Search results for: biodegradability index
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3694

Search results for: biodegradability index

904 Monitoring of Cannabis Cultivation with High-Resolution Images

Authors: Levent Basayigit, Sinan Demir, Burhan Kara, Yusuf Ucar

Abstract:

Cannabis is mostly used for drug production. In some countries, an excessive amount of illegal cannabis is cultivated and sold. Most of the illegal cannabis cultivation occurs on the lands far from settlements. In farmlands, it is cultivated with other crops. In this method, cannabis is surrounded by tall plants like corn and sunflower. It is also cultivated with tall crops as the mixed culture. The common method of the determination of the illegal cultivation areas is to investigate the information obtained from people. This method is not sufficient for the determination of illegal cultivation in remote areas. For this reason, more effective methods are needed for the determination of illegal cultivation. Remote Sensing is one of the most important technologies to monitor the plant growth on the land. The aim of this study is to monitor cannabis cultivation area using satellite imagery. The main purpose of this study was to develop an applicable method for monitoring the cannabis cultivation. For this purpose, cannabis was grown as single or surrounded by the corn and sunflower in plots. The morphological characteristics of cannabis were recorded two times per month during the vegetation period. The spectral signature library was created with the spectroradiometer. The parcels were monitored with high-resolution satellite imagery. With the processing of satellite imagery, the cultivation areas of cannabis were classified. To separate the Cannabis plots from the other plants, the multiresolution segmentation algorithm was found to be the most successful for classification. WorldView Improved Vegetative Index (WV-VI) classification was the most accurate method for monitoring the plant density. As a result, an object-based classification method and vegetation indices were sufficient for monitoring the cannabis cultivation in multi-temporal Earthwiev images.

Keywords: Cannabis, drug, remote sensing, object-based classification

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903 The Effectiveness of Sleep Behavioral Interventions during the Third Trimester of Pregnancy on Sleep Quality and Postpartum Depression in a Randomized Clinical Controlled Trial

Authors: Somaye Ghafarpour, Kamran Yazdanbakhsh, Mohamad Reza Zarbakhsh, Simin Hosseinian, Samira Ghafarpour

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Unsatisfactory sleep quality is one of the most common complications of pregnancy, which can predispose mothers to postpartum depression, requiring implementing effective psychological interventions to prevent and modify behaviors accentuating sleep problems. This study was a randomized clinical controlled trial with a pre-test/post-test design aiming to investigate the effectiveness of sleep behavioral interventions during the third trimester of pregnancy on sleep quality and postpartum depression. A total of 50 pregnant mothers in the 26-30 weeks of pregnancy suffering from sleep problems (based on the score obtained from the Pittsburgh Sleep Questionnaire) were randomized into two groups (control and intervention, n= 25 per group). The data were collected using interviews, the Pittsburgh Sleep Quality Index (PSQI), and the Edinburgh Postnatal Depression Scale (EPDS) were used. The participants in the intervention group received eight 60-minute sessions of combinational training for behavioral therapy techniques. At the end of the intervention and four weeks after delivery, sleep quality and postpartum depression were evaluated. Considering that the Kolmogorov Smirnov test confirmed the normal distribution of the data, the independent t-test and analysis of covariance were used to analyze the data, showing that the behavioral interventions were effective on the overall sleep quality after delivery (p=0.001); however, no statistically significant effects were observed on postpartum depression, the sub-scales of sleep disorders, and daily functioning (p>0.05). Considering the potential effectiveness of behavioral interventions in improving sleep quality and alleviating insomnia symptoms, it is recommended to implement such measures as an effective intervention to prevent or treat these problems during prenatal and postnatal periods.

Keywords: behavioral interventions, sleep quality, postpartum depression, pregnancy, delivery

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902 Prevalence of Malocclusion and Assessment of Orthodontic Treatment Needs in Malay Transfusion-Dependent Thalassemia Patients

Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

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Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

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901 Turin, from Factory City to Talents Power Player: The Role of Private Philanthropy Agents of Innovation in the Revolution of Human Capital Market in the Contemporary Socio-Urban Scenario

Authors: Renato Roda

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With the emergence of the so-called 'Knowledge Society', the implementation of policies to attract, grow and retain talents, in an academic context as well, has become critical –both in the perspective of didactics and research and as far as administration and institutional management are concerned. At the same time, the contemporary philanthropic entities/organizations, which are evolving from traditional types of social support towards new styles of aid, envisaged to go beyond mere monetary donations, face the challenge of brand-new forms of complexity in supporting such specific dynamics of the global human capital market. In this sense, it becomes unavoidable for the philanthropic foundation, while carrying out their daily charitable tasks, to resort to innovative ways to facilitate the acquisition and the promotion of talents by academic and research institutions. In order to deepen such a specific perspective, this paper features the case of Turin, former 'factory city' of Italy’s North West, headquarters -and main reference territory- of Italy’s largest and richest private formerly bank-based philanthropic foundation, the Fondazione Compagnia di San Paolo. While it was assessed and classified as 'medium' in the city Global Talent Competitiveness Index (GTCI) of 2020, Turin has nevertheless acquired over the past months status of impact laboratory for a whole series of innovation strategies in the competition for the acquisition of excellence human capital. Leading actors of this new city vision are the foundations with their specifically adjusted financial engagement and a consistent role of stimulus towards innovation for research and education institutions.

Keywords: human capital, post-Fordism, private foundation, war on talents

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900 Revised Risk Priority Number in Failure Mode and Effects Analysis Model from the Perspective of Healthcare System

Authors: Fatemeh Rezaei, Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshnas

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Background: Failure Modes and Effect Analysis is now having known as the main methods of risk assessment and the accreditation requirements for many organizations. The Risk Priority Number (RPN) approach is generally preferred, especially for its easiness of use. Indeed it does not require statistical data, but it is based on subjective evaluations given by the experts about the Occurrence (O i), the Severity (Si) and the Detectability (D i) of each cause of failure. Methods: This study is a quantitative – qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment was conducted to calculate RPN score. Results; We have studied patient’s journey process in surgery ward and the most important phase of the process determined Transport of the patient from the holding area to the operating room. Failures of the phase with the highest priority determined by defining inclusion criteria included severity (clinical effect, claim consequence, waste of time and financial loss), occurrence (time- unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) and quantifying risks priority criteria in the context of RPN index. Ability of improved RPN reassess by root cause (RCA) analysis showed some variations. Conclusions: Finally, It could be concluded that understandable criteria should have been developed according to personnel specialized language and communication field. Therefore, participation of both technical and clinical groups is necessary to modify and apply these models.

Keywords: failure mode, effects analysis, risk priority number(RPN), health system, risk assessment

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899 Endophytic Fungi Recovered from Lycium arabicum as an Eco-Friendly Alternative for Fusarium Crown and Root Rot Disease Control and Tomato Growth Enhancement

Authors: Ahlem Nefzi, Rania Aydi Ben Abdallah, Hayfa Jabnoun-Khiareddine, Ammar Nawaim, Rabiaa Haouala, Mejda Daami-Remadi

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Seven endophytic fungi were isolated from the wild Solanaceous species Lycium arabicum growing in the Tunisian Centre-East and were assessed for their ability to suppress Fusarium Crown and Root Rot disease caused by Fusarium oxysporum f. sp. radicis lycopersici (FORL) and to enhance plant growth. Fungal isolates were shown able to colonize tomato cv. Rio Grande roots, crowns, and stems. A significant promotion in all studied growth parameters (root length, shoot height, and roots and shoots fresh weight) was recorded in tomato plants treated with fungal conidial suspensions or their cell-free culture filtrates compared to FORL-inoculated or pathogen-free controls. I15 and I18 isolates were shown to be the most effective leading to 85.7-87.5 and 93.6-98.4% decrease in leaf and root damage index and the vascular discoloration extent, respectively, over FORL-inoculated and untreated control. These two bioactive and growth-promoting isolates (I15 and I18) were morphologically characterized and identified using rDNA sequencing gene as being Alternaria alternata (MF693801) and Fusarium fujikuroi (MF693802). These fungi significantly suppressed FORL mycelial growth and showed chitinolytic, proteolytic and amylase activities whereas only F. fujikuroi displayed a lipolytic activity. This study clearly demonstrated the potential use of fungi naturally associated with L. arabicum as biocontrol and bio-fertilizing agents.

Keywords: biocontrol, endophytic fungi, Fusarium oxysporum f. sp. radicis-lycopersici, tomato promotion, Lycium arabicum

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898 Applying Swanson's Theory of Caring to Manage Multiple Trauma Patient

Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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897 The Quasar 3C 47:Extreme Population B Jetted Source with Double-Peaked Profile

Authors: Shimeles Terefe Mengistue, Paola Marziani, Ascensióndel Olmo, Jaime Perea, Mirjana Pović

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The theory that rotating accretion disks are responsible for the broad emission-line profiles in quasars is frequently put forth; however, the presence of accretion disk (AD) in active galactic nuclei (AGN) had limited and indirect observational support. In order to evaluate the extent to which the AD is a source of the broad Balmer lines and high ionization UV lines in radio-loud (RL) AGN, we focused on an extremely jetted RL quasar, 3C 47 that clearly shows a double peaked profile. This work presents its optical spectra and UV observations from the HST/FOS covering the rest-frame spectral range from 2000 to 7000 \AA. The fit of the low ionization lines, Hbeta, Halpha and MgII2800 show profiles that are in very good agreement with a relativistic Keplerian AD model. The profile of the prototypical high ionization lines can also be modeled by the contribution of the AD, with additional components due to outflows and emissions from the innermost part of the narrow line regions (NLRs). A prominent fit of the resulting double peaked profiles were found and very important disk parameters of the disk have been determined using the Hbeta, Halpha and MgII2800 lines: the inner and outer radii (both in units of G/mbh, where mbh is the supermassive black hole), an inclination to the line of sight, the emissivity index and the local broadening parameter. In addition, the accretion parameters, /mbh and /lledd are also determined. This work indicates that the line profile of 3C 47 shows the most convincing direct evidence for the presence of a rotating AD in AGN and the broad, double-peaked profiles originate from this AD that surrounds an /mbh.

Keywords: active galactic nuclei, quasars, emission lines, Double-peaked, supermassive black hole

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896 Optimizing Super Resolution Generative Adversarial Networks for Resource-Efficient Single-Image Super-Resolution via Knowledge Distillation and Weight Pruning

Authors: Hussain Sajid, Jung-Hun Shin, Kum-Won Cho

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Image super-resolution is the most common computer vision problem with many important applications. Generative adversarial networks (GANs) have promoted remarkable advances in single-image super-resolution (SR) by recovering photo-realistic images. However, high memory requirements of GAN-based SR (mainly generators) lead to performance degradation and increased energy consumption, making it difficult to implement it onto resource-constricted devices. To relieve such a problem, In this paper, we introduce an optimized and highly efficient architecture for SR-GAN (generator) model by utilizing model compression techniques such as Knowledge Distillation and pruning, which work together to reduce the storage requirement of the model also increase in their performance. Our method begins with distilling the knowledge from a large pre-trained model to a lightweight model using different loss functions. Then, iterative weight pruning is applied to the distilled model to remove less significant weights based on their magnitude, resulting in a sparser network. Knowledge Distillation reduces the model size by 40%; pruning then reduces it further by 18%. To accelerate the learning process, we employ the Horovod framework for distributed training on a cluster of 2 nodes, each with 8 GPUs, resulting in improved training performance and faster convergence. Experimental results on various benchmarks demonstrate that the proposed compressed model significantly outperforms state-of-the-art methods in terms of peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), and image quality for x4 super-resolution tasks.

Keywords: single-image super-resolution, generative adversarial networks, knowledge distillation, pruning

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895 Evaluation of NASA POWER and CRU Precipitation and Temperature Datasets over a Desert-prone Yobe River Basin: An Investigation of the Impact of Drought in the North-East Arid Zone of Nigeria

Authors: Yusuf Dawa Sidi, Abdulrahman Bulama Bizi

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The most dependable and precise source of climate data is often gauge observation. However, long-term records of gauge observations, on the other hand, are unavailable in many regions around the world. In recent years, a number of gridded climate datasets with high spatial and temporal resolutions have emerged as viable alternatives to gauge-based measurements. However, it is crucial to thoroughly evaluate their performance prior to utilising them in hydroclimatic applications. Therefore, this study aims to assess the effectiveness of NASA Prediction of Worldwide Energy Resources (NASA POWER) and Climate Research Unit (CRU) datasets in accurately estimating precipitation and temperature patterns within the dry region of Nigeria from 1990 to 2020. The study employs widely used statistical metrics and the Standardised Precipitation Index (SPI) to effectively capture the monthly variability of precipitation and temperature and inter-annual anomalies in rainfall. The findings suggest that CRU exhibited superior performance compared to NASA POWER in terms of monthly precipitation and minimum and maximum temperatures, demonstrating a high correlation and much lower error values for both RMSE and MAE. Nevertheless, NASA POWER has exhibited a moderate agreement with gauge observations in accurately replicating monthly precipitation. The analysis of the SPI reveals that the CRU product exhibits superior performance compared to NASA POWER in accurately reflecting inter-annual variations in rainfall anomalies. The findings of this study indicate that the CRU gridded product is often regarded as the most favourable gridded precipitation product.

Keywords: CRU, climate change, precipitation, SPI, temperature

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894 Assessment of Heavy Metal Contamination for the Sustainable Management of Vulnerable Mangrove Ecosystem, the Sundarbans

Authors: S. Begum, T. Biswas, M. A. Islam

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The present research investigates the distribution and contamination of heavy metals in core sediments collected from three locations of the Sundarbans mangrove forest. In this research, quality of the analysis is evaluated by analyzing certified reference materials IAEA-SL-1 (lake sediment), IAEA-Soil-7, and NIST-1633b (coal fly ash). Total concentrations of 28 heavy metals (Na, Al, K, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Zn, Ga, As, Sb, Cs, La, Ce, Sm, Eu, Tb, Dy, Ho, Yb, Hf, Ta, Th, and U) have determined in core sediments of the Sundarbans mangrove by neutron activation analysis (NAA) technique. When compared with upper continental crustal (UCC) values, it is observed that mean concentrations of K, Ti, Zn, Cs, La, Ce, Sm, Hf, and Th show elevated values in the research area is high. In this research, the assessments of metal contamination levels using different environmental contamination indices (EF, Igeo, CF) indicate that Ti, Sb, Cs, REEs, and Th have minor enrichment of the sediments of the Sundarbans. The modified degree of contamination (mCd) of studied samples of the Sundarbans ecosystem show low contamination. The pollution load index (PLI) values for the cores suggested that sampling points are moderately polluted. The possible sources of the deterioration of the sediment quality can be attributed to the different chemical carrying cargo accidents, port activities, ship breaking, agricultural and aquaculture run-off of the area. Pearson correlation matrix (PCM) established relationships among elements. The PCM indicates that most of the metal's distributions have been controlled by the same factors such as Fe-oxy-hydroxides and clay minerals, and also they have a similar origin. The poor correlations of Ca with most of the elements in the sediment cores indicate that calcium carbonate has a less significant role in this mangrove sediment. Finally, the data from this research will be used as a benchmark for future research and help to quantify levels of metal pollutions, as well as to manage future ecological risks of the vulnerable mangrove ecosystem, the Sundarbans.

Keywords: contamination, core sediment, trace element, sundarbans, vulnerable

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893 Assessment of Risk Factors in Residential Areas of Bosso in Minna, Nigeria

Authors: Junaid Asimiyu Mohammed, Olakunle Docas Tosin

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The housing environment in many developing countries is fraught with risks that have potential negative impacts on the lives of the residents. The study examined the risk factors in residential areas of two neighborhoods in Bosso Local Government Areas of Minna in Nigeria with a view to determining the level of their potential impacts. A sample of 378 households was drawn from the estimated population of 22,751 household heads. The questionnaire and direct observation were used as instruments for data collection. The data collected were analyzed using the Relative Importance Index (RII) rule to determine the level of the potential impact of the risk factors while ArcGIS was used for mapping the spatial distribution of the risks. The study established that the housing environment of Angwan Biri and El-Waziri areas of Bosso is poor and vulnerable as 26% of the houses were not habitable and 57% were only fairly habitable. The risks of epidemics, building collapse and rainstorms were evident in the area as 53% of the houses had poor ventilation; 20% of residents had no access to toilets; 47% practiced open waste dumping; 46% of the houses had cracked walls while 52% of the roofs were weak and sagging. The results of the analysis of the potential impact of the risk factors indicate a RII score of 0.528 for building collapse, 0.758 for rainstorms and 0.830 for epidemics, indicating a moderate to very high level of potential impacts. The mean RII score of 0.639 shows a significant potential impact of the risk factors. The study recommends the implementation of sanitation measures, provision of basic urban facilities and neighborhood revitalization through housing infrastructure retrofitting as measures to mitigate the risks of disasters and improve the living conditions of the residents of the study area.

Keywords: assessment, risk, residential, Nigeria

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892 Assessment of Knowledge, Awareness about Hemorrhoids Causes and Stages among the General Public of Saudi Arabia

Authors: Asaiel Mubark Al Hadi

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Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.

Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding

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891 Analysis of Non-Coding Genome in Streptococcus pneumoniae for Molecular Epidemiology Typing

Authors: Martynova Alina, Lyubov Buzoleva

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Streptococcus pneumoniae is the causative agent of pneumonias and meningitids throught all the world. Having high genetic diversity, this microorganism can cause different clinical forms of pneumococcal infections and microbiologically it is really difficult diagnosed by routine methods. Also, epidemiological surveillance requires more developed methods of molecular typing because the recent method of serotyping doesn't allow to distinguish invasive and non-invasive isolates properly. Non-coding genome of bacteria seems to be the interesting source for seeking of highly distinguishable markers to discriminate the subspecies of such a variable bacteria as Streptococcus pneumoniae. Technically, we proposed scheme of discrimination of S.pneumoniae strains with amplification of non-coding region (SP_1932) with the following restriction with 2 types of enzymes of Alu1 and Mn1. Aim: This research aimed to compare different methods of typing and their application for molecular epidemiology purposes. Methods: we analyzed population of 100 strains of S.pneumoniae isolated from different patients by different molecular epidemiology methods such as pulse-field gel electophoresis (PFGE), restriction polymorphism analysis (RFLP) and multilolocus sequence typing (MLST), and all of them were compared with classic typing method as serotyping. The discriminative power was estimated with Simpson Index (SI). Results: We revealed that the most discriminative typing method is RFLP (SI=0,97, there were distinguished 42 genotypes).PFGE was slightly less discriminative (SI=0,95, we identified 35 genotypes). MLST is still the best reference method (SI=1.0). Classic method of serotyping showed quite weak discriminative power (SI=0,93, 24 genotypes). In addition, sensivity of RFLP was 100%, specificity was 97,09%. Conclusion: the most appropriate method for routine epidemiology surveillance is RFLP with non-coding region of Streptococcsu pneumoniae, then PFGE, though in some cases these results should be obligatory confirmed by MLST.

Keywords: molecular epidemiology typing, non-coding genome, Streptococcus pneumoniae, MLST

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890 Nutritional Status of Rural Women in Bengaluru Rural District of Karnataka, India

Authors: A. M. Maruthesh, B. M. Anandakumar, O. Kumara, Akshatha Gombi, S. R. Rajini

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Women play a vital role in ensuring proper development and growth of children. They also contribute significantly towards income generation, food preparation and health. Nutritional status reflects the health of a person and is influenced by the quality of foods eaten and the ability of the body to utilize these foods to meet its needs it is affected by various socio-economic factors including income, family size, occupation and educational status of the people. The study was undertaken on nutritional status of rural women in Heggadehalli of Doddaballapurtaluk and Venkathalli of Devanahallitaluk in Bengaluru rural district with the sample size of 200 respondents. The prevalence of symptoms of malnutrition in a community is in turn a reflection of dietary consumption of its members. Mean anthropometric measurement of rural women were 153.8 cm of height, 46.8 kg of weight. In comparison with the mean BMI standards, it was observed that 20 percent of women were under nourished, 64 percent of women were normal and 16 percent women were obese. In comparison with the mean waist/hip ratio with standards, it was observed that 84 percent were in normal category and 16 percent were obese. Education, land holding, income and age had significant positive association with anthropometric measurements of rural women. The deficient level of haemoglobin existed in 53 percent of rural women, low in 20 percent and only 27 percent had acceptable level. The occurrence of morbidity symptoms was higher in rural women, its illness reported among women in the study were pain in hands and legs, backache, headache, pain in abdomen, fever, weakness, cold and cough and acidity. This may be due to considerable amount of workload on women who spend 8 to 9 hours at work and after returning continue their day’s work at home also.

Keywords: anthrometry, body index, hemoglobin, nutrient deficiency, rural women, nutritional status

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889 Use of the Occupational Repetitive Action Method in Different Productive Sectors: A Literature Review 2007-2018

Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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888 Evaluation of Chromium Fortified - Parboiled Rice Coated with Herbal Extracts: Cooking Quality and Sensory Properties

Authors: Wisnu Adi Yulianto, Agus Slamet, Sri Luwihana, Septian Albar Dwi Suprayogi

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Parboiled rice was developed to produce rice, which has a low glycemic index for diabetics. However, diabetics also have a chromium (Cr) deficiency. Thus, it is important to fortify rice with Cr to increase the Cr content. Moreover, parboiled rice becomes rancid easily and has a musty odor, rendering the rice unfavorable. Natural herbs such as pandan leaves (Pandanus amaryllifolius Roxb.), bay leaves (Syzygium polyanthum [Wigh] Walp) and cinnamon bark powder (Cinnamomon cassia) are commonly added to food as aroma enhancers. Previous research has shown that these herbs could improve insulin sensitivity. The purpose of this study was to evaluate the effect of herbal extract coatings on the cooking quality and the preference level of chromium fortified - parboiled rice (CFPR). The rice grain variety used for this experiment was Ciherang and the fortificant was CrCl3. The three herbal extracts used for coating the CFPR were cinnamon, pandan and bay leaf, with concentration variations of 3%, 6%, and 9% (w/w) for each of the extracts. The samples were analyzed for their alkali spreading value, cooking time, elongation, water uptake ratio, solid loss, colour and lightness; and their sensory properties were determined by means of an organoleptic test. The research showed that coating the CFPR with pandan and cinnamon extracts at a concentration of 3% each produced a preferred CFPR. When coated with those herbal extracts the CFPR had the following cooking quality properties: alkali spreading value 5 (intermediate gelatinization temperature), cooking time, 26-27 min, color value, 14.95-15.00, lightness, 42.30 – 44.06, elongation, 1.53 – 1.54, water uptake ratio , 4.05-4.06, and solid loss, 0.09/100 g – 0.13 g/100 g.

Keywords: bay leaves, chromium, cinnamon, pandan leaves, parboiled rice

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887 Environmental Drivers of Ichthyofauna Species Diversity and Richness in the Lower Reaches of Warri River, a Typical Mangrove Ecosystem in the Niger Delta, Nigeria

Authors: F. O. Arimoro, F. N. Okonkwo, R. B. Ikomi

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The environmental determinants structuring species richness has been generating interest recently but we still lack an understanding of these patterns in various regions (e.g. Afrotropical), and how seasons help to structure these patterns. Our aim was to assessed the environmental drivers importance in regulating species richness and community structure of fish species. The lchthyofauna assemblage of Warri River, Niger Delta area of Nigeria was studied between August 2013 and July 2014. A total of 1152 individuals representing 43 species in 23 families and 30 genera were caught. Of the 43 species recorded, 67.4%, 53.5% and 67.4% of the species occurred in Stations 1, 2 and 3 respectively. Eight taxa representing 18.6% of the total abundance were ubiquitous. The claroteid, Chrysichthys walkeri and the cichlid, Chromidotilapia guentheri were the most dominant species accounting for 19.2% and 6.0% respectively of the total catch. The species richness and general diversity were relatively higher in station 1 although Jaccard similarity index revealed that stations 1 and 3 were significantly similar while station 2 showed complete dissimilarity with stations 1 and 3. Canonical correspondence analysis indicated that dissolved oxygen, electrical conductivity, total nitrogen, Biochemical Oxygen demand and temperature were important variables structuring the overall fish assemblages. The presence of appreciable number of juveniles in this water body suggests that the Warri River is a breeding and nursery ground for fish species particularly those of brackish origin. These findings indicate that the water body is still useful as a good fishing ground for the rural communities and every effort should be put in place to ensure its protection and conservation for the production of healthy fish.

Keywords: Chrysichthys walkeri, fish communities, mangrove ecosystem, physicochemical parameters, Warri River

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886 Combined Cervical Headache Snag with Cervical Snag Half Rotation Techniques on Cervicogenic Headache Patients

Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

Abstract:

Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

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885 Erectile Function and Heart Rate Variability in Men under 40 Years Old

Authors: Rui Miguel Costa, Jose Pestana, David Costa, Paula Mangia, Catarina Correia, Mafalda Pinto Coelho

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There is lack of studies examining the relation of different heart rate variability (HRV) parameters with the risk of erectile dysfunction (ED) in younger men. Thus, the present study aimed at examining, in a nonclinical sample of men aged 19-39 years old (mean age = 23.98 years, SD = 4.90), the relations of risk of ED with the standard deviation of the heart rate (SD of HR), high and low frequency power of HRV, and low-to-high frequency HRV ratio. Eighty-three heterosexual Portuguese men completed the 5-item version of the International Index of Erectile Function (IIEF-5) and HRV parameters were calculated from a 5-minute resting period. Risk of ED was determined by IIEF-5 scores of 21 or less. Fifteen men (18.1%) reported symptoms of ED (14 with mild and one with mild to moderate symptoms). Univariate analyses of variance revealed that risk of ED was related to lesser SD of HR and lesser low-frequency power, the two HRV parameters that express a coupling of higher vagal and sympathetic tone. Risk of ED was unrelated to high-frequency power and low-to-high frequency HRV ratio. Further, in a logistic regression, the risk of ED was independently predicted by older age and lower SD of HR, but not by low-frequency power, having a regular sexual partner, and cohabiting. The results provide preliminary evidence that, in younger men, a coupling of higher vagal and sympathetic tone, as indexed by the SD of HR, is important for erections. Greater resting SD of HR might reflect better vascular and interpersonal function via vagal tone coupled with greater motor mobilization to pursue sexual intercourse via sympathetic tone. Many interventions can elevate HRV; future research is warranted on how they can be tailored to treat ED in younger men.

Keywords: erectile dysfunction, heart rate variability, standard deviation of the heart rate, younger men

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884 Multiple-Channel Piezoelectric Actuated Tunable Optical Filter for WDM Application

Authors: Hailu Dessalegn, T. Srinivas

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We propose new multiple-channel piezoelectric (PZT) actuated tunable optical filter based on racetrack multi-ring resonators for wavelength de-multiplexing network applications. We design tunable eight-channel wavelength de-multiplexer consisting of eight cascaded PZT actuated tunable multi-ring resonator filter with a channel spacing of 1.6 nm. The filter for each channel is basically structured on a suspended beam, sandwiched with piezoelectric material and built in integrated ring resonators which are placed on the middle of the beam to gain uniform stress and linearly varying longitudinal strain. A reference single mode serially coupled multi stage racetrack ring resonator with the same radii and coupling length is designed with a line width of 0.8974 nm with a flat top pass band at 1dB of 0.5205 nm and free spectral range of about 14.9 nm. In each channel, a small change in the perimeter of the rings is introduced to establish the shift in resonance wavelength as per the defined channel spacing. As a result, when a DC voltage is applied, the beams will elongate, which involves mechanical deformation of the ring resonators that induces a stress and a strain, which brings a change in refractive index and perimeter of the rings leading to change in the output spectrum shift providing the tunability of central wavelength in each channel. Simultaneous wave length shift as high as 45.54 pm/V has been achieved with negligible tunability variation in the eight channel tunable optical filter proportional to the DC voltage applied in the structure, and it is capable of tuning up to 3.45 nm in each channel with a maximum loss difference of 0.22 dB in the tuning range and out of band rejection ratio of 35 dB, with a low channel crosstalk ≤ 30 dB.

Keywords: optical MEMS, piezoelectric (PZT) actuation, tunable optical filter, wavelength de-multiplexer

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883 Social Aspect of Energy Transition in Frankfurt

Authors: Aly Ahmed, Aber Kay Obwona, Mokrzecka Martyna, Piotrowska Małgorzata, Richardson Stephen

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Frankfurt am Main, the fifth largest city in Germany, ranked at 15th place by the Global Financial Centers Index in 2014, and a finalist of European Green Capital, 214 is a crucial player in German Environmental Policy. Since 2012 the city Authorities have been working on implementing the plan, which assumed to reduce the energy consumption by 50%, and fully switch to renewable energy by the year 2050. To achieve this goal, the Municipality of Frankfurt has begun preparing the Master plan, which will be introduced to public by the end of 2015. A significant question when facing the starting of Master Plan public’s introduction was deciding which method should be used to increase the public engagement. In order to answer this question, the city and region authorities in the cooperation with Frankfurt’s Universities and Climate KIC, organized a two-week PhD scientific workshops, in which participated more than 30 students from numerous countries. The paper presented the outcome of the research and solution proposal of the winning team. Transitions theory tells, that to address challenges as complex as Climate Change and the Energiewende, using of new technologies and system to the public is not sufficient. Transition –by definition is a process, and in such a large scale (city and region transition) can be fulfilled only, when operates within a broad socio – technical system. Authors believe that only by close cooperation with city dwellers, as well as different stakeholders, the Transition in Frankfurt can be successful. The vital part is the strategy which will ensure the engagement, sense of ownership and broad support within Frankfurt society. Author proposal based therefore, on fostering the citizens engagement through a comprehensive, innovative communication strategy.

Keywords: city development, communication strategies, social transition, sustainability

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882 The Associations of Pes Planus Plantaris (Flat Foot) to the Postural Stability of Basketball Student-Athletes Through the Ground Reaction Force Vector (vGRF)

Authors: Def Primal, Sasanty Kusumaningtyas, Ermita I. Ibrahim

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Purpose: The main objective of this study is to determine the pes planus plantaris (flat foot) condition can contribute to the disturbance of postural stability in basketball athletes in static and dynamic activities. Methods: This cross-sectional quantitative analytical retrospective study on 47 subjects of basketball student-athletes identified the foot arch index by extensive footprint area and AMTI (Advanced Mechanical Technology Inc.) Force flat-form (force plate) determined their postural stability. Subjects were conducted in three activities (static, dynamic vertical jump, and dynamic loading response) for ground reaction force (GRF) resultant vectors towards the vertical plane of body mass (W). Results Analytical results obtained that 80.9% of subjects had pes planus plantaris. It shows no significant differences in pes planus plantaris incidence in both sexes subject (p>0.005); however, there are differences in athlete’s exercise period aspect. Athlete students who have practiced strictly for more than four years’ experience over 50% of pes planus plantaris; furthermore, a long period of exercise was believed to stimulate pes planus. The average value of GRF vectors of pes planus plantaris subjects on three different basketball movements shows a significant correlation to postural stability. Conclusions Pes planus plantaris affected almost basketball athletes regarding the length and intensity of exercise performed. The condition significantly contributes to postural stability disturbance on a static condition, dynamic vertical jump, and dynamic vertical jump loading response.

Keywords: pes planus plantaris, flatfoot, ground reaction force, static and dynamic stability

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881 The Effect of Vitamin D Supplements and Aerobic Exercise on Hunger and Serum Insulin Levels in Adolescents With Metabolic Syndrome

Authors: Vahab Behmanesh

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Metabolic syndrome is defined as having at least three of the five metabolic risk factors, including abdominal obesity, high blood pressure, high triglycerides, low HDL, and insulin resistance. Lifestyle changes towards reducing physical activity, unhealthy eating habits Especially the high-fat and high-carbohydrate diet is directly related to metabolic syndrome, and due to the epidemic of overweight and sedentary life, metabolic syndrome is a serious problem worldwide. On the other hand, vitamin D deficiency is considered as one of the most common problems in the world, which is related to the dysfunction of beta cells and insulin resistance, and therefore, vitamin D deficiency is considered as a factor in the occurrence of metabolic syndrome. 40 subjects (age: 16.12 ± 4.4 years and body mass index 25.61 ± 4.4 kg/m2) were randomly assigned to groups of aerobic exercise and placebo, aerobic exercise and vitamin D and placebo (no exercise) were divided. Vitamin D was taken at a dose of 50,000 units per week in a double-blind format for eight weeks, and the daily aerobic exercise program was performed for 50 to 60 minutes, three doses per week, with an intensity of 50-60% of the maximum heart rate. From one-way analysis of variance, Factorial variance analysis (2x2) repeated measurement and correlated t-test were used for data analysis. Aerobic exercise and vitamin D intake reduced all metabolic risk indicators and blood insulin (P < 0.05). However, the subjective feeling of hunger did not change significantly (P < 0.05). Regarding waist circumference and blood glucose, the effect of exercise combined with vitamin D consumption was greater than the corresponding effect in the vitamin D group (P < 0.05). Aerobic exercises and vitamin D intake are safe and effective for improving cardiometabolic health, Imam adds vitamin D to the exercise program has more benefits for weight and blood sugar control, which suggests prescribing it for patients with metabolic syndrome.

Keywords: vitamin D, aerobic exercise, metabolic control, adolescents

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880 Combination of Work and Family Demands Correlated with the Severity of Wrist Musculoskeletal Disorders among Nurses

Authors: Hsien Hwa Kuo, Lin Wen Chun, Lin Wen Chun, Hsien Wen Kuo

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Objective: Nurses represent an important occupational group frequently affected by wrist musculoskeletal disorders (WMSDs) due to a heavy workload, working shifts, poor posture, giving shots, making beds, lifting patients, bending their waist and insufficient rest time every day. However, lack of research reported nurses whether workload in household correlated with the severity of WMSDs. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire including the demographic information, workplace condition and nine body parts of musculoskeletal disorders. Results: 17.9% and 23.9% of severity and symptoms in WMSDs among nurses with children were significant higher than among nurses without children (1​2.4% and 15.9%). Based on multiple logistic regression models adjusted for age, work duration, job title and body mass index (BMI), we found that heavy workload in hospital had higher odds ratio (OR) of the severity and symptoms of WMSD among nurses with children (OR= 8.67 and OR= 4.30, p<0.05) compared to nurses without children (OR= 1.94 and OR= 1.70). Conclusion: The severity and symptoms of WMSDs among nurses significantly correlated with workload in hospital among nurses with children. If women are at greater risk because of the combination of their work and family demands, synergistic effect of WMSDs was found among nurses. Comment: Women's domestic work, especially once they become mothers, they invest more time and energy caring for children, helping others, and doing housework. Thus domestic work, per se, may be a risk factor for wrist musculoskeletal problems, and, more importantly, it may constrain women's ability to protect themselves from the effects of their paid work. If nurses with more domestic work periodically make efforts to physical activity or modify inappropriate posture, their WMSDs symptoms will be alleviated.

Keywords: musculoskeletal disorders, nurse, NMQ, WMSDs

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879 Clinical Parameters Response to Low Level Laser Versus Monochromatic Near Infrared Photo Energy in Diabetic Patient with Peripheral Neuropathy

Authors: Abeer Ahmed Abdehameed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common micro vascular complications of type 2 diabetes. Loss of sensation is thought to contribute to lake of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low level laser (LLL) and monochromatic near infrared photo energy (MIRE) on pain , cutaneous sensation, static stability and index of lower limb blood flow in diabetic with peripheral neuropathy. Methods: Forty subjects with diabetic peripheral neuropathy were recruited for study. They were divided into two groups: The ( MIRE) group that included (20) patients and (LLL) group included (20) patients. All patients in the study had been subjected to various physical assessment procedures including pain, cutaneous sensation, Doppler flow meter and static stability assessments. The baseline measurements were followed by treatment sessions that conducted twice a week for 6 successive weeks. Results: The statistical analysis of the data had revealed significant improvement of the pain in both groups, with significant improvement in cutaneous sensation and static balance in (MIRE) group compared to (LLL) group; on the other hand results showed no significant differences on lower limb blood flow in both groups. Conclusion: Low level laser and monochromatic near infrared therapy can improve painful symptoms in patients with diabetic neuropathy. On the other hand (MIRE) is useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: diabetic neuropathy, doppler flow meter, low level laser, monochromatic near infrared photo energy

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878 Jabodebek Light Rail Transit with Grade of Automation (GoA) No.3 (Driverless) Technology towards Jakarta Net-Zero Emissions (NZE) 2050

Authors: Nadilla Saskia, Octoria Nur, Assegaf Zareeva

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Mass transport infrastructures are essential to enhance the connectivity between regions and regional equity in Indonesia. Indonesia’s capital city, Jakarta, ranked the 10th highest congestion rate in the world based on the 2019 traffic index, contributing to air pollution and energy consumption. Other than that, the World Air Quality Report in 2019 depicted Jakarta’s air pollutant concentration at 49.4 mg, the 5th highest in the world. Issues of severe traffic congestion, lack of sufficient urban infrastructure in Jakarta, and greenhouse gas emissions have to be addressed through mass transportation. Indonesia’s government is currently constructing The Greater Jakarta LRT (Light Rapid Transit) as convenient, efficient, and environmentally friendly transportation connecting Jakarta with Bekasi and Cibubur areas and plans to serve the passengers in August 2023. Greater Jakarta LRT is operated with Grade of Automation (GoA) No.3, Driverless Train Operation (DTO). Hence, the automated technology used in rail infrastructure is anticipated to address these issues with greater results. The paper will be validated and establish the extent to which the automation system would increase energy efficiency, help reduce carbon emissions, and benefit the environment. Based on the calculated CO2 emissions and fuel consumption for the existing condition (2015) during the feasibility study of the LRT Project and the predicted condition in 2030, it is obtained that Greater Jakarta LRT with GoA3 operation will reduce the CO2 emissions and fuel consumption by more than 50% in 2030. In the bigger picture, Greater Jakarta LRT supports the government's goal of achieving Jakarta Net-Zero Emissions (NZE) 2050.

Keywords: LRT, Grade of Automation (GoA), energy efficiency, carbon emissions, railway infrastructure, DKI Jakarta

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877 The Role of Transport Investment and Enhanced Railway Accessibility in Regional Efficiency Improvement in Saudi Arabia: Data Envelopment Analysis

Authors: Saleh Alotaibi, Mohammed Quddus, Craig Morton, Jobair Bin Alam

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This paper explores the role of large-scale investment in transport sectors and the impact of increased railway accessibility on the efficiency of the regional economic productivity in the Kingdom of Saudi Arabia (KSA). There are considerable differences among the KSA regions in terms of their levels of investment and productivity due to their geographical scale and location, which in turn greatly affect their relative efficiency. The study used a non-parametric linear programming technique - Data Envelopment Analysis (DEA) - to measure the regional efficiency change over time and determine the drivers of inefficiency and their scope of improvement. In addition, Window DEA analysis is carried out to compare the efficiency performance change for various time periods. Malmquist index (MI) is also analyzed to identify the sources of productivity change between two subsequent years. The analysis involves spatial and temporal panel data collected from 1999 to 2018 for the 13 regions of the country. Outcomes reveal that transport investment and improved railway accessibility, in general, have significantly contributed to regional economic development. Moreover, the endowment of the new railway stations has spill-over effects. The DEA Window analysis confirmed the dynamic improvement in the average regional efficiency over the study periods. MI showed that the technical efficiency change was the main source of regional productivity improvement. However, there is evidence of investment allocation discrepancy among regions which could limit the achievement of development goals in the long term. These relevant findings will assist the Saudi government in developing better strategic decisions for future transport investments and their allocation at the regional level.

Keywords: data envelopment analysis, transport investment, railway accessibility, efficiency

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876 Early Childhood Developmental Delay in 63 Low- and Middle-Income Countries: Prevalence and Inequalities Estimated from National Health Surveys

Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

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875 Shoulder-Arm Mobility and Upper and Lower Extremity Muscle Function are Impaired in Patients with Systemic Sclerosis

Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

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Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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