Search results for: Andre J. Souza

Authors: Jessie André

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In the past 10 years, more studies have begun exploring the psychological impact of those who have been subjected to and have adopted two different cultures. Currently, there is no existing literature regarding how individuals with a bicultural identity navigate their often-conflicting cultures on topics such as sexual pleasure and sexual scripts. The purpose of this study was to explore how first-generation Afro/Black Caribbean-American women navigate their multiple cultural identities with regards to sexual pleasure and sexual scripts. This study contains an exploration of participants self-described challenges, attitudes, and beliefs associated to how they navigate and experience their sexuality. This research study uses an explanatory, qualitative method design with semi structured interviews to answer the primary and secondary research question. Research findings indicate that the later the age of immigration, the stronger their ties were to the culture from their country of origin, which affected their self-assessments of sexual desirability and sexual self-esteem. Findings also suggest that even though women who immigrated at a younger age had higher rates of difficulty navigating and identifying with their adopted culture’s sexual mores. These women also reported lower ratings of comfort voicing sexual desires and concerns to their partner and had lower self-ratings of feeling connected to their cultural identity. These participants had challenges utilizing the dual and conflicting sexual mores and rules they received from U.S. society and their country of origin, resulting in less pleasurable sexual experiences. Whereas women who immigrated at an older age reported having more pleasurable sexual experiences.

Keywords: bicultural identity, sexual pleasure, first-generation immigrants, afro/black caribbean-American

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Authors: Simin Shahvazi, Sepideh Soltani, Seyed Mehdi Ahmadi, Russell J. De Souza, Amin Salehi-Abargouei

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Background and Objectives: Vitamin D has received attention for its potential to disrupt cancer processes such as attenuating cell proliferation and exacerbating differentiation and apoptosis. However, whether there exists a role for vitamin D in the treatment of prostate cancer specifically remains controversial. We systematically review the literature to assess whether supplementation with vitamin D influences PSA response and overall survival in patients with prostate cancer. Methods: We searched PubMed, Scopus, ISI Web of Science and Google scholar from inception through up to 10 September 2017 for both before-and-after and randomized trials that evaluated the effect of vitamin D supplementation on the prostate specific antigen (PSA) response rate in participants with prostate cancer. The DerSimonian and Laird, inverse-weighted random-effects model was used to pool effect estimates from the studies. Heterogeneity and potential publication bias were evaluated. Subgroup analyses were also performed. Results: Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in meta-analysis. The analysis on controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD) = -1.66 ng/ml, 95%CI: -0.69, 0.36, P= 0.543)], PSA response (RR=1.18, 95%CI: 0.97, 1.45, P=0.104) and mortality rate (risk ratio (RR) = 1.05, 95% CI: 0.81-1.36; P=0.713) was not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had had a modest effect on PSA response rate: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Conclusion: We found that vitamin D modestly increases the PSA response rate in single arm studies. No effect on serum PSA levels, PSA response and mortality was seen in randomized controlled clinical trials. It does not seem patients with prostate cancer benefit from vitamin D supplementation.

Keywords: mortality, prostatic neoplasms, PSA response, vitamin D

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Authors: Natasha Venter

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Recent publications, including Truth to Power by André de Ruyter, Gangster State by Pieter-Louis Myburgh, and Enemy of the People by Pieter du Toit and Adriaan Basson, expose alleged corrupt acts by high-ranking members of State, as well as those in charge of State-owned entities. These literary contributions have gripped the attention of a nation plagued by corruption scandals and the alleged misappropriation of state funds on an almost daily basis. The books, however, leave the populace with the burning question of why “nothing happens” to these individuals who are so directly implicated in the literature. The process followed by the State in the largest successful prosecution of a corrupt state official, Jackie Selebi, sheds some light as to how such high-ranking persons might be brought to book. The Supreme Court of Appeal’s definition of corruption and the interpretation of the facts (as presented by the State prosecutors) by the court is also valuable. Furthermore, some insight into the laws that criminalise corruption in South Africa, as well as applicable international instruments, is necessary. South Africa is ranked as the 70th most corrupt country out of 180 countries by Transparency International’s 2021 Corruption Perceptions Index. This is worrisome as South Africa is a signatory of the United Nations Convention Against Corruption (2004) and, as such, has certain international obligations to fulfil. However, if the political will to prosecute corrupt officials in South Africa exists, there are laws and instruments available to punish these individuals. This would not only vindicate the authors of literature about corruption in the country but also restore the hope of South Africans that, ultimately, crime does not pay.

Keywords: corruption, eskom, state capture, government, literature, united nations, law, legal, Jackie selebi, supreme court of appeal

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Authors: Jennifer M. Glennon, Hana D'Souza, Luke Mason, Annette Karmiloff-Smith, Michael S. C. Thomas

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Genetic syndrome groups that feature high rates of autism comorbidity, like Down syndrome (DS) and fragile X syndrome (FXS), have been presented as useful models for understanding risk and protective factors involved in the emergence of autistic traits. Yet despite reaching clinical thresholds, these ‘syndromic’ forms of autism appear to differ in important ways from the idiopathic or ‘non-syndromic’ autism phenotype. To uncover the true nature of these comorbidities, it is necessary to extend definitions of autism to include the cognitive characteristics of the disorder and to then apply this broadened conceptualisation to the study of syndromic autism profiles. The current study employs a variety of well-established eye-tracking paradigms to assess visual attentional performance in children with DS and FXS who reach thresholds for autism on the Social Communication Questionnaire. It investigates whether autism profiles in these children are accompanied by visual orienting difficulties (‘sticky attention’), decreased social attention, and enhanced visual search performance, all of which are characteristic of the idiopathic autism phenotype. Data is collected from children with DS and FXS aged between 6 and 10 years, in addition to two control groups matched on age and intellectual ability (i.e., children with idiopathic autism and neurotypical controls). Cross-sectional developmental trajectory analyses are conducted to enable visuo-attentional profile comparisons. Significant differences in the visuo-attentional processes underpinning autism presentations in children with FXS and DS are hypothesised, supporting notions of syndrome specificity. The study provides insight into the complex heterogeneity associated with syndromic autism presentations and autism per se, with clinical implications for the utility of autism intervention programmes in DS and FXS populations.

Keywords: autism, down syndrome, fragile X syndrome, eye tracking

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Authors: Ana Luiza Da Gama E Souza

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This article aims to discuss the problem of food insecurity in Brazil in what it refers to contamination of food by chemical substances such as herbicides, pesticides, and other contaminants. The issue will be faced by analyzing, on the one hand, the standards that guide the food system in the world and, on the other hand, human rights indicators whose purpose is to provide an effective monitoring of the State's obligations to guarantee food security, analyzing the implications of the former for the success of the latter. The methodology adopted in this article was bibliographic-documentary and consists of three moments of analysis. The first moment consists in the analysis of the reports of the Commission on Human Rights of the Organization of American States to identify the set of progress indicators developed by the Commission. This analysis will involve the new methodology used to evaluate the efficiency in monitoring food security in Brazil the case of using pesticides in the production of food at levels of toxicity not admitted by the inspection bodies. The second moment consists in evaluating the mechanism for monitoring food security in Brazil, which was initially established by the National Food Security Plan (PLANSAN) for 2012-2015 and improved by the II National Food Security Plan for 2016-2019. Those mechanisms were prepared by the Chamber (CAISAN), and have the function to compare the monitoring proposals with the results presented by CAISAN on the Indicators and Results Report of the National Plan for Food and Nutrition Security 2012-2015. The third moment was intended to understand, analyze and evaluate the standardization process of the agri-food system, especially regarding the level of toxicity standards, that is related to food safety monitoring as a guarantee of pesticide-free food. The results show the dependence between private standards of toxicity and the indicators of food safety that leads to inefficiency on monitoring that mechanism in Brazil.

Keywords: standards, indicators, human rights, food security

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Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

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Authors: Mariana Roberta Ribeiro, Isabela de Cássia Caramello, Roberto Saverio Souza Costa

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Currently, one of the most important environmental problems is soil degradation. This wear is the result of inadequate agricultural practices, with water erosion as the main agent. As the runoff water is concentrated in certain points, it can reach a more advanced stage, which are the gullies. In view of this, the objective of this work was to evaluate which methodology is most suitable for the purpose of elaborating a project for the recovery of a gully, relating work time, data reliability, and the final cost. The work was carried out on a rural road in Monte Alto - SP, where there is 0.30 hectares of area under the influence of a gully. For the evaluation, an aerophotogrammetric survey was used with RPA, with georeferenced points, and with a GNSS L1/L2 receiver. To assess the importance of georeferenced points, there was a comparison of altimetric data using the support points with altimetric data using only the aircraft's internal GPS. Another method used was the survey by conventional topography, where coordinates were collected by total station and L1/L2 Geodetic GPS receiver. Statistical analysis was performed using analysis of variance (ANOVA) using the F test (p<0.05), and the means between treatments were compared using the Tukey test (p<0.05). The results showed that the surveys carried out by aerial photogrammetry and by conventional topography showed no significant difference for the analyzed parameters. Considering the data presented, it is possible to conclude that, when comparing the parameters of accuracy, the final volume of the gully, and cost, for the purpose of elaborating a project for the recovery of a gully, the methodologies of aerial photogrammetric survey and conventional topography do not differ significantly. However, when working time, use of labor, and project detail are compared, the aerial photogrammetric survey proves to be more viable.

Keywords: drones, erosion, soil conservation, technology in agriculture

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Authors: Nthabiseng Portia Mahumapelo, Andre van Niekerk, Ndabenhle Sosibo, Nirdesh Singh

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The foundry industry generates large quantities of solid waste in the form of waste foundry sand. The ever-increasing quantities of this type of industrial waste put pressure on land-filling space and its proper management has become a global concern. The South African foundry industry is not different when it comes to this solid waste generation. Utilizing the foundry waste sand in other applications has become an attractive avenue to deal with this waste stream. In the present paper, an evaluation was done on the suitability of foundry waste sand as an additive in clay masonry products. Purchased clay was added to the foundry waste sand sample in a 50/50 ratio. The mixture was named FC sample. The FC sample was mixed with water in a pan mixer until the mixture was consistent and suitable for extrusion. The FC sample was extruded and cut into briquettes. Water absorption, shrinkage and modulus of rupture tests were conducted on the resultant briquettes. Foundry waste sand and FC samples were respectively characterized mineralogically using X-Ray Diffraction, and the major and trace elements were determined using Inductively Coupled Plasma Optical Emission Spectroscopy. Adding purchased clay to the foundry waste sand positively influenced the workability of the test sample. Another positive characteristic was the low linear shrinkage, which indicated that products manufactured from the FC sample would not be susceptible to cracking. The water absorption values were acceptable and the unfired and fired strength values of the briquette’s samples were acceptable. In conclusion, tests showed that foundry waste sand can be used as an additive in masonry clay bricks, provided it is blended with good quality clay.

Keywords: foundry waste sand, masonry clay bricks, modulus of rupture, shrinkage

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Authors: S. M. Rifat, André L. Marchildon, Mark F. Tachie

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Experiments were performed to investigate the effects of roughness on the reattachment and redevelopment regions over a 12 mm forward facing step (FFS) in an open channel flow. The experiments were performed over an upstream smooth wall and a smooth FFS, an upstream wall coated with sandpaper 36 grit and a smooth FFS and an upstream rough wall produced from sandpaper 36 grit and a FFS coated with sandpaper 36 grit. To investigate only the wall roughness effects, Reynolds number, Froude number, aspect ratio and blockage ratio were kept constant. Upstream profiles showed reduced streamwise mean velocities close to the rough wall compared to the smooth wall, but the turbulence level was increased by upstream wall roughness. The reattachment length for the smooth-smooth wall experiment was 1.78h; however, when it is replaced with rough-smooth wall the reattachment length decreased to 1.53h. It was observed that the upstream roughness increased the physical size of contours of maximum turbulence level; however, the downstream roughness decreased both the size and magnitude of contours in the vicinity of the leading edge of the step. Quadrant analysis was performed to investigate the dominant Reynolds shear stress contribution in the recirculation region. The Reynolds shear stress and turbulent kinetic energy profiles after the reattachment showed slower recovery compared to the streamwise mean velocity, however all the profiles fairly collapse on their corresponding upstream profiles at x/h = 60. It was concluded that to obtain a complete collapse several more streamwise distances would be required.

Keywords: forward facing step, open channel, separated and reattached turbulent flows, wall roughness

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Authors: M. S. Sulaiman, N. Hassan, M. A. Aziz, M. S. A. Haron, J. H. A. Halim

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The classic profile of heritage clay roof tiles gives unique characteristics and timeless style to the almost historical building. It is not only designed to meet basic construction needs, offering great performance and durability but also highlights unnoticed stamp impressions, known as ‘insignia imprinted.’ It seems that the insignia imprinted is not significant to all stakeholders, especially in preserving heritage clay roof tiles in Malaysia. They are not even realized the existence and importance of that element, where it represents the cognitive and social character of that particular era. It creates a sense of belongings for the manufacturers regarding their most elementary features, such as a fortress, crown, fauna and etc. This research aims to identify and analyze the late stamp marks on heritage interlocking clay roof tiles in a government heritage building in Malaysia. The methodology used is literature reviews (desktop study), observation on sites, and interviews. Initial findings from the preliminary observation on-site in Peninsular Malaysia show some evidence that the stamp marks appear on the front and back sides of the tile that indicates the year, manufacturer, code numbers, and logos. Almost more than 30 samples of different types of stamp marks were found and collected. Some of which had been described Guichard & Carvin Cie Marsielle St Andre France, Pierre Sacoman St Henry Marsielle, Tuileries Aixoises Les Milles B.D.R France, The Calicut Tile Co Feroke, And B. Pinto & Co Mangalore dated 1865, 1919 and 1936. In view of this abundance of materials, it will lead to the establishment of a comprehensive database consisting of detailed specifications and material performance for future conservation works and maintenance purposes that will sustain for future references.

Keywords: clay roof tiles, insignia imprinted, interlocking, stamp mark

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Authors: Naz Najma, Grace T. M. Dal Sasso, Maria de Lourdes de Souza

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The development of information and communication technologies and the accessibility of mobile devices has increased the possibilities of the teaching and learning process anywhere and anytime. Mobile and web application allows the production of constructive teaching and learning models in various educational settings, showing the potential for active learning in nursing. The objective of this study was to present the development of an educational technology (Savinglife®, an app) for learning cardiopulmonary resuscitation and advanced cardiovascular life support training. Savinglife® is a technological production, based on the concept of virtual learning and problem-based learning approach. The study was developed from January 2016 to November 2016, using five phases (analyze, design, develop, implement, evaluate) of the instructional systems development process. The technology presented 10 scenarios and 12 simulations, covering different aspects of basic and advanced cardiac life support. The contents can be accessed in a non-linear way leaving the students free to build their knowledge based on their previous experience. Each scenario is presented through interactive tools such as scenario description, assessment, diagnose, intervention and reevaluation. Animated ECG rhythms, text documents, images and videos are provided to support procedural and active learning considering real life situation. Accessible equally on small to large devices with or without an internet connection, Savinglife® offers a dynamic, interactive and flexible tool, placing students at the center of the learning process. Savinglife® can contribute to the student’s learning in the assessment and management of basic and advanced cardiac life support in a safe and ethical way.

Keywords: problem-based learning, cardiopulmonary resuscitation, nursing education, advanced cardiac life support, educational technology

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Authors: Angel Liduvino Vara-Vela, Dirceu Luis Herdies, Debora Souza Alvim, Eder Paulo Vendrasco, Silvio Nilo Figueroa, Jayant Pendharkar, Julio Pablo Reyes Fernandez

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Biomass-burning episodes are quite common in the central Amazon rainforest and represent a dominant source of aerosols during the dry season, between August and October. The increase in the occurrence of fires in 2019 in the world’s largest biomes has captured the attention of the international community. In particular, a rare and extreme smoke-related event occurred in the afternoon of Monday, August 19, 2019, in the most populous city in the Western Hemisphere, the São Paulo Metropolitan Area (SPMA), located in southeastern Brazil. The sky over the SPMA suddenly blackened, with the day turning into night, as reported by several news media around the world. In order to clarify whether or not the smoke that plunged the SPMA into sudden darkness was related to wildfires in the Amazon rainforest region, a set of 48-hour simulations over South America were performed using the Weather Research and Forecasting with Chemistry (WRF-Chem) model at 20 km horizontal resolution, on a daily basis, during the period from August 16 to August 19, 2019. The model results were satisfactorily compared against satellite-based data products and in situ measurements collected from air quality monitoring sites. Although a very strong smoke transport coming from the Amazon rainforest was observed in the middle of the afternoon on August 19, its impact on air quality over the SPMA took place in upper levels far above the surface, where, conversely, low air pollutant concentrations were observed.

Keywords: Amazon rainforest, biomass burning aerosols, São Paulo metropolitan area, WRF-Chem model

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Authors: Sandra H. Fukurozaki, Andre L. N. Silva, Joao B. F. Neto, Fernando J. G. Landgraf

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Nowadays, the rare earth (RE) metals play an important role in emerging technologies that are crucial for the decarbonisation of the energy sector. Their unique properties have led to increasing clean energy applications, such as wind turbine generators, and hybrid and electric vehicles. Despite the substantial media coverage that has recently surrounded the mining and processing of rare earth metals, very little quantitative information is available concerning their subsequent life stages, especially related to the metallic production of didymium (Nd-Pr) in fluoride molten salt system. Here we investigate a gate to gate scale life cycle assessment (LCA) of the didymium electrolysis based on three different scenarios of operational conditions. The product system is modeled with SimaPro Analyst 8.0.2 software, and IMPACT 2002+ was applied as an impact assessment tool. In order to develop a life cycle inventories built in software databases, patents, and other published sources together with energy/mass balance were utilized. Analysis indicates that from the 14 midpoint impact categories evaluated, the global warming potential (GWP) is the main contributors to the total environmental burden, ranging from 2.7E2 to 3.2E2 kg CO2eq/kg Nd-Pr. At the damage step assessment, the results suggest that slight changes in materials flows associated with enhancement of current efficiency (between 2.5% and 5%), could lead a reduction up to 12% and 15% of human health and climate change damage, respectively. Additionally, this paper highlights the knowledge gaps and future research efforts needing to understand the environmental impacts of Nd-Pr electrolysis process from the life cycle perspective.

Keywords: didymium electrolysis, environmental impacts, life cycle assessment, rare earth metals

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Authors: Andre Bechuke

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The quality of every learning programme in Higher Education (HE) is dependent on the planning, design, and development of the curriculum decisions. These curriculum development decisions are highly influenced by the knowledge of the end-user, who are not always just the students. When curriculum experts plan, design and develop learning programmes, they always have the end-users in mind throughout the process. Without proper knowledge of the end-user(s), the design and development of a learning programme might be flawed. Curriculum experts often struggle to determine who the real end-user is. As such, it is even more challenging to establish what needs to be known about the end user that should inform the plan, design, and development of a learning programme. This research sought suggest approaches to guide curriculum experts to identify the end-user(s), taking into consideration the pressure and influence other agencies and structures or stakeholders (industry, students, government, universities context, lecturers, international communities, professional regulatory bodies) have on the design of a learning programme and the graduates of the programmes. Considering the influence of these stakeholders, which is also very important, the task of deciding who the real end-user of the learning programme becomes very challenging. This study makes use of criteria 1 and 18 of the Council on Higher Education criteria for programme accreditation to guide the process of identifying the end-users when developing a learning programme. Criterion 1 suggests that designers must ensure that the programme is consonant with the institution’s mission, forms part of institutional planning and resource allocation, meets national requirements and the needs of students and other stakeholders, and is intellectually credible. According to criterion 18, in designing a learning programme, steps must be taken to enhance the employability of students and alleviate shortages of expertise in relevant fields. In conclusion, there is hardly ever one group of end-users to be considered for developing a learning programme, and the notion that students are the end-users is not true, especially when the graduates are unable to use the qualification for employment.

Keywords: council on higher education, curriculum design and development, higher education, learning programme

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Authors: Ana Campina, Maria Manuela Magalhaes, Eusebio André Machado, Cristina Costa-Lobo

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Inclusive school advocates respect for differences, for equal opportunities and for a quality education for all, including for students with special educational needs. In the pursuit of educational equity, guaranteeing equality in access and results, it becomes the responsibility of the school to recognize students' needs, adapting to the various styles and rhythms of learning, ensuring the adequacy of curricula, strategies and resources, materials and humans. This paper presents a set of theoretical reflections in the disciplinary interface between legal and education sciences, school administration and management, with the aim of understand the real inclusion characteristics in a balance with the inclusion policies and the need(s) of an education for Human Rights, especially for diversity. Considering the actual social complexity but the important education instruments and strategies, mostly patented in the policies, this paper aims expose the existing contexts opposed to the laws, policies and inclusion educational needs. More than a single study, this research aims to develop a map of the reality and the guidelines to implement the action. The results point to the usefulness and pertinence of a school in which educational managers, teachers, parents, and students, are involved in the creation, implementation and monitoring of flexible curricula and adapted to the educational needs of students, promoting a collaborative work among teachers. We are then faced with a scenario that points to the need to reflect on the legislation and curricular management of inclusive classes and to operationalize the processes of elaboration of curricular adaptations and differentiation in the classroom. The transdisciplinary is a pedagogic and social education perfect approach using the Human Rights binomio – teaching and learning – supported by the inclusion laws according to the realistic needs for an effective successful society construction.

Keywords: rights, transdisciplinary, inclusion policies, education for diversity

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Authors: Suelen C. Lima, André C. de Oliveira, Rosemary A. Roque

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Dengue is fatal arboviruses transmitted by the A. aegypti mosquito to more than 100 countries, for which the WHO estimates that 2.5 million people will be infected by these disease. The widespread of these diseases is due, among other factors, to the resistance that A. aegypti has to several commercial insecticides. On the other hand, natural products based on plants of the genus Piper (Piperaceae) are characterized by their insecticidal activities against mosquitoes. Piper longepetiolatum and Piper brachypetiolatum are species with wide distribution in the State of Amazonas. However, there is no investigation of phytochemical or biological of these plants against mosquitoes such as A. aegypti. The main of this study was to identify the chemical composition of the essential oil (EOs) from P. longepetiolatum and P. brachypetiolatum and to evaluate the biological activity against A. aegypti. The EOs were extracted by hydrodistillation from leaves (200 g) of P. longepetiolatum and P. brachypetiolatum and analyzed by GC-MS and GC-FID. The main compounds β-caryophyllene (99.9% of purity) and E-nerolidol (99.4% of purity) were purchased from Sigma-Aldrich® Brazil. The larvicidal activity of EOs (20 to 100 ppm), β-caryophyllene and E-nerolidol (10 to 50 ppm) was performed according to WHO protocol against A. aegypti larvae. The GC-MS and GC-FID analysis of EOs from P. longepetiolatum and P. brachypetiolatum indicated the majority presence of β-caryophyllene (35.42%) and E-nerolidol (49.79%), respectively. The results showed that all natural products presented larvicidal activity against A. aegypti. In this aspect, the OE from P. brachypetiolatum (LC50 of 15.51 ppm and LC90 of 22.79 ppm) was more active than the OE from P. longepetiolatum (LC50 of 47.17 ppm and LC90 of 69.60 ppm) (p < 0.05). Regarding of main compounds, E-nerolidol (LC50 of 9.50 ppm and LC90 of 23.89 ppm) showed higher larvicidal activity than the β-caryophyllene compound (LC50 of 79.00 ppm and LC90 of 230.91 ppm) (p < 0.05). The larvae treated with these natural products showed tremors and lethargic movements, suggesting that these natural products have neurotoxic action. These observations support studies to investigate the mechanism of action. This is the first record of the chemical composition and larvicidal activity of the EO from P. longepetiolatum and P. brachypetiolatum rich in β-caryophyllene and E-nerolidol against A. aegypti larvae.

Keywords: piperaceae, aedes, sesquiterpenes, biological control

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Authors: Andre S. de Lima, Alfredo R. de Faria, Jose J. R. Faria

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Accurate prediction of thermal stresses is particularly important for laminated composite structures, as large temperature changes may occur during fabrication and field application. The normal transverse deformation plays an important role in the prediction of such stresses, especially for problems involving thick laminated plates subjected to uniform temperature loads. Bearing this in mind, the present study aims to investigate the thermo-mechanical behavior of laminated composite structures using a new beam element based on global-local superposition, accounting for through-the-thickness effects. The element formulation is based on a global-local superposition in the thickness direction, utilizing a cubic global displacement field in combination with a linear layerwise local displacement distribution, which assures zig-zag behavior of the stresses and displacements. By enforcing interlaminar stress (normal and shear) and displacement continuity, as well as free conditions at the upper and lower surfaces, the number of degrees of freedom in the model is maintained independently of the number of layers. Moreover, the proposed formulation allows for the determination of transverse shear and normal stresses directly from the constitutive equations, without the need of post-processing. Numerical results obtained with the beam element were compared to analytical solutions, as well as results obtained with commercial finite elements, rendering satisfactory results for a range of length-to-thickness ratios. The results confirm the need for an element with through-the-thickness capabilities and indicate that the present formulation is a promising alternative to such analysis.

Keywords: composite beam element, global-local superposition, laminated composite structures, thermal stresses

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Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti

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Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.

Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology

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Authors: André C. Silva, Izabela L. A. Moraes, Elenice M. S. Silva, Carlos M. Silva Filho

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In Brazil, most soils are acidic and low in essential nutrients required for the growth and development of plants, making fertilizers essential for agriculture. As the biggest producer of soy in the world and a major producer of coffee, sugar cane and citrus fruits, Brazil is a large consumer of phosphate. Brazilian’s phosphate ores are predominantly from igneous rocks showing a complex mineralogy, associated with carbonites and oxides, typically iron, silicon and barium. The adopted industrial concentration circuit for this type of ore is a mix between magnetic separation (both low and high field) to remove the magnetic fraction and a froth flotation circuit composed by a reverse flotation of apatite (barite’s flotation) followed by direct flotation circuit (rougher, cleaner and scavenger circuit). Since the 70’s fatty acids obtained from vegetable oils are widely used as lower-cost collectors in apatite froth flotation. This is a very effective approach to the apatite family of minerals, being that this type of collector is both selective and efficient (high recovery). This paper presents Jatropha curcas L. oil (JCO) as a renewable and sustainable source of fatty acids with high selectivity in froth flotation of apatite. JCO is considerably rich in fatty acids such as linoleic, oleic and palmitic acid. The experimental campaign involved 216 tests using a modified Hallimond tube and two different minerals (apatite and quartz). In order to be used as a collector, the oil was saponified. The results found were compared with the synthetic collector, Fotigam 5806 produced by Clariant, which is composed mainly by soy oil. JCO showed the highest selectivity for apatite flotation with cold saponification at pH 8 and concentration of 2.5 mg/L. In this case, the mineral recovery was around 95%.

Keywords: froth flotation, jatropha curcas, microflotation, selectivity

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Authors: Michael Luc Andre, Célia Maintenant

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Theory of mind is a milestone in child development which allows children to understand that others could have different mental states than theirs. Understanding the developmental stages of theory of mind in children leaded researchers on two Connected research problems. In one hand, the link between executive function and theory of mind, and on the other hand, the relationship of theory of mind and syntax processing. These two lines of research involved a great literature, full of important results, despite certain level of disagreement between researchers. For a long time, these two research perspectives continue to grow up separately despite research conclusion suggesting that the three variables should implicate same developmental period. Indeed, our goal was to study the relation between theory of mind, executive function, and language via a unique research question. It supposed that between executive function and language, one of the two variables could play a critical role in the relationship between theory of mind and the other variable. Thus, 112 children aged between three and six years old were recruited for completing a receptive and an expressive vocabulary task, a syntax understanding task, a theory of mind task, and three executive function tasks (inhibition, cognitive flexibility and working memory). The results showed significant correlations between performance on theory of mind task and performance on executive function domain tasks, except for cognitive flexibility task. We also found significant correlations between success on theory of mind task and performance in all language tasks. Multiple regression analysis justified only syntax and general abilities of language as possible predictors of theory of mind performance in our preschool age children sample. The results were discussed in the perspective of a great role of language abilities in theory of mind development. We also discussed possible reasons that could explain the non-significance of executive domains in predicting theory of mind performance, and the meaning of our results for the literature.

Keywords: child development, executive function, general language, syntax, theory of mind

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Authors: Nádia Pereira, Paula Ferreira, Sofia Francisco, Sofia Oliveira, Sidclay Souza, Paula Paulino, Ana Margarida Veiga Simão

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Social media has progressed into a platform for hate speech among its users, and thus, there is an increasing need to develop automatic detection classifiers of offense and conflicts to help decrease the prevalence of such incidents. Online communication can be used to intentionally harm someone, which is why such classifiers could be essential in social networks. A possible application of these classifiers is the automatic detection of cyberbullying. Even though identifying the aggressive language used in online interactions could be important to build cyberbullying datasets, there are other criteria that must be considered. Being able to capture the language, which is indicative of the intent to harm others in a specific context of online interaction is fundamental. Offense and hate speech may be the foundation of online conflicts, which have become commonly used in social media and are an emergent research focus in machine learning and natural language processing. This study presents two Portuguese language offense-related datasets which serve as examples for future research and extend the study of the topic. The first is similar to other offense detection related datasets and is entitled Aggressiveness dataset. The second is a novelty because of the use of the history of the interaction between users and is entitled the Conflicts/Attacks dataset. Both datasets were developed in different phases. Firstly, we performed a content analysis of verbal aggression witnessed by adolescents in situations of cyberbullying. Secondly, we computed frequency analyses from the previous phase to gather lexical and linguistic cues used to identify potentially aggressive conflicts and attacks which were posted on Twitter. Thirdly, thorough annotation of real tweets was performed byindependent postgraduate educational psychologists with experience in cyberbullying research. Lastly, we benchmarked these datasets with other machine learning classifiers.

Keywords: aggression, classifiers, cyberbullying, datasets, hate speech, machine learning

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Authors: Pedro Miguel Cardoso Carneiro, Ricardo André Nunes Borges, João Pedro Soares Loureiro, Hermínio Maio Graça Fernandes

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Wind energy has been exponentially growing over the last years and will allow countries to progress regarding the decarbonization objective. In parallel, the maintenance activities have also been increasing in consequence of ageing and deterioration of the wind farms. The time available for wind blade maintenance is given by the weather window that is based upon weather conditions. Most of the wind blade repair and maintenance activities require a narrow window of temperature and humidity. Due to this limitation, the current weather windows result only on approximately 35% days/year are used for maintenance, that takes place mostly during summertime. This limitation creates large economic losses in the energy production of the wind towers, since they can be inoperative or with the energy production output reduced for days or weeks due to existing damages. Another important aspect is that the maintenance costs are higher due to the high standby time and seasonality imposed on the technicians. To reduce the relevant maintenance costs of blades and energy loses some technological developments were carried out to significantly improve this reality. The focus of this activity was to develop a series of key developments to have in the near future a suspended access equipment that can operate in harsh conditions, wind rain, cold/hot environment. To this end we have identified key areas that need to be revised and require new solutions to be found; a habitat system, multi-configurable roof and floor, roof and floor interface to blade, secondary attachment solutions to the blade and to the tower. On this paper we will describe the advances produced during a national R&D project made in partnership with an end-user (Onrope) and a test center (ISQ).

Keywords: wind turbine maintenance, cost reduction, technological innovations, wind turbine blade

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Authors: Claudio L. M. Souza, Milton Erthal, Aldo Shimoya, Elias R. Goncalves, Igor C. Rangel, Allysson R. T. Tavares, Elias G. Figueira

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The process of choosing a region for the implementation of wind farms involves factors such as the wind regime, economic viability, land value, topography, and accessibility. This work presents results obtained by multi-criteria decision analysis, and it establishes a hierarchy, regarding the installation of wind farms, among geopolicy regions in the state of ‘Rio de Janeiro’, Brazil: ‘Regiao Norte-RN’, ‘Regiao dos Lagos-RL’ and ‘Regiao Serrana-RS’. The wind regime map indicates only these three possible regions with an average annual wind speed of above of 6.0 m/s. The method applied was the Analytical Hierarchy Process-AHP, designed to prioritize and rank the three regions based on four criteria as follows: 1) potential of the site and average wind speeds of above 6.0 ms-¹, 2) average land value, 3) distribution and interconnection to electric network with the highest number of electricity stations, and 4) accessibility with proximity and quality of highways and flat topography. The values of energy generation were calculated for wind turbines 50, 75, and 100 meters high, considering the production of site (GWh/Km²) and annual production (GWh). The weight of each criterion was attributed by six engineers and by analysis of Road Map, the Map of the Electric System, the Map of Wind Regime and the Annual Land Value Report. The results indicated that in 'RS', the demand was estimated at 2,000 GWh, so a wind farm can operate efficiently in 50 m turbines. This region is mainly mountainous with difficult access and lower land value. With respect to ‘RL’, the wind turbines have to be installed at a height of 75 m high to reach a demand of 6,300 GWh. This region is very flat, with easy access, and low land value. Finally, the ‘NR’ was evaluated as very flat and with expensive lands. In this case, wind turbines with 100 m can reach an annual production of 19,000 GWh. In this Region, the coast area was classified as of greater logistic, productivity and economic potential.

Keywords: AHP, renewable energy, wind energy

Procedia PDF Downloads 111

Authors: Ivana R. Moser, Joao C. Souza

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Building fires are random phenomena that can be extremely violent, and safe evacuation of people is the most guaranteed tactic in saving lives. The correct evacuation of buildings, and other spaces occupied by people, means leaving the place in a short time and by the appropriate way. It depends on the perception of spaces by the individual, the architectural layout and the presence of appropriate routing systems. As historical buildings were constructed in other times, when, as in general, the current security requirements were not available yet, it is necessary to adapt these spaces to make them safe. Computer models of evacuation simulation are widely used tools for assessing the safety of people in a building or agglomeration sites and these are associated with the analysis of human behaviour, makes the results of emergency evacuation more correct and conclusive. The objective of this research is the performance evaluation of historical interest buildings, regarding the safe evacuation of people, through computer simulation, using PTV Viswalk software. The buildings objects of study are the Colégio Catarinense, centennial building, located in the city of Florianópolis, Santa Catarina / Brazil. The software used uses the variables of human behaviour, such as: avoid collision with other pedestrians and avoid obstacles. Scenarios were run on the three-dimensional models and the contribution to safety in risk situations was verified as an alternative measure, especially in the impossibility of applying those measures foreseen by the current fire safety codes in Brazil. The simulations verified the evacuation time in situations of normality and emergency situations, as well as indicate the bottlenecks and critical points of the studied buildings, to seek solutions to prevent and correct these undesirable events. It is understood that adopting an advanced computational performance-based approach promotes greater knowledge of the building and how people behave in these specific environments, in emergency situations.

Keywords: computer simulation, escape routes, fire safety, historic buildings, human behavior

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Authors: Abolfazl Zaraki, Yoshikatsu Hayashi, Harry Thorpe, Vincent Strong, Gisle-Andre Larsen, William Holderbaum

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Thanks to the high maneuverability of the cable-driven hyper-redundant manipulators (HRMs), this class of robots has shown a superior capability in highly confined and unstructured space applications. Although the large number of degrees of freedom (DOF) of HRMs enhances the motion flexibility and the robot’s reachability range, it highly increases the complexity of the kinematic configuration which makes the kinematic control problem very challenging or even impossible to solve. This paper presents our current progress achieved on the development of a kinematic-based leader-follower control system which is designed to control not only the robot’s body posture but also to control the trajectory of the robot’s movement in a semi-autonomous manner (the human operator is retained in the robot’s control loop). To obtain the forward kinematic model, the coordinate frames are established by the classical Denavit–Hartenburg (D-H) convention for a hyper-redundant serial manipulator which has a controlled cables-driven mechanism. To solve the inverse kinematics of the robot, unlike the conventional methods, a leader-follower mechanism, based on the sequential inverse kinematic, is followed. Using this mechanism, the inverse kinematic problem is solved for all sequential joints starting from the head joint to the base joint of the robot. To verify the kinematic design and simulate the robot motion, the MATLAB robotic toolbox is used. The simulation result demonstrated the promising capability of the proposed leader-follower control system in controlling the robot motion and trajectory in our confined space application.

Keywords: hyper-redundant robots, kinematic analysis, semi-autonomous control, serial manipulators

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Authors: Maria Lucia G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Isosporiasis is an affliction caused by coccidial protozoa belonging to genera Isospora spp. or Cystoisospora spp., which may parasitize the small and large intestines of dogs, of which neonates and young animals present higher risk of infection. This study aims at reporting a case of isosporiasis in neonate Pitbull dogs, as well as the diagnosis and treatment. Seven Pitbull puppies were admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, with history of yellowish diarrhea without mucus or blood for the past two days. The animals were five days old. The history of the mother, a primiparous two-year-old, revealed that she was properly vaccinated, not de-wormed and did not present diarrhea. The clinical examination revealed that the neonates weighted between 308 and 360 grams, and presented normal reflexes, moderate dehydration, body temperatures between 36.8 and 37.2 ºC, blood sugar between 103 and 124 mg/dL and normal appetite. A full blood count and a parasitology assay were performed to aid in the diagnosis. The full blood count detected eosinophilia, without any other relevant alterations. The parasitology assay (Willis-Molly & Faust) revealed the presence of Cystoisospora spp. The treatment was instituted with heated fluid therapy with Ringer’s Lactate (4 mL/100 g, subcutaneous) and antibiotic therapy with sulfamethoxazole-trimethoprim (15 mg/kg, orally) every 12 hours for ten days. The mother and other dogs that came in contact with the newborns were also treated. The environment was disinfected for 10 minutes with 1.6% quaternary ammonium. After 10 days, the newborns presented normal clinical signs and no alterations in the full blood count. Isosporiasis is an affliction with high mortality rates in litters that should be diagnosed and treated as soon as possible to increase the survival rates in these patients.

Keywords: Cystoisospora spp., neonatal infection, puppies, diarrhea,

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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In veterinary medicine, the standard procedure during a caesarian section is clamping the umbilical cord immediately after birth. In human neonates, when the umbilical cord is kept intact after birth, blood continues to flow from the cord to the newborn, but this procedure may prove to be difficult in dogs due to the shorter umbilical cord and the number of newborns in the litter. However, a possible detachment of the placenta while keeping the umbilical cord intact may make the residual blood to flow to the neonate. This study compared the effects on neonatal vitality between clamping and no clamping the umbilical cord of dogs born through cesarean section, assessing them through Apgar and reflex scores. Fifty puppies delivered from 16 bitches were randomly allocated to receive clamping of the umbilical cord immediately (n=25) or to not receive the clamping until breathing (n=25). The neonates were assessed during the first five min of life and once again 10 min after the first assessment. The differences observed between the two moments were significant (p < 0.01) for both the Apgar and reflex scores. The differences observed between the groups (clamped vs. not clamped) were not significant for the Apgar score in the 1st moment (p=0.1), but the 2nd moment was significantly (p < 0.01) in the group not clamped, as well as significant (p < 0.05) for the reflex score in the 1st moment and 2nd moment (p < 0.05), revealing higher neonatal vitality in the not clamped group. The differences observed between the moments (1st vs. 2nd) of each group as significant (p < 0.01), revealing higher neonatal vitality in the 2nd moments. In the no clamping group, after removing the neonates together with the umbilical cord and the placenta, we observed that the umbilical cords were full of blood at the time of birth and later became whitish and collapsed, demonstrating the blood transfer. The results suggest that keeping the umbilical cord intact for at least three minutes after the onset breathing is not detrimental and may contribute to increase neonate vitality in puppies delivered by cesarean section.

Keywords: puppy vitality, newborn dog, cesarean section, Apgar score

Procedia PDF Downloads 119

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

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Authors: Alyona Cerfontyne, Levita D'Souza, Lefteris Patlamazoglou

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Unlike adoption and donor-assisted reproduction, misattributed paternity occurring within the context of spontaneous conception and outside of formally recognised practices of having a child remains largely an understudied phenomenon. In adulthood, to discover misattributed paternity, i.e., that the man you call your father is not related to you genetically, can have profound implications for everyone affected. Until the advent of direct-to-consumer DNA testing 20 years ago, such discoveries were relatively rare. Despite the growing number of individuals uncovering their biogenetic paternity through genetic testing, there is very limited research on misattributed paternity from the perspective of adult children affected by it. No research exists on how to support these individuals through counselling post-discovery. Framed as insider action research, this study aimed to explore the perceived psychosocial consequences of misattributed paternity discoveries and coping strategies used by individuals who discover their misattributed paternity status in adulthood. In total, 12 individuals with misattributed paternity participated in semi-structured interviews in July-August 2022. The collected data was analysed using reflexive thematic analysis. The study’s results indicate that discovering misattributed paternity in adulthood can be likened to a watershed moment forever changing the trajectory of one’s life. Psychological experiences consistent with trauma, as well as grief and loss, re-evaluation of close family relationships, reestablishment of one’s identity, as well as experiencing a profound need to belong are the key themes emerging from the analysis of psychosocial experiences. Post-discovery, individuals with misattributed paternity employ a wide range of emotional and problem-focused coping strategies, amongst which seeking connection with those who understand, searching for information on the new biogenetic family and finding new meanings to life are most prominent. The study contributes both to the academic and practical knowledge of experiences of misattributed paternity and highlights the importance of further research on the topic.

Keywords: discovery of misattributed paternity, misattributed paternity, paternal discrepancy, psychosocial consequences, coping

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

Procedia PDF Downloads 379