented above makes us discuss certain questions within this study: how do Syrian-Armenian refugees define themselves and their status? Which are their gender roles in the socio-economic context? How do social and economic challenges re-shape Syrian-Armenian women refugees’ identities? The study applies qualitative research methods of analysis, which includes semi-structured and in-depth interviews with 15 participants (18-25, 26-40 age groups), and two focus group works, involving 8 participants (18-35 age group) for each focus group activity. The activities were carried out in October 2016, Yerevan, Armenia. The study also includes Secondary Data Analysis. In addition, in order to centralize refugee women’s experiences and identity issues, the study adopts a qualitative lens from a feminist standpoint position. It is based on the assumption that human activity structures and limits understanding, and that the distorted comprehension of events or activities has emerged from the male-oriented dominant judgement which can be discovered through uncovering the understanding of the situation from women’s activity perspectives. The findings suggest that identity is dynamic, complex, over-changing and sensitive to time and space, gender and class. The process of re-shaping identity is even more complicated and multi-layered and is based on internal and external factors, conditioned by individual and collective needs and interests. Refugees are mostly considered as people who lost their identity in the past since they have no longer connection anywhere and try to find it in the present. In turn, female refugees, being a more vulnerable class, go through more complicated identity re-formulating discourse negotiations. They stand between the borders of the old and new, borders of lost and re-found selves, borders of creating and self-fashioning, between illusions and the challenging reality. Particularly, refugee women become more sensitive within the discourses of the private and the public domains: some of them try to create a ‘new-self’, creating their space in a new society, whereas others try to negotiate their affective/emotional labour within their own family domains.

Keywords: feminist standpoint position, gender, identity, refugee studies, Syrian-Armenian women refugees

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Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.

Keywords: coping, distress, hearing loss, personality

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Authors: E. O. Okan, A. Kepic, P. Williams

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Iron oxide copper gold (IOCG) deposits constitute important sources of copper and gold in Australia especially since the discovery of the supergiant Olympic Dam deposits in 1975. They are considered to be metasomatic expressions of large crustal-scale alteration events occasioned by intrusive actions and are associated with felsic igneous rocks in most cases, commonly potassic igneous magmatism, with the deposits ranging from ~2.2 –1.5 Ga in age. For the past two decades, geological, geochemical and potential methods have been used to identify the structures hosting these deposits follow up by drilling. Though these methods have largely been successful for shallow targets, at deeper depth due to low resolution they are limited to mapping only very large to gigantic deposits with sufficient contrast. As the search for ore-bodies under regolith cover continues due to depletion of the near surface deposits, there is a compelling need to develop new exploration technology to explore these deep seated ore-bodies within 1-4km which is the current mining depth range. Seismic reflection method represents this new technology as it offers a distinct advantage over all other geophysical techniques because of its great depth of penetration and superior spatial resolution maintained with depth. Further, in many different geological scenarios, it offers a greater ‘3D mapability’ of units within the stratigraphic boundary. Despite these superior attributes, no arguments for crustal scale seismic surveys have been proposed because there has not been a compelling argument of economic benefit to proceed with such work. For the seismic reflection method to be used at these scales (100’s to 1000’s of square km covered) the technical risks or the survey costs have to be reduced. In addition, as most IOCG deposits have large footprint due to its association with intrusions and large fault zones; we hypothesized that these deposits can be found by mainly looking for the seismic signatures of intrusions along prospective structures. In this study, we present two of such cases: - Olympic Dam and Vulcan iron-oxide copper-gold (IOCG) deposits all located in the Gawler craton, South Australia. Results from our 2D modelling experiments revealed that seismic reflection surveys using 20m geophones and 40m shot spacing as an exploration tool for locating IOCG deposit is possible even when hosted in very complex structures. The migrated sections were not only able to identify and trace various layers plus the complex structures but also show reflections around the edges of intrusive packages. The presences of such intrusions were clearly detected from 100m to 1000m depth range without losing its resolution. The modelled seismic images match the available real seismic data and have the hypothesized characteristics; thus, the seismic method seems to be a valid exploration tool to find IOCG deposits. We therefore propose that 2D seismic survey is viable for IOCG exploration as it can detect mineralised intrusive structures along known favourable corridors. This would help in reducing the exploration risk associated with locating undiscovered resources as well as conducting a life-of-mine study which will enable better development decisions at the very beginning.

Keywords: crustal scale, exploration, IOCG deposit, modelling, seismic surveys

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Authors: Aathira Peedikaparambil Somasundaran

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The beginning of the 20th century marked the perios when a new generation of Lebanese radicals sowed the seeds for the second phase of Levant literary modernism, situated in the Levant. Beirut, during this era popularly fit every radical writer’s criterion owing to its weakened censorship and political control, despite the absence of a protective womb for the development of literary modernism, caused by the natively prevalent political unsettlement. The third stage of literary modernization, in which scholars used Western-inspired critical techniques to better understand their own cultures, coincides with the time period examined in this paper, which involved the international-inspired critical analysis of native cultural stimulants, which raised questions among Arab freethinking intellectuals. Locals who ventured outside recognised the difference between the West's progress and their own nations' stagnation. The awareness of such ‘gap of success’ aroused an ambition from journalists, authors, and proletarian revolutionaries who had studied in Europe, and finally developed enlightened ideas. Some Middle Eastern authors and artists only adopted current social and political frameworks after discovering western modernity. After learning about the upheavals that were happening in the West, these thinkers aspired to bring about equally broad drastic developments in their own country's social, political, and cultural milieu. These occurrences illustrate the increased power of migration to alter the cultural and literary scene in the Levant. The paper intends to discuss the different effects of migration that contributed to Levant literary modernism. The exploration of these factors as causes begins with addressing the politically influenced activism, that has always been a relevant part of Beirut, and then diving into the psychological effects of migration in the individuals of the society, which might have induced an accommodability to alien thoughts and ideas over time, as a coping mechanism. Nature or environmental stimuli, a common trigger for any creative output, often having the highest influence during travel will be identified and analysed to inspect the extent of its impact on the exchange of ideas that resulted in Levant modernism. The efficiency of both the stimulating component of travel and the diaspora of the indigenous, a by-product of travel in catalysing modernism in the Levant has to be proven in order to understand how migration indirectly affected the transmission and adoption of ideas in Levant literature. The paper will revisit the events revolving around these key players and platforms like Shir, to understand how the Lebanese literature, tied down in poetry drastically mutated under the leadership of Adonis, Yusuf et Khal, and other pioneers of Levant literary modernism. The conclision will identify the triggers that helped authors overcome personal and geographical barriers to unite the West and the Levant, and investigate the extent to which the bi-directional migration prompted a transformation in the local poetry. Consequently, the paper aims to shed light into the unique factor that provoked the shift in the literary scene of Twentieth century in the Middle East.

Keywords: literature, modernism, Middle East, levant, Beirut

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Authors: U.K. Sarkar, G. Karnatak, P. Mishal, Lianthuamluaia, S. Kumari, S.K. Das, B.K. Das

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Inland open water fisheries provide food, income, livelihood and nutritional security to millions of fishers across the globe. However, the open water ecosystem and fisheries are threatened due to climate change and anthropogenic pressures, which are more visible in the recent six decades, making the resources vulnerable. Understanding the interaction between meteorological parameters and inland fisheries is imperative to develop mitigation and adaptation strategies. As per IPCC 5th assessment report, the earth is warming at a faster rate in recent decades. Global mean surface temperature (GMST) for the decade 2006–2015 (0.87°C) was 6 times higher than the average over the 1850–1900 period. The direct and indirect impacts of climatic parameters on the ecology of fisheries ecosystem have a great bearing on fisheries due to alterations in fish physiology. The impact of meteorological factors on ecosystem health and fish food organisms brings about changes in fish diversity, assemblage, reproduction and natural recruitment. India’s average temperature has risen by around 0.7°C during 1901–2018. The studies show that the mean air temperature in the Ganga basin has increased in the range of 0.20 - 0.47 °C and annual rainfall decreased in the range of 257-580 mm during the last three decades. The studies clearly indicate visible impacts of climatic and environmental factors on inland open water fisheries. Besides, a significant reduction in-depth and area (37.20–57.68% reduction), diversity of natural indigenous fish fauna (ranging from 22.85 to 54%) in wetlands and progression of trophic state from mesotrophic to eutrophic were recorded. In this communication, different applications of biometeorology in inland fisheries management with special reference to the assessment of ecosystem and species vulnerability to climatic variability and change have been discussed. Further, the paper discusses the impact of climate anomaly and extreme climatic events on inland fisheries and emphasizes novel modeling approaches for understanding the impact of climatic and environmental factors on reproductive phenology for identification of climate-sensitive/resilient fish species for the adoption of climate-smart fisheries in the future. Adaptation and mitigation strategies to enhance fish production and the role of culture-based fisheries and enclosure culture in converting sequestered carbon into blue carbon have also been discussed. In general, the type and direction of influence of meteorological parameters on fish biology in open water fisheries ecosystems are not adequately understood. The optimum range of meteorological parameters for sustaining inland open water fisheries is yet to be established. Therefore, the application of biometeorology in inland fisheries offers ample scope for understanding the dynamics in changing climate, which would help to develop a database on such least, addressed research frontier area. This would further help to project fisheries scenarios in changing climate regimes and develop adaptation and mitigation strategies to cope up with adverse meteorological factors to sustain fisheries and to conserve aquatic ecosystem and biodiversity.

Keywords: biometeorology, inland fisheries, aquatic ecosystem, modeling, India

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Authors: Marina Gold, Yves Jackson, David Parrat

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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.

Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries

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Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

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Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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Authors: Laverne Seales

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When most people think of Panama, they immediately think of the Canal; however, the construction and the people who made it possible are often omitted and seldom acknowledged. The reality is that the construction of this waterway was achieved through forced migration and discriminatory practices toward people of African descent, specifically black people from the Caribbean. From the colonial period to the opening and subsequent operation of the Panama Canal by the United States, this paper goes through the rich layers of Panamanian history to examine the life of Afro-Caribbeans and their descendants in Panama. It also considers the role of the United States in Panama; it explores how the United States in Panama forged a racially complex country that made the integration of Afro-Caribbeans and their descendants difficult. After laying a historical foundation, the exploration of Afro-Caribbean people and Panamanians of Afro-Caribbean descent are analyzed through Afro-Panamanian writer Carlos Guillermo ‘Cubena’ Wilson's novels, short stories, and poetry. This study focuses on how Cubena addresses racism, discrimination, inequality, and social justice issues towards Afro-Caribbeans and their descendants who traveled to Panama to construct the Canal. Content analysis methodology can yield several significant contributions, and analyzing Carlos Guillermo Wilson's literature under this framework allows us to consider social commentary and critique of Panamanian society. It identifies the social issues and concerns of Afro-Caribbeans and people of Afro-Caribbean descent, such as inequality, corruption, racism, political oppression, and cultural identity. Analysis methodology allows us to explore how Cubena's literature engages with questions of cultural identity and belonging in Panamanian society. By examining themes related to race, ethnicity, language, and heritage, this research uncovers the complexities of Panamanian cultural identity, allowing us to interrogate power dynamics and social hierarchies in Panamanian society. Analyzing the portrayal of different social groups, institutions, and power structures helps uncover how power is wielded, contested, and resisted; Cubena's fictional world allows us to see how it functions in Panama. Content analysis methodology also provides for critiquing political systems and governance in Panama. By examining the representation and presentation of political figures, institutions, and events in Cubena's literature, we uncover his commentary on corruption, authoritarianism, governance, and the role of the United States in Panama. Content analysis highlights how Wilson's literature amplifies the voices and experiences of marginalized individuals and communities in Panamanian society. By centering the narratives of Afro-Panamanians and other marginalized groups, this researcher uncovers Cubena's commitment to social justice and inclusion in his writing and helps the reader engage with historical narratives and collective memory in Panama. Overall, analyzing Carlos Guillermo ‘Cubena’ Wilson's literature as a platform for social commentary and critique of Panamanian society using content analysis methodology provides valuable insights into the cultural, social, and political dimensions of Afro-Panamanians during and after the construction of the Panama Canal.

Keywords: Afro-Caribbean, Panama Canal, race, Afro-Panamanian, identity, history

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Authors: Olagunju John Olusesan-Remi

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The study area Ijero-Ekiti falls within the Ilesha-Ekiti Schist belt, originating from the long year of the Pan-Africa orogenic events and various cataclysmic tectonic activities in history. Ijero-Ekiti is situated within latitude 7 degree 45N and 7 Degree 55N. Ijero Ekiti is bordered between the Dahomean Basin and the southern Bida/Benue basin on the Geological map of Nigeria. This research work centers on majorly on investigating the chemical composition and as well as the mineralogical distribution of the various mineral-bearing rocks that composed the study area. This work is essentially carried out with a view to assessing and at the same time ascertaining the economic potentials and or the industrial significance of the area to Ekiti-south western region and the Nigeria nation as a whole. The mineralogical distribution pattern is of particular interest to us in this study. In this regard essential focus is put on the mostly the economic gemstones distributions within the various mineral bearing rocks in the zone, some of which includes the tourmaline formation, cassiterite deposit, tin-ore, tantalum columbite, smoky quartz, amethyst, polychrome and emerald variety beryl among others as they occurred within the older granite of the Precambrian rocks. To this end, samples of the major rock types were taken from various locations within the study area for detail scientific analysis as follows: The Igemo pegmatite of Ijero west, the epidiorite of Idaho, the biotitic hornblende gneiss of Ikoro-Ijero north and the beryl crystalline rock types to mention a few. The slides of the each rock from the aforementioned zones were later prepared and viewed under a cross Nichol petro graphic microscope with a particular focus on the light reflection ability of the constituent minerals in each rock samples. The results from the physical analysis viewed from the colour had it that the pegmatite samples ranges from pure milky white to fairly pinkish coloration. Other physical properties investigated include the streak, luster, form, specific gravity, cleavage/fracture pattern etc. The optical examination carried out centers on the refractive indices and pleochroism of the minerals present while the chemical analysis reveals from the tourmaline samples a differing correlation coefficient of the various oxides in each samples collected through which the mineral presence was established. In conclusion, it was inferred that the various minerals outlined above were in reasonable quantity within the Ijero area. With the above discoveries, therefore, we strongly recommend a detailed scientific investigation to be carried out such that will lead to a comprehensive mining of the area. Above all, it is our conclusion that a comprehensive mineralogical exploitation of this area will not only boost the socio-economic potential of the area but at the same time will go a long way contributing immensely to the socio-economic growth and development of the Nation-Nigeria at large.

Keywords: Ijero Ekiti, Southwestern Nigeria, economic minerals, pegmatite of the pan African origin, cataclastic tectonic activities, Ilesha Schistbelt, precambrian formations

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Authors: Birgit A. A. Solem, Kristin Bentsen

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Scholarly attention in entrepreneurship is currently directed towards understanding entrepreneurial venture creation as a process -the journey of new economic activities from nonexistence to existence often studied through flow- or network models. To complement existing research on entrepreneurial venture creation with more interactivity-based research of organized activities, this study examines two pop-up stores as anchor events involving on-site activities of fifteen participating entrepreneurs launching their new ventures. The pop-up stores were arranged in two middle-sized Norwegian cities and contained different brand stores that brought together actors of sub-networks and communities executing venture creation activities. The pop-up stores became on-site arenas for the entrepreneurs to create, maintain, and rejuvenate their networks, at the same time as becoming venues for temporal coordination of activities involving existing and potential customers in their venture creation. In this work, we apply a conceptual framework based on frequently addressed dilemmas within entrepreneurship theory (discovery/creation, causation/effectuation) to further shed light on the broad aspect of on-site anchor event activities and their venture creation outcomes. The dilemma-based concepts are applied as an analytic toolkit to pursue answers regarding the nature of anchor event activities typically found within entrepreneurial venture creation and how these anchor event activities affect entrepreneurial venture creation outcomes. Our study combines researcher participation with 200 hours of observation and twenty in-depth interviews. Data analysis followed established guidelines for hermeneutic analysis and was intimately intertwined with ongoing data collection. Data was coded and categorized in NVivo 12 software, and iterated several times as patterns were steadily developing. Our findings suggest that core anchor event activities typically found within entrepreneurial venture creation are; a concept- and product experimentation with visitors, arrangements to socialize (evening specials, auctions, and exhibitions), store-in-store concepts, arranged meeting places for peers and close connection with municipality and property owners. Further, this work points to four main entrepreneurial venture creation outcomes derived from the core anchor event activities; (1) venture attention, (2) venture idea-realization, (3) venture collaboration, and (4) venture extension. Our findings show that, depending on which anchor event activities are applied, the outcomes vary. Theoretically, this study offers two main implications. First, anchor event activities are both discovered and created, following the logic of causation, at the same time as being experimental, based on “learning by doing” principles of effectuation during the execution. Second, our research enriches prior studies on venture creation as a process. In this work, entrepreneurial venture creation activities and outcomes are understood through pop-up stores as on-site anchor event arenas, particularly suitable for interactivity-based research requested by the entrepreneurship field. This study also reveals important managerial implications, such as that entrepreneurs should allow themselves to find creative physical venture creation arenas (e.g., pop-up stores, showrooms), as well as collaborate with partners when discovering and creating concepts and activities based on new ideas. In this way, they allow themselves to both strategically plan for- and continually experiment with their venture.

Keywords: anchor event, interactivity-based research, pop-up store, entrepreneurial venture creation

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Authors: Stefan W. Kienzle

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The increasing number of occurrences of extreme weather and climate events have significant impacts on society and are the cause of continued and increasing loss of human and animal lives, loss or damage to property (houses, cars), and associated stresses to the public in coping with a changing climate. A climate index breaks down daily climate time series into meaningful derivatives, such as the annual number of frost days. Climate indices allow for the spatially consistent analysis of a wide range of climate-dependent variables, which enables the quantification and mapping of historical and future climate change across regions. As trends of phenomena such as the length of the growing season change differently in different hydro-climatological regions, mapping needs to be carried out at a high spatial resolution, such as the 10km by 10km Canadian Climate Grid, which has interpolated daily values from 1950 to 2017 for minimum and maximum temperature and precipitation. Climate indices form the basis for the analysis and comparison of means, extremes, trends, the quantification of changes, and their respective confidence levels. A total of 39 temperature indices and 16 precipitation indices were computed for the period 1951 to 2017 for the Province of Alberta. Temperature indices include the annual number of days with temperatures above or below certain threshold temperatures (0, +-10, +-20, +25, +30ºC), frost days, and timing of frost days, freeze-thaw days, growing or degree days, and energy demands for air conditioning and heating. Precipitation indices include daily and accumulated 3- and 5-day extremes, days with precipitation, period of days without precipitation, and snow and potential evapotranspiration. The rank-based nonparametric Mann-Kendall statistical test was used to determine the existence and significant levels of all associated trends. The slope of the trends was determined using the non-parametric Sen’s slope test. The Google mapping interface was developed to create the website albertaclimaterecords.com, from which beach of the 55 climate indices can be queried for any of the 6833 grid cells that make up Alberta. In addition to the climate indices, climate normals were calculated and mapped for four historical 30-year periods and one future period (1951-1980, 1961-1990, 1971-2000, 1981-2017, 2041-2070). While winters have warmed since the 1950s by between 4 - 5°C in the South and 6 - 7°C in the North, summers are showing the weakest warming during the same period, ranging from about 0.5 - 1.5°C. New agricultural opportunities exist in central regions where the number of heat units and growing degree days are increasing, and the number of frost days is decreasing. While the number of days below -20ºC has about halved across Alberta, the growing season has expanded by between two and five weeks since the 1950s. Interestingly, both the number of days with heat waves and cold spells have doubled to four-folded during the same period. This research demonstrates the enormous potential of using climate indices at the best regional spatial resolution possible to enable society to understand historical and future climate changes of their region.

Keywords: climate change, climate indices, habitat risk, regional, mapping, extremes

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Authors: Neha Adsul, Rohit Shah

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Background: The global history of nursing is exclusively a history of deep contradictions as it seeks to negotiate inclusion in an already gendered world. Although a powerful 'clinical gaze exists, nurses have toiled to re-negotiate and subvert the 'medical gaze' by practicing the 'therapeutic gaze' to tether back 'care into nursing practice.' This helps address the duality of the 'body' and 'mind' wherein the patient is not just limited to being an object of medical inquiry. Nevertheless, there has been a consistent effort to fit 'nursing' into being an art or an emerging science over the years. Especially with advances in hospital-based techno-centric medical practices, the boundaries between technology and nursing practices are becoming more blurred as the technical process becomes synonymous with nursing, eroding the essence of nursing care. Aim: This paper examines the history of nursing and offers insights into how gendered relations and the ideological belief of 'nursing as gendered work' have propagated to the subjugation of the nursing profession. It further aims to provide insights into the patriarchally imbibed techno-centrism that negates the gendered caregiving which lies at the crux of a nurse's work. Method: A literature search was carried out using Google Scholar, Web of Science and PubMed databases. Search words included: technology and nursing, medical technology and nursing, history of nursing, sociology and nursing and nursing care. The history of nursing is presented in a discussion that weaves together the historical events of the 'Birth of the Clinic' and the shift from 'bed-side medicine' to 'hospital-based medicine' that legitimizes exploitation of the bodies of patients to the 'medical gaze while the emergence of nursing as acquiescent to instrumental, technical, positivist and dominant views of medicine. The resultant power asymmetries, wherein in contemporary nursing, the constant struggle of nurses to juggle between being the physicians "operational right arm" to harboring that subjective understanding of the patients to refrain from de-humanizing nursing-care. Findings: The nursing profession suffers from being rendered invisible due to gendered relations having patrifocal societal roots. This perpetuates a notion rooted in the idea that emphasizes empiricism and has resulted in theoretical and epistemological fragmentation of the understanding of body and mind as separate entities. Nurses operate within this structure while constantly being at the brink of being pushed beyond the legitimate professional boundaries while being labeled as being 'unscientific' as the work does not always corroborate and align with the existing dominant positivist lines of inquiries. Conclusion: When understood in this broader context of how nursing as a practice has evolved over the years, it provides a particularly crucial testbed for understanding contemporary gender relations. Not because nurses like to live in a gendered work trap but because the gendered relations at work are written in a covert narcissistic patriarchal milieu that fails to recognize the value of intangible yet utmost necessary 'caring work in nursing. This research urges and calls for preserving and revering the humane aspect of nursing care alongside the emerging tech-savvy expectations from nursing work.

Keywords: nursing history, technocentric, power relations, scientific duality

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Authors: G. Kontochristopoulos, T. Spiliopoulos, V. Markantoni, E. Platsidaki, A. Kouris, E. Balamoti, C. Bokotas, G. Haidemenos

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Introduction: There is a high patient demand for periorbital rejuvenation since the facial area is often the first to show visible signs of aging. With advancing age, there are sometimes marked changes that occur in the skin, fat, muscle and bone of the periorbital region, resulting to wrinkles and skin laxity. These changes are among the easiest areas to correct using several minimally invasive techniques, which have become increasingly popular over the last decade. Lasers, radiofrequency, botulinum toxin, fat grafting and fillers are available treatments sometimes in combination to traditional blepharoplasty. This study attempts to show the benefits of a minimally invasive approach to periorbital wrinkles and skin laxity that combine microneedling and 10% trichloroacetic acid (TCA) peels. Method: Eleven female patients aged 34-72 enrolled in the study. They all gave informed consent after receiving detailed information regarding the treatment procedure. Exclusion criteria in the study were previous treatment for the same condition in the past six months, pregnancy, allergy or hypersensitivity to the components, infection, inflammation and photosensitivity on the affected region. All patients had diffuse periorbital wrinkles and mild to moderate upper or lower eyelid skin laxity. They were treated with Automatic Microneedle Therapy System-Handhold and topical application of 10% trichloroacetic acid solution to each periorbital area for five minutes. Needling at a 0,25 mm depth was performed in both latelar (x-y) directions. Subsequently, the peeling agent was applied to each periorbital area for five minutes. Patients were subjected to the above combination every two weeks for a series of four treatments. Subsequently they were followed up regularly every month for two months. The effect was photo-documented. A Physician's and a Patient's Global Assessment Scale was used to evaluate the efficacy of the treatment (0-25% indicated poor response, 25%-50% fair, 50%-75% good and 75%-100% excellent response). Safety was assessed by monitoring early and delayed adverse events. Results: At the end of the study, almost all patients demonstrated significant aesthetic improvement. Physicians assessed a fair and a good improvement in 9(81.8% of patients) and 2(18.1% of patients) participants respectively. Patients Global Assessment rated a fair and a good response in 6 (54.5%) and 5 (45.4%) participants respectively. The procedure was well tolerated and all patients were satisfied. Mild discomfort and transient erythema were quite common during or immediately after the procedure, however only temporary. During the monthly follow up, no complications or scars were observed. Conclusions: Microneedling is known as a simple, office–based collagen induction therapy. Low concentration TCA solution applied to the epidermis that has been more permeable by microneedling, can reach the dermis more effectively. In the present study, chemical peels with 10% TCA acted as an adjuvant to microneedling, as it causes controlled skin damage, promoting regeneration and rejuvenation of tissues. This combined therapy improved periorbital fine lines, wrinkles, and overall appearance of the skin. Thus it constitutes an alternative treatment of periorbital skin aging, with encouraging results and minor side-effects.

Keywords: chemical peels, microneedling, periorbital wrinkles, skin laxity

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Authors: Dorian Audot, Isobel Margaret Thompson, Dominic Hudson, Joseph Banks, Martin Warner

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In competitive swimming, after dives and turns, athletes perform underwater undulatory swimming (UUS), copying marine mammals’ method of locomotion. The body, performing this wave-like motion, accelerates the fluid downstream in its vicinity, generating propulsion with minimal resistance. Through this technique, swimmers can maintain greater speeds than surface swimming and take advantage of the overspeed granted by the dive (or push-off). Almost all previous work has considered UUS when performed at maximum effort. Critical parameters to maximize UUS speed are frequently discussed; however, this does not apply to most races. In only 3 out of the 16 individual competitive swimming events are athletes likely to attempt to perform UUS with the greatest speed, without thinking of the cost of locomotion. In the other cases, athletes will want to control the speed of their underwater swimming, attempting to maximise speed whilst considering energy expenditure appropriate to the duration of the event. Hence, there is a need to understand how swimmers adapt their underwater strategies to optimize the speed within the allocated energetic cost. This paper develops a consistent methodology that enables different sets of UUS kinematics to be investigated. These may have different propulsive efficiencies and force generation mechanisms (e.g.: force distribution along with the body and force magnitude). The developed methodology, therefore, needs to: (i) provide an understanding of the UUS propulsive mechanisms at different speeds, (ii) investigate the key performance parameters when UUS is not performed solely for maximizing speed; (iii) consistently determine the propulsive efficiency of a UUS technique. The methodology is separated into two distinct parts: kinematic data acquisition and computational fluid dynamics (CFD) analysis. For the kinematic acquisition, the position of several joints along the body and their sequencing were either obtained by video digitization or by underwater motion capture (Qualisys system). During data acquisition, the swimmers were asked to perform UUS at a constant depth in a prone position (facing the bottom of the pool) at different speeds: maximum effort, 100m pace, 200m pace and 400m pace. The kinematic data were input to a CFD algorithm employing a two-dimensional Large Eddy Simulation (LES). The algorithm adopted was specifically developed in order to perform quick unsteady simulations of deforming bodies and is therefore suitable for swimmers performing UUS. Despite its approximations, the algorithm is applied such that simulations are performed with the inflow velocity updated at every time step. It also enables calculations of the resistive forces (total and applied to each segment) and the power input of the modeled swimmer. Validation of the methodology is achieved by comparing the data obtained from the computations with the original data (e.g.: sustained swimming speed). This method is applied to the different kinematic datasets and provides data on swimmers’ natural responses to pacing instructions. The results show how kinematics affect force generation mechanisms and hence how the propulsive efficiency of UUS varies for different race strategies.

Keywords: CFD, efficiency, human swimming, hydrodynamics, underwater undulatory swimming

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Authors: Dibyendu Rakshit, Santosh K. Sarkar

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The study illustrates a comprehensive account of large-scale changes plankton community structure in relevance to water quality characteristics due to anthropogenic stresses, mainly concerned for Annual Gangasagar Festival (AGF) at the southern tip of Sagar Island of Indian Sundarban wetland for 3-year duration (2012-2014; n=36). This prograding, vulnerable and tide-dominated megadelta has been formed in the estuarine phase of the Hooghly Estuary infested by largest continuous tract of luxurious mangrove forest, enriched with high native flora and fauna. The sampling strategy was designed to characterize the changes in plankton community and water quality considering three diverse phases, namely during festival period (January) and its pre - (December) as well as post (February) events. Surface water samples were collected for estimation of different environmental variables as well as for phytoplankton and microzooplankton biodiversity measurement. The preservation and identification techniques of both biotic and abiotic parameters were carried out by standard chemical and biological methods. The intensive human activities lead to sharp ecological changes in the context of poor water quality index (WQI) due to high turbidity (14.02±2.34 NTU) coupled with low chlorophyll a (1.02±0.21 mg m-3) and dissolved oxygen (3.94±1.1 mg l-1), comparing to pre- and post-festival periods. Sharp reduction in abundance (4140 to 2997 cells l-1) and diversity (H′=2.72 to 1.33) of phytoplankton and microzooplankton tintinnids (450 to 328 ind l-1; H′=4.31 to 2.21) was very much pronounced. The small size tintinnid (average lorica length=29.4 µm; average LOD=10.5 µm) composed of Tintinnopsis minuta, T. lobiancoi, T. nucula, T. gracilis are predominant and reached some of the greatest abundances during the festival period. Results of ANOVA revealed a significant variation in different festival periods with phytoplankton (F= 1.77; p=0.006) and tintinnid abundance (F= 2.41; P=0.022). RELATE analyses revealed a significant correlation between the variations of planktonic communities with the environmental data (R= 0.107; p= 0.005). Three distinct groups were delineated from principal component analysis, in which a set of hydrological parameters acted as the causative factor(s) for maintaining diversity and distribution of the planktonic organisms. The pronounced adverse impact of anthropogenic stresses on plankton community could lead to environmental deterioration, disrupting the productivity of benthic and pelagic ecosystems as well as fishery potentialities which directly related to livelihood services. The festival can be considered as multiple drivers of changes in relevance to beach erosion, shoreline changes, pollution from discarded plastic and electronic wastes and destruction of natural habitats resulting loss of biodiversity. In addition, deterioration in water quality was also evident from immersion of idols, causing detrimental effects on aquatic biota. The authors strongly recommend for adopting integrated scientific and administrative strategies for resilience, sustainability and conservation of this megadelta.

Keywords: Gangasagar festival, phytoplankton, Sundarban megadelta, tintinnid

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Authors: Luis F. Caballero-castro, Dirsa Feliciano, Daniela Novoa, Orlando Arroyo, Jesús D. Villalba-morales

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Colombia faces a critical challenge in seismic resilience due to the prevalence of informal housing, which constitutes approximately 70% of residential structures. More than 10 million Colombians (20% of the population), live in homes susceptible to collapse in the event of an earthquake. This, combined with the fact that 83% of the population is in intermediate and high seismic hazard areas, has brought serious consequences to the country. These consequences became evident during the 1999 Armenia earthquake, which affected nearly 100,000 properties and represented economic losses equivalent to 1.88% of that year's Gross Domestic Product (GDP). Despite previous efforts to reinforce informal housing through methods like externally reinforced masonry walls, alternatives related to seismic protection systems (SPDs), such as Buckling-Restrained Braces (BRB), have not yet been explored in the country. BRBs are reinforcement elements capable of withstanding both compression and tension, making them effective in enhancing the lateral stiffness of structures. In this study, the use of low-cost and easily installable BRBs for the retrofit of informal housing in Colombia was evaluated, considering the economic limitations of the communities. For this purpose, a case study was selected involving an informally constructed dwelling in the country, from which field information on its structural characteristics and construction materials was collected. Based on the gathered information, nonlinear models with and without BRBs were created, and their seismic performance was analyzed and compared through incremental static (pushover) and nonlinear dynamic analyses. In the first analysis, the capacity curve was identified, showcasing the sequence of failure events occurring from initial yielding to structural collapse. In the second case, the model underwent nonlinear dynamic analyses using a set of seismic records consistent with the country's seismic hazard. Based on the results, fragility curves were calculated to evaluate the probability of failure of the informal housings before and after the intervention with BRBs, providing essential information about their effectiveness in reducing seismic vulnerability. The results indicate that low-cost BRBs can significantly increase the capacity of informal housing to withstand earthquakes. The dynamic analysis revealed that retrofit structures experienced lower displacements and deformations, enhancing the safety of residents and the seismic performance of informally constructed houses. In other words, the use of low-cost BRBs in the retrofit of informal housing in Colombia is a promising strategy for improving structural safety in seismic-prone areas. This study emphasizes the importance of seeking affordable and practical solutions to address seismic risk in vulnerable communities in earthquake-prone regions in Colombia and serves as a model for addressing similar challenges of informal housing worldwide.

Keywords: buckling-restrained braces, fragility curves, informal housing, incremental dynamic analysis, seismic retrofit

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Authors: Anantha S. Babbili

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This paper analyzes the current media practices dominant in global journalistic practices within the framework of world press theories of Libertarian, Authoritarian, Communist, and Social Responsibility to evaluate their efficacy in addressing their role in the coverage of the coronavirus, also known as COVID-19. The global media flows, determinants of news coverage, and international awareness and the Western view of the world will be critically analyzed within the context of the prevalent news values that underpin free press and media coverage of the world. While evaluating the global discourse paramount to a sustained and dispassionate understanding of world events, this paper proposes an ethical framework that brings clarity devoid of sensationalism, partisanship, right-wing and left-wing interpretations to a breaking and dangerous development of a pandemic. As the world struggles to contain the coronavirus pandemic with death climbing close to 6,000 from late January to mid-March, 2020, the populations of the developed as well as the developing nations are beset with news media renditions of the crisis that are contradictory, confusing and evoking anxiety, fear and hysteria. How are we to understand differing news standards and news values? What lessons do we as journalism and mass media educators, researchers, and academics learn in order to construct a better news model and structure of media practice that addresses science, health, and media literacy among media practitioners, journalists, and news consumers? As traditional media struggles to cover the pandemic to its audience and consumers, social media from which an increasing number of consumers get their news have exerted their influence both in a positive way and in a negative manner. Even as the world struggles to grasp the full significance of the pandemic, the World Health Organization (WHO) has been feverishly battling an additional challenge related to the pandemic in what it termed an 'infodemic'—'an overabundance of information, some accurate and some not, that makes it hard for people to find trustworthy sources and reliable guidance when they need it.' There is, indeed, a need for journalism and news coverage in times of pandemics that reflect social responsibility and ethos of public service journalism. Social media and high-tech information corporations, collectively termed GAMAF—Google, Apple, Microsoft, Amazon, and Facebook – can team up with reliable traditional media—newspapers, magazines, book publishers, radio and television corporates—to ease public emotions and be helpful in times of a pandemic outbreak. GAMAF can, conceivably, weed out sensational and non-credible sources of coronavirus information, exotic cures offered for sale on a quick fix, and demonetize videos that exploit peoples’ vulnerabilities at the lowest ebb. Credible news of utility delivered in a sustained, calm, and reliable manner serves people in a meaningful and helpful way. The world’s consumers of news and information, indeed, deserve a healthy and trustworthy news media – at least in the time of pandemic COVID-19. Towards this end, the paper will propose a practical model for news media and journalistic coverage during times of a pandemic.

Keywords: COVID-19, international news flow, social media, social responsibility

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Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

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Authors: Hadush Kidane Meresa

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The hydrological extremes frequency analysis is the foundation for the hydraulic engineering design, flood protection, drought management and water resources management and planning to utilize the available water resource to meet the desired objectives of different organizations and sectors in a country. This spatial variation of the statistical characteristics of the extreme flood and drought events are key practice for regional flood and drought analysis and mitigation management. For different hydro-climate of the regions, where the data set is short, scarcity, poor quality and insufficient, the regionalization methods are applied to transfer at-site data to a region. This study aims in regional high and low flow frequency analysis for Poland River Basins. Due to high frequent occurring of hydrological extremes in the region and rapid water resources development in this basin have caused serious concerns over the flood and drought magnitude and frequencies of the river in Poland. The magnitude and frequency result of high and low flows in the basin is needed for flood and drought planning, management and protection at present and future. Hydrological homogeneous high and low flow regions are formed by the cluster analysis of site characteristics, using the hierarchical and C- mean clustering and PCA method. Statistical tests for regional homogeneity are utilized, by Discordancy and Heterogeneity measure tests. In compliance with results of the tests, the region river basin has been divided into ten homogeneous regions. In this study, frequency analysis of high and low flows using AM for high flow and 7-day minimum low flow series is conducted using six statistical distributions. The use of L-moment and LL-moment method showed a homogeneous region over entire province with Generalized logistic (GLOG), Generalized extreme value (GEV), Pearson type III (P-III), Generalized Pareto (GPAR), Weibull (WEI) and Power (PR) distributions as the regional drought and flood frequency distributions. The 95% percentile and Flow duration curves of 1, 7, 10, 30 days have been plotted for 10 stations. However, the cluster analysis performed two regions in west and east of the province where L-moment and LL-moment method demonstrated the homogeneity of the regions and GLOG and Pearson Type III (PIII) distributions as regional frequency distributions for each region, respectively. The spatial variation and regional frequency distribution of flood and drought characteristics for 10 best catchment from the whole region was selected and beside the main variable (streamflow: high and low) we used variables which are more related to physiographic and drainage characteristics for identify and delineate homogeneous pools and to derive best regression models for ungauged sites. Those are mean annual rainfall, seasonal flow, average slope, NDVI, aspect, flow length, flow direction, maximum soil moisture, elevation, and drainage order. The regional high-flow or low-flow relationship among one streamflow characteristics with (AM or 7-day mean annual low flows) some basin characteristics is developed using Generalized Linear Mixed Model (GLMM) and Generalized Least Square (GLS) regression model, providing a simple and effective method for estimation of flood and drought of desired return periods for ungauged catchments.

Keywords: flood , drought, frequency, magnitude, regionalization, stochastic, ungauged, Poland

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Authors: Claude Nsobya, Alice Moncaster, Karen Potter, Jed Ramsay

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The shift in Flood Risk Governance (FRG) has moved away from traditional approaches that solely relied on centralized decision-making and structural flood defenses. Instead, there is now the adoption of integrated flood risk management measures that involve various actors and stakeholders. This new approach emphasizes people-centered approaches, including adaptation and learning. This shift to a diversity of FRG approaches has been identified as a significant factor in enhancing resilience. Resilience here refers to a community's ability to withstand, absorb, recover, adapt, and potentially transform in the face of flood events. It is argued that if the FRG merely focused on the conventional 'fighting the water' - flood defense - communities would not be resilient. The move to these people-centered approaches also implies that communities will be more involved in FRG. It is suggested that effective flood risk governance influences resilience through meaningful community involvement, and effective community engagement is vital in shaping community resilience to floods. Successful community participation not only uses context-specific indigenous knowledge but also develops a sense of ownership and responsibility. Through capacity development initiatives, it can also raise awareness and all these help in building resilience. Recent Flood Risk Management (FRM) projects have thus had increasing community involvement, with varied conceptualizations of such community engagement in the academic literature on FRM. In the context of overland floods, there has been a substantial body of literature on Flood Risk Governance and Management. Yet, groundwater flooding has gotten little attention despite its unique qualities, such as its persistence for weeks or months, slow onset, and near-invisibility. There has been a little study in this area on how successful community involvement in Flood Risk Governance may improve community resilience to groundwater flooding in particular. This paper focuses on a case study of a flood risk management project in the United Kingdom. Buckinghamshire Council is leading Project Groundwater, which is one of 25 significant initiatives sponsored by England's Department for Environment, Food and Rural Affairs (DEFRA) Flood and Coastal Resilience Innovation Programme. DEFRA awarded Buckinghamshire Council and other councils 150 million to collaborate with communities and implement innovative methods to increase resilience to groundwater flooding. Based on a literature review, this paper proposes a new paradigm for effective community engagement in Flood Risk Governance (FRG). This study contends that effective community participation can have an impact on various resilience capacities identified in the literature, including social capital, institutional capital, physical capital, natural capital, human capital, and economic capital. In the case of social capital, for example, successful community engagement can influence social capital through the process of social learning as well as through developing social networks and trust values, which are vital in influencing communities' capacity to resist, absorb, recover, and adapt. The study examines community engagement in Project Groundwater using surveys with local communities and documentary analysis to test this notion. The outcomes of the study will inform community involvement activities in Project Groundwater and may shape DEFRA policies and guidelines for community engagement in FRM.

Keywords: flood risk governance, community, resilience, groundwater flooding

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Authors: Grace E. Santella, Shawn G. Gallaher, Joseph P. Smith

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In order to determine the importance of small-system riverine heat flux on regional landfast sea ice breakup, our study explores the annual spring freshet of the Sagavanirktok River from 2014-2019. Seasonal heat cycling ultimately serves as the driving mechanism behind the freshet; however, as an emerging area of study, the extent to which inland thermodynamics influence coastal tundra geomorphology and connected landfast sea ice has not been extensively investigated in relation to small-scale Arctic river systems. The Sagavanirktok River is a small-to-midsized river system that flows south-to-north on the Alaskan North Slope from the Brooks mountain range to the Beaufort Sea at Prudhoe Bay. Seasonal warming in the spring rapidly melts snow and ice in a northwards progression from the Brooks Range and transitional tundra highlands towards the coast and when coupled with seasonal precipitation, results in a pulsed freshet that propagates through the Sagavanirktok River. The concentrated presence of newly exposed vegetation in the transitional tundra region due to spring melting results in higher absorption of solar radiation due to a lower albedo relative to snow-covered tundra and/or landfast sea ice. This results in spring flood runoff that advances over impermeable early-season permafrost soils with elevated temperatures relative to landfast sea ice and sub-ice flow. We examine the extent to which interannual temporal variability influences the onset and magnitude of river discharge by analyzing field measurements from the United States Geological Survey (USGS) river and meteorological observation sites. Rapid influx of heat to the Arctic Ocean via riverine systems results in a noticeable decay of landfast sea ice independent of ice breakup seaward of the shear zone. Utilizing MODIS imagery from NASA’s Terra satellite, interannual variability of river discharge is visualized, allowing for optical validation that the discharge flow is interacting with landfast sea ice. Thermal erosion experienced by sediment fast ice at the arrival of warm overflow preconditions the ice regime for rapid thawing. We investigate the extent to which interannual heat flux from the Sagavanirktok River’s freshet significantly influences the onset of local landfast sea ice breakup. The early-season warming of atmospheric temperatures is evidenced by the presence of storms which introduce liquid, rather than frozen, precipitation into the system. The resultant decreased albedo of the transitional tundra supports the positive relationship between early-season precipitation events, inland thermodynamic cycling, and degradation of landfast sea ice. Early removal of landfast sea ice increases coastal erosion in these regions and has implications for coastline geomorphology which stress industrial, ecological, and humanitarian infrastructure.

Keywords: Albedo, freshet, landfast sea ice, riverine heat flux, seasonal heat cycling

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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Authors: Leonid Zhukov, Dmytro Petrenko

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Optical thermometry has no alternative in many cases of industrial most effective continuous temperature control. Classical optical thermometry technologies can be used on available for pyrometers controlled objects with stable radiation characteristics and transmissivity of the intermediate medium. Without using temperature corrections, it is possible in the case of a “black” body for energy pyrometry and the cases of “black” and “grey” bodies for spectral ratio pyrometry or with using corrections – for any colored bodies. Consequently, with increasing the number of operating waves, optical thermometry possibilities to reduce methodical errors significantly expand. That is why, in recent 25-30 years, research works have been reoriented on more perfect spectral (multicolor) thermometry technologies. There are two physical material substances, i.e., substance (controlled object) and electromagnetic field (thermal radiation), to be operated in optical thermometry. Heat is transferred by radiation; therefore, radiation has the energy, entropy, and temperature. Optical thermometry was originating simultaneously with the developing of thermal radiation theory when the concept and the term "radiation temperature" was not used, and therefore concepts and terms "conditional temperatures" or "pseudo temperature" of controlled objects were introduced. They do not correspond to the physical sense and definitions of temperature in thermodynamics, molecular-kinetic theory, and statistical physics. Launched by the scientific thermometric society, discussion about the possibilities of temperature measurements of objects, including colored bodies, using the temperatures of their radiation is not finished. Are the information about controlled objects transferred by their radiation enough for temperature measurements? The positive and negative answers on this fundamental question divided experts into two opposite camps. Recent achievements of spectral thermometry develop events in her favour and don’t leave any hope for skeptics. This article presents the results of investigations and developments in the field of spectral thermometry carried out by the authors in the Department of Thermometry and Physics-Chemical Investigations. The authors have many-year’s of experience in the field of modern optical thermometry technologies. Innovative technologies of optical continuous temperature control have been developed: symmetric-wave, two-color compensative, and based on obtained nonlinearity equation of spectral emissivity distribution linear, two-range, and parabolic. Тhe technologies are based on direct measurements of physically substantiated and proposed by Prof. L. Zhukov, radiation temperatures with the next calculation of the controlled object temperature using this radiation temperatures and corresponding mathematical models. Тhe technologies significantly increase metrological characteristics of continuous contactless and light-guide temperature control in energy, metallurgical, ceramic, glassy, and other productions. For example, under the same conditions, the methodical errors of proposed technologies are less than the errors of known spectral and classical technologies in 2 and 3-13 times, respectively. Innovative technologies provide quality products obtaining at the lowest possible resource-including energy costs. More than 600 publications have been published on the completed developments, including more than 100 domestic patents, as well as 34 patents in Australia, Bulgaria, Germany, France, Canada, the USA, Sweden, and Japan. The developments have been implemented in the enterprises of USA, as well as Western Europe and Asia, including Germany and Japan.

Keywords: emissivity, radiation temperature, object temperature, spectral thermometry

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Authors: Tarek Abdoun, Waleed Elsekelly

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Introduction: Liquefaction of soils during earthquakes can have significant consequences on the stability of structures and infrastructure. This study focuses on comparing two liquefaction case histories in California, namely the response of the Wildlife site in the Imperial Valley to the 2010 El-Mayor Cucapah earthquake (Mw = 7.2, amax = 0.15g) and the response of the Treasure Island Fire Station (F.S.) site in the San Francisco Bay area to the 1989 Loma Prieta Earthquake (Mw = 6.9, amax = 0.16g). Both case histories involve liquefiable layers of silty sand with non-plastic fines, similar shear wave velocities, low CPT cone penetration resistances, and groundwater tables at similar depths. The liquefaction charts based on shear wave velocity field predict liquefaction at both sites. However, a significant difference arises in their pore pressure responses during the earthquakes. The Wildlife site did not experience liquefaction, as evidenced by piezometer data, while the Treasure Island F.S. site did liquefy during the shaking. Objective: The primary objective of this study is to investigate and understand the reason for the contrasting pore pressure responses observed at the Wildlife site and the Treasure Island F.S. site despite their similar geological characteristics and predicted liquefaction potential. By conducting a detailed analysis of similarities and differences between the two case histories, the objective is to identify the factors that contributed to the higher liquefaction resistance exhibited by the Wildlife site. Methodology: To achieve this objective, the geological and seismic data available for both sites were gathered and analyzed. Then their soil profiles, seismic characteristics, and liquefaction potential as predicted by shear wave velocity-based liquefaction charts were analyzed. Furthermore, the seismic histories of both regions were examined. The number of previous earthquakes capable of generating significant excess pore pressures for each critical layer was assessed. This analysis involved estimating the total seismic activity that the Wildlife and Treasure Island F.S. critical layers experienced over time. In addition to historical data, centrifuge and large-scale experiments were conducted to explore the impact of prior seismic activity on liquefaction resistance. These findings served as supporting evidence for the investigation. Conclusions: The higher liquefaction resistance observed at the Wildlife site and other sites in the Imperial Valley can be attributed to preshaking by previous earthquakes. The Wildlife critical layer was subjected to a substantially greater number of seismic events capable of generating significant excess pore pressures over time compared to the Treasure Island F.S. layer. This crucial disparity arises from the difference in seismic activity between the two regions in the past century. In conclusion, this research sheds light on the complex interplay between geological characteristics, seismic history, and liquefaction behavior. It emphasizes the significant impact of past seismic activity on liquefaction resistance and can provide valuable insights for evaluating the stability of sandy sites in other seismic regions.

Keywords: liquefaction, case histories, centrifuge, preshaking

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Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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Authors: Vittorio Astarita, Giuseppe Guido, Vincenzo Pasquale Giofre, Alessandro Vitale

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Traffic microsimulation has been used extensively to evaluate consequences of different traffic planning and control policies in terms of travel time delays, queues, pollutant emissions, and every other common measured performance while at the same time traffic safety has not been considered in common traffic microsimulation packages as a measure of performance for different traffic scenarios. Vehicle conflict techniques that were introduced at intersections in the early traffic researches carried out at the General Motor laboratory in the USA and in the Swedish traffic conflict manual have been applied to vehicles trajectories simulated in microscopic traffic simulators. The concept is that microsimulation can be used as a base for calculating the number of conflicts that will define the safety level of a traffic scenario. This allows engineers to identify unsafe road traffic maneuvers and helps in finding the right countermeasures that can improve safety. Unfortunately, most commonly used indicators do not consider conflicts between single vehicles and roadside obstacles and barriers. A great number of vehicle crashes take place with roadside objects or obstacles. Only some recent proposed indicators have been trying to address this issue. This paper introduces a new procedure based on the simulation of potential crash events for the evaluation of safety levels in microsimulation traffic scenarios, which takes into account also potential crashes with roadside objects and barriers. The procedure can be used to define new conflict indicators. The proposed simulation procedure generates with the random perturbation of vehicle trajectories a set of potential crashes which can be evaluated accurately in terms of DeltaV, the energy of the impact, and/or expected number of injuries or casualties. The procedure can also be applied to real trajectories giving birth to new surrogate safety performance indicators, which can be considered as “simulation-based”. The methodology and a specific safety performance indicator are described and applied to a simulated test traffic scenario. Results indicate that the procedure is able to evaluate safety levels both at the intersection level and in the presence of roadside obstacles. The procedure produces results that are expressed in the same unity of measure for both vehicle to vehicle and vehicle to roadside object conflicts. The total energy for a square meter of all generated crash can be used and is shown on the map, for the test network, after the application of a threshold to evidence the most dangerous points. Without any detailed calibration of the microsimulation model and without any calibration of the parameters of the procedure (standard values have been used), it is possible to identify dangerous points. A preliminary sensitivity analysis has shown that results are not dependent on the different energy thresholds and different parameters of the procedure. This paper introduces a specific new procedure and the implementation in the form of a software package that is able to assess road safety, also considering potential conflicts with roadside objects. Some of the principles that are at the base of this specific model are discussed. The procedure can be applied on common microsimulation packages once vehicle trajectories and the positions of roadside barriers and obstacles are known. The procedure has many calibration parameters and research efforts will have to be devoted to make confrontations with real crash data in order to obtain the best parameters that have the potential of giving an accurate evaluation of the risk of any traffic scenario.

Keywords: road safety, traffic, traffic safety, traffic simulation

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Authors: Panagiota Katsikouli, William Hamilton Byrne, Thomas Gammeltoft-Hansen, Tijs Slaats

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An individual who demonstrates a well-founded fear of persecution or faces real risk of being subjected to torture is eligible for asylum. In Danish law, the exact legal thresholds reflect those established by international conventions, notably the 1951 Refugee Convention and the 1950 European Convention for Human Rights. These international treaties, however, remain largely silent when it comes to how states should assess asylum claims. As a result, national authorities are typically left to determine an individual’s legal eligibility on a narrow basis consisting of an oral testimony, which may itself be hampered by several factors, including imprecise language interpretation, insecurity or lacking trust towards the authorities among applicants. The leaky ground, on which authorities must assess their subjective perceptions of asylum applicants' credibility, questions whether, in all cases, adjudicators make the correct decision. Moreover, the subjective element in these assessments raises questions on whether individual asylum cases could be afflicted by implicit biases or stereotyping amongst adjudicators. In fact, recent studies have uncovered significant correlations between decision outcomes and the experience and gender of the assigned judge, as well as correlations between asylum outcomes and entirely external events such as weather and political elections. In this study, we analyze a publicly available dataset containing approximately 8,000 summaries of asylum cases, initially rejected, and re-tried by the Refugee Appeals Board (RAB) in Denmark. First, we look for variations in the recognition rates, with regards to a number of applicants’ features: their country of origin/nationality, their identified gender, their identified religion, their ethnicity, whether torture was mentioned in their case and if so, whether it was supported or not, and the year the applicant entered Denmark. In order to extract those features from the text summaries, as well as the final decision of the RAB, we applied natural language processing and regular expressions, adjusting for the Danish language. We observed interesting variations in recognition rates related to the applicants’ country of origin, ethnicity, year of entry and the support or not of torture claims, whenever those were made in the case. The appearance (or not) of significant variations in the recognition rates, does not necessarily imply (or not) bias in the decision-making progress. None of the considered features, with the exception maybe of the torture claims, should be decisive factors for an asylum seeker’s fate. We therefore investigate whether the decision can be predicted on the basis of these features, and consequently, whether biases are likely to exist in the decisionmaking progress. We employed a number of machine learning classifiers, and found that when using the applicant’s country of origin, religion, ethnicity and year of entry with a random forest classifier, or a decision tree, the prediction accuracy is as high as 82% and 85% respectively. tentially predictive properties with regards to the outcome of an asylum case. Our analysis and findings call for further investigation on the predictability of the outcome, on a larger dataset of 17,000 cases, which is undergoing.

Keywords: asylum adjudications, automated decision-making, machine learning, text mining

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