Search results for: stimulating

Authors: Dominique Arrouays, Songchao Chen, Anne C. Richer-De-Forges

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Soils are at the crossing of many issues such as food and water security, sustainable energy, climate change mitigation and adaptation, biodiversity protection, human health and well-being. They deliver many ecosystem services that are essential to life on Earth. Therefore, there is a growing demand for soil information on a national and global scale. Unfortunately, many countries do not have detailed soil maps, and, when existing, these maps are generally based on more or less complex and often non-harmonized soil classifications. An estimate of their uncertainty is also often missing. Thus, there are not easy to understand and often not properly used by end-users. Therefore, there is an urgent need to provide end-users with spatially exhaustive grids of essential soil properties, together with an estimate of their uncertainty. One way to achieve this is digital soil mapping (DSM). The concept of DSM relies on the hypothesis that soils and their properties are not randomly distributed, but that they depend on the main soil-forming factors that are climate, organisms, relief, parent material, time (age), and position in space. All these forming factors can be approximated using several exhaustive spatial products such as climatic grids, remote sensing products or vegetation maps, digital elevation models, geological or lithological maps, spatial coordinates of soil information, etc. Thus, DSM generally relies on models calibrated with existing observed soil data (point observations or maps) and so-called “ancillary co-variates” that come from other available spatial products. Then the model is generalized on grids where soil parameters are unknown in order to predict them, and the prediction performances are validated using various methods. With the growing demand for soil information at a national and global scale and the increase of available spatial co-variates national and continental DSM initiatives are continuously increasing. This short review illustrates the main national and continental advances in Europe, the diversity of the approaches and the databases that are used, the validation techniques and the main scientific and other issues. Examples from several countries illustrate the variety of products that were delivered during the last ten years. The scientific production on this topic is continuously increasing and new models and approaches are developed at an incredible speed. Most of the digital soil mapping (DSM) products rely mainly on machine learning (ML) prediction models and/or the use or pedotransfer functions (PTF) in which calibration data come from soil analyses performed in labs or for existing conventional maps. However, some scientific issues remain to be solved and also political and legal ones related, for instance, to data sharing and to different laws in different countries. Other issues related to communication to end-users and education, especially on the use of uncertainty. Overall, the progress is very important and the willingness of institutes and countries to join their efforts is increasing. Harmonization issues are still remaining, mainly due to differences in classifications or in laboratory standards between countries. However numerous initiatives are ongoing at the EU level and also at the global level. All these progress are scientifically stimulating and also promissing to provide tools to improve and monitor soil quality in countries, EU and at the global level.

Keywords: digital soil mapping, global soil mapping, national and European initiatives, global soil mapping products, mini-review

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Authors: Fernanda Piculo, Giovana Vesentini, Gabriela Marini, Debora Cristina Damasceno, Angelica Mercia Pascon Barbosa, Marilza Vieira Cunha Rudge

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Introduction: Women with previous gestational diabetes mellitus (GDM) were significantly more likely to have urinary incontinence (UI) and pelvic floor muscle dysfunction compared to non-diabetic women two years after a cesarean section. Additional results demonstrated that induced diabetes causes detrimental effects on pregnant rat urethral muscle. These results indicate the need for exploration of the mechanistic role of a recovery factor in female UI. Chemokine ligand 7 (CCL7) was significantly over expressed in rat serum, urethral and vaginal tissues immediately following induction of stress UI in a rat model simulating birth trauma. CCL7 over expression has shown potency for stimulating targeted stem cell migration and provide a translational link (clinical measurement) which further provide opportunities for treatment. The aim of this study was to investigate the CCL7 levels profile in diabetic pregnant women with urinary incontinence during pregnancy over the first year postpartum. Methods: This study was conducted in the Perinatal Diabetes Research Center of the Botucatu Medical School/UNESP, and was approved by the Research Ethics Committee of the Institution (CAAE: 20639813.0.0000.5411). The diagnosis of GDM was established between 24th and 28th gestational weeks, by the 75 g-OGTT test according to ADA’s criteria. Urinary incontinence was defined according to the International Continence Society and the CCL7 levels was measured by ELISA (R&D Systems, Catalog Number DCC700). Two hundred twelve women were classified into four study groups: normoglycemic continent (NC), normoglycemic incontinent (NI), diabetic continent (DC) and diabetic incontinent (DI). They were evaluated at six-time-points: 12-18, 24-28 and 34-38 gestational weeks, 24-48 hours, 6 weeks and 6-12 months postpartum. Results: At 12-18 weeks, it was possible to consider only two groups, continent and incontinent, because at this early gestational period has not yet been the diagnosis of GDM. The group with GDM and UI (DI group) showed lower levels of CCL7 in all time points during pregnancy and postpartum, compared to normoglycemic groups (NC and NI), indicating that these women have not recovered from child birth induced UI during the 6-12 months postpartum compared to their controls, and that the progression of UI and/or lack of recovery throughout the first postpartum year can be related with lower levels of CCL7. Instead, serum CCL7 was significantly increased in the NC group. Taken together, these findings of overexpression of CCL7 in the NC group and decreased levels in the DI group, could confirm that diabetes delays the recovery from child birth induced UI, and that CCL7 could potentially be used as a serum marker of injury. Conclusion: This study demonstrates lower levels of CCL7 in the DI group during pregnancy and postpartum and suggests that the progression of UI in diabetic women and/or lack of recovery throughout the first postpartum year can be related with low levels of CCL7. This provides a translational potential where CCL7 measurement could be used as a surrogate for injury after delivery. Successful controlled CCL7 mediated stem cell homing to the lower urinary tract could one day introduce the potential for non-operative treatment or prevention of stress urinary incontinence.

Keywords: CCL7, gestational diabetes, pregnancy, urinary incontinence

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Authors: Sanaz Moayer, Fang Huang, Scott Gardner

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In the highly leveraged business world of today, an organisation’s success depends on how it can manage and organize its traditional and intangible assets. In the knowledge-based economy, knowledge as a valuable asset gives enduring capability to firms competing in rapidly shifting global markets. It can be argued that ability to create unique knowledge assets by configuring ICT and human capabilities, will be a defining factor for international competitive advantage in the mid-21st century. The concept of KM is recognized in the strategy literature, and increasingly by senior decision-makers (particularly in large firms which can achieve scalable benefits), as an important vehicle for stimulating innovation and organisational performance in the knowledge economy. This thinking has been evident in professional services and other knowledge intensive industries for over a decade. It highlights the importance of social capital and the value of the intellectual capital embedded in social and professional networks, complementing the traditional focus on creation of intellectual property assets. Despite the growing interest in KM within professional services there has been limited discussion in relation to multinational resource based industries such as mining and petroleum where the focus has been principally on global portfolio optimization with economies of scale, process efficiencies and cost reduction. The Australian minerals and metals mining industry, although traditionally viewed as capital intensive, employs a significant number of knowledge workers notably- engineers, geologists, highly skilled technicians, legal, finance, accounting, ICT and contracts specialists working in projects or functions, representing potential knowledge silos within the organisation. This silo effect arguably inhibits knowledge sharing and retention by disaggregating corporate memory, with increased operational and project continuity risk. It also may limit the potential for process, product, and service innovation. In this paper the strategic application of knowledge management incorporating contemporary ICT platforms and data mining practices is explored as an important enabler for knowledge discovery, reduction of risk, and retention of corporate knowledge in resource based industries. With reference to the relevant strategy, management, and information systems literature, this paper highlights possible connections (currently undergoing empirical testing), between an Strategic Knowledge Management (SKM) framework incorporating supportive Data Mining (DM) practices and competitive advantage for multinational firms operating within the Australian resource sector. We also propose based on a review of the relevant literature that more effective management of soft and hard systems knowledge is crucial for major Australian firms in all sectors seeking to improve organisational performance through the human and technological capability captured in organisational networks.

Keywords: competitive advantage, data mining, mining organisation, strategic knowledge management

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Authors: Paul Flynn, Luke O’Donnell

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There is a pressing societal need for educators in formal and non-formal settings to develop pedagogical frameworks, programmes, and interventions that support the development of transversal skills for life beyond the classroom. These skills include communication, collaboration, interpersonal relationship building, problem-solving, and planning, and organizational skills; or lifeworld literacies encountered first hand. This is particularly true for young people aged between 15-18. This demographic represents both the future of society and those best positioned to take advantage of well-designed, structured educational supports within and across formal and non-formal settings. Secondary school history has been identified as an appropriate area of study which deftly develops many of those transversal skills so crucial to positive societal engagement. However, in the formal context, students often challenge history’s relevance to their own lived experience and dismiss it as a study option. In response to such challenges, teachers will often design stimulating lessons which are often well-received. That said, some students continue to question modern-day connections, presenting a persistent and pervasive classroom distraction. The continuing decline in numbers opting to study second-level history indicates an erosion of what should be a critical opportunity to develop all-important lifeworld literacies within formal education. In contrast, students readily acknowledge relevance in non-formal settings where many participants meaningfully engage with history by way of student-focused activities. Furthermore, many do so without predesigned pedagogical aids which support transversal skills development as embodied learning outcomes. As this paper will present, there is a dearth of work pertaining to the circular subject of history and its embodied learning outcomes, including lifeworld literacies, in formal and non-formal settings. While frequently challenging to reconcile formal (often defined by strict curricula and examination processes), and non-formal engagement with history, opportunities do exist. In the Irish context, this is exemplified by a popular university outreach programme: breaking the SEAL. This programme supports second-level history students as they fulfill curriculum requirements in completing a research study report. This report is a student-led research project pulling on communication skills, collaboration with peers and teachers, interpersonal relationships, problem-solving, and planning and organizational skills. Completion of this process has been widely recognized as excellent preparation not only for higher education (third level) but work-life demands as well. Within a formal education setting, the RSR harnesses non-formal learning virtues and exposes students to limited aspects of independent learning that relate to a professional work setting –a lifeworld literacy. Breaking the SEAL provides opportunities for students to enhance their lifeworld literacy by engaging in an independent research and learning process within the protective security of the classroom and its teacher. This paper will highlight the critical role this programme plays in preparing participating students (n=315) for life after compulsory education and presents examples of how lifeworld literacies may be developed through a scaffolded process of historical research and reporting anchored in non-formal contexts.

Keywords: history, education, literacy, transversal skills

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Authors: Kanokwan Chancharoenchai

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Economic growth can be considered as an important element of countries’ development process. For developing countries, like Thailand, to ensure the continuous growth of the economy, the Thai government usually implements various policies to stimulate economic growth. They may take the form of fiscal, monetary, trade, and other policies. Because of these different aspects, understanding factors relating to economic growth could allow the government to introduce the proper plan for the future economic stimulating scheme. Consequently, this issue has caught interest of not only policymakers but also academics. This study, therefore, investigates explanatory variables for economic growth in Thailand from 2005 to 2017 with a total of 52 quarters. The findings would contribute to the field of economic growth and become helpful information to policymakers. The investigation is estimated throughout the production function with non-linear Cobb-Douglas equation. The rate of growth is indicated by the change of GDP in the natural logarithmic form. The relevant factors included in the estimation cover three traditional means of production and implicit effects, such as human capital, international activity and technological transfer from developed countries. Besides, this investigation takes the internal and external instabilities into account as proxied by the unobserved inflation estimation and the real effective exchange rate (REER) of the Thai baht, respectively. The unobserved inflation series are obtained from the AR(1)-ARCH(1) model, while the unobserved REER of Thai baht is gathered from naive OLS-GARCH(1,1) model. According to empirical results, the AR(|2|) equation which includes seven significant variables, namely capital stock, labor, the imports of capital goods, trade openness, the REER of Thai baht uncertainty, one previous GDP, and the world financial crisis in 2009 dummy, presents the most suitable model. The autoregressive model is assumed constant estimator that would somehow cause the unbias. However, this is not the case of the recursive coefficient model from the state space model that allows the transition of coefficients. With the powerful state space model, it provides the productivity or effect of each significant factor more in detail. The state coefficients are estimated based on the AR(|2|) with the exception of the one previous GDP and the 2009 world financial crisis dummy. The findings shed the light that those factors seem to be stable through time since the occurrence of the world financial crisis together with the political situation in Thailand. These two events could lower the confidence in the Thai economy. Moreover, state coefficients highlight the sluggish rate of machinery replacement and quite low technology of capital goods imported from abroad. The Thai government should apply proactive policies via taxation and specific credit policy to improve technological advancement, for instance. Another interesting evidence is the issue of trade openness which shows the negative transition effect along the sample period. This could be explained by the loss of price competitiveness to imported goods, especially under the widespread implementation of free trade agreement. The Thai government should carefully handle with regulations and the investment incentive policy by focusing on strengthening small and medium enterprises.

Keywords: autoregressive model, economic growth, state space model, Thailand

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Authors: Lizinis Cassendra Frederick Dony, Jirom Jeremy Frederick Dony, Andrew Nicholas, Dewi Binti Tajuddin

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Starting and surviving a business is influenced by various entrepreneurship socio-economics activities. The study revealed that some of the entrepreneurs are not registered under SME but running own business as an intermediary with the private organization entrusted as “Self-Employed.” SME is known as “Small Medium Enterprise” contributes growth in Malaysia. Therefore, the entrepreneurialism business interest and entrepreneurial intention enhancing new spurring production, expanding employment opportunities, increasing productivity, promoting exports, stimulating innovation and providing new avenue in the business market place. This study has identified the unique contribution to the full understanding of complex mechanisms through entrepreneurship obstacles and education impacts on happiness and well-being to society. Moreover, “Ethnic” term has defined as a curious meaning refers to a classification of a large group of people customs implies to ancestral, racial, national, tribal, religious, linguistic and cultural origins. It is a social phenomenon.1 According to Sabah data population is amounting to 2,389,494 showed the predominant ethnic group being the Kadazan Dusun (18.4%) followed by Bajau (17.3%) and Malays (15.3%). For the year 2010, data statistic immigrants population report showed the amount to 239,765 people which cover 4% of the Sabahan’s population.2 Sabah has numerous group of talented entrepreneurs. The business environment among the minority ethnics are influenced with the business sentiment competition. The literature on ethnic entrepreneurship recognizes two main type entrepreneurships: the middleman and enclave entrepreneurs. According to Adam Smith,3 there are evidently some principles disposition to admire and maintain the distinction business rank status and cause most universal business sentiments. Due to credit barriers competition, the minority ethnics are losing the business market and since 2014, many illegal immigrants have been found to be using permits of the locals to operate businesses in Malaysia.4 The development of small business entrepreneurship among the minority ethnics in Sabah evidenced based variety of complex perception and differences concepts. The studies also confirmed the effects of heterogeneity on group decision and thinking caused partly by excessive pre-occupation with maintaining cohesiveness and the presence of cultural diversity in groups should reduce its probability.5 The researchers proposed that there are seven success determinants particularly to determine the involvement of minority ethnics comparing to the involvement of the immigrants in Sabah. Although, (SMEs) have always been considered the backbone of the economy development, the minority ethnics are often categorized it as the “second-choice.’ The study showed that illegal immigrants entrepreneur imposed a burden on Sabahan social programs as well as the prison, court and health care systems. The tension between the need for cheap labor and the impulse to protect Malaysian in Sabah workers, entrepreneurs and taxpayers, among the subjects discussed in this study. This is clearly can be advantages and disadvantages to the Sabah economic development.

Keywords: entrepreneurial firms, self-employed, immigrants, minority ethnic, economic impacts

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Authors: Li Yang

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Tourism is employed by many countries to facilitate socioeconomic development and to assist in the heritage preservation. An “ethnic culture boom” is currently driving the tourism industry in China. Ethnic minorities, commonly portrayed as primitive, colorful and exotic, have become a big tourist draw. Many cultural attractions have been built throughout China to meet the demands of domestic tourists. Sacred cultural heritage sites have been rehabilitated as a major component of ethnic tourism. The purpose of this study is to examine the interconnected consequences of tourism development and tourism-related leisure property development and, and to discuss, in a broader context, issues and considerations that are pertinent to the management and development of ethnic attractions. The role of real estate in tourism development and its sociocultural consequences are explored. An empirical research was conducted in Yiren Ancient Town (literally, "Ancient Town of Yi People") in Chuxiong City, Yunnan Province, China. Multiple research methods, including in-depth interviews, informal discussions, on-site observations, and secondary data review were employed to measure residents and tourism decision-makers’ perceptions of ethnic tourism and to explore the impacts of tourism on local community. Key informants from government officials, tourism developers and local communities were interviewed individually to gather what they think about benefits and costs of tourism, and what their concerns about and hopes for tourism development are. Yiren Ancient Town was constructed in classical Yi architecture style featuring tranquil garden scenery. Commercial streets, entertainment complexes, and accommodation facilities occupied the center of the town, creating culturally distinctive and visually stimulating places for tourists. A variety of activities are presented to visitors, including walking tours of the town, staged dance shows, musical performances, ethnic festivals and ceremonies, tasting minority food and wedding shows. This study reveals that tourism real estate has transformed the town from a traditional neighborhood into diverse real estate landscapes. Ethnic architecture, costumes, festivals and folk culture have been represented, altered and reinvented through the tourist gaze and mechanisms of cultural production. Tourism is now a new economic driver of the community providing opportunities for the creation of small businesses. There was a general appreciation in the community that tourism has created many employment opportunities, especially for self-employment. However, profit-seeking is a primary motivation for the government, developers, businesses, and other actors involved in the tourism development process. As the town has attracted an increasing number of visitors, commercialization and business competition are intense in the town. Many residents complained about elevated land prices, making the town and the surroundings comparatively high-value locales. Local community is also concerned about the decline of traditional ethnic culture and an erosion of the sense of identity and place. A balance is difficult to maintain between protection and development. The preservation of ethnic culture and heritage should be enhanced if long-term sustainable development of tourism is to occur and the loss of ethnic identities is to be avoided.

Keywords: ancient town, ethnic tourism, local community, real estate, China

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Authors: Priyanka Mokashi, Aparna Khanna, Nancy Pandita

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Diabetes mellitus is a chronic metabolic disorder which will be the 7th leading cause of death by 2030. The current line of treatment for the diabetes mellitus is oral antidiabetic drugs (biguanides, sulfonylureas, meglitinides, thiazolidinediones and alpha-glycosidase inhibitors) and insulin therapy depending upon the type 1 or type 2 diabetes mellitus. But, these treatments have their disadvantages, ranging from the developing of resistance to the drugs and adverse effects caused by them. Alternative to these synthetic agents, natural products provides a new insight for the development of more efficient and safe drugs due to their therapeutic values. Enicostema littorale blume (A. Raynal) is a traditional Indian plant belongs to the Gentianaceae family. It is widely distributed in Asia, Africa, and South America. There are few reports on Swrtiamarin, major component of this plant for its antidiabetic activity. However, the antidiabetic activity of flavonoids from E. littorale and their mechanism of action have not yet been elucidated. Flavonoids have a positive relationship with disease prevention and can act on various molecular targets and regulate different signaling pathways in pancreatic β-cells, adipocytes, hepatocytes and skeletal myofibers. They may exert beneficial effects in diabetes by (i) improving hyperglycemia through regulation of glucose metabolism in hepatocytes; (ii) enhancing insulin secretion and reducing apoptosis and promoting proliferation of pancreatic β-cells; (iii) increasing glucose uptake in hepatocytes, skeletal muscle and white adipose tissue (iv) reducing insulin resistance, inflammation and oxidative stress. Therefore, we have isolated four flavonoid rich fractions, Fraction A (FA), Fraction B (FB), Fraction C (FC), Fraction D (FD) from crude alcoholic hot (AH) extract from E. littorale, identified by LC/MS. Total eight flavonoids were identified on the basis of fragmentation pattern. Flavonoid FA showed the presence of swertisin, isovitexin, and saponarin; FB showed genkwanin, quercetin, isovitexin, FC showed apigenin, swertisin, quercetin, 5-O-glucosylswertisin and 5-O-glucosylisoswertisin whereas FD showed the presence of swertisin. Further, these fractions were assessed for their antidiabetic activity on stimulating glucose uptake in insulin-resistant HepG2 cell line model (IR/HepG2). The results showed that FD containing C-glycoside Swertisin has significantly increased the glucose uptake rate of IR/HepG2 cells at the concentration of 10 µg/ml as compared to positive control Metformin (0.5mM) which was determined by glucose oxidase- peroxidase method. It has been reported that enhancement of glucose uptake of cells occurs due the translocation of Glut4 vesicles to cell membrane through IR/IRS1/AKT pathway. Therefore, we have studied expressions of three genes IRS1, AKT and Glut4 by real-time PCR to evaluate whether they follow the same pathway or not. It was seen that the glucose uptake rate has increased in FD treated IR/HepG2 cells due to the activation of insulin receptor substrate-1 (IRS1) followed by protein kinase B (AKT) through phosphoinositide 3-kinase (PI3K) leading to translocation of Glut 4 vesicles to cell membrane, thereby enhancing glucose uptake and insulin sensitivity of insulin resistant HepG2 cells. Hence, the up-regulation indicated the mechanism of action through which FD (Swertisin) acts as antidiabetic candidate in the treatment of type 2 diabetes mellitus.

Keywords: E. littorale, glucose transporter, glucose uptake rate, insulin resistance

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Authors: Paulo Roberto Vasconcellos-Silva

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The "Janeiro Roxo" (Purple January) campaign in Brazil aims to promote awareness of leprosy and its early symptoms. The COVID-19 pandemic has adversely affected institutional campaigns, mostly considering leprosy a neglected disease by the media. Google Trends (GT) is a tool that tracks user searches on Google, providing insights into the popularity of specific search terms. Our prior research has categorized online searches into two types: "Reactive searches," driven by transient campaign-related stimuli, and "Proactive searches," driven by personal interest in early symptoms and self-diagnosis. Using GT we studied: (i) the impact of "Janeiro Roxo" on public interest in leprosy (assessed through reactive searches) and its early symptoms (evaluated through proactive searches) over the past five years; (ii) changes in public interest during and after the COVID-19 pandemic; (iii) patterns in the dynamics of reactive and proactive searches Methods: We used GT's "Relative Search Volume" (RSV) to gauge public interest on a scale from 0 to 100. "HANSENÍASE" (HAN) was a proxy for reactive searches, and "HANSENÍASE SINTOMAS" (leprosy symptoms) (H.SIN) for proactive searches (interest in leprosy or in self-diagnosis). We analyzed 261 weeks of data from 2018 to 2023, using polynomial trend lines to model trends over this period. Analysis of Variance (ANOVA) was used to compare weekly RSV, monthly (MM) and annual means (AM). Results: Over a span of 261 weeks, there was consistently higher Relative Search Volume (RSV) for HAN compared to H.SIN. Both search terms exhibited their highest (MM) in January months during all periods. COVID-19 pandemic: a decline was observed during the pandemic years (2020-2021). There was a 24% decrease in RSV for HAN and a 32.5% decrease for H.SIN. Both HAN and H.SIN regained their pre-pandemic search levels in January 2022-2023. Breakpoints indicated abrupt changes - in the 26th week (February 2019), 55th and 213th weeks (September 2019 and 2022) related to September regional campaigns (interrupted in 2020-2021). Trend lines for HAN exhibited an upward curve between 33rd-45th week (April to June 2019), a pandemic-related downward trend between 120th-136th week (December 2020 to March 2021), and an upward trend between 220th-240th week (November 2022 to March 2023). Conclusion: The "Janeiro Roxo" campaign, along with other media-driven activities, exerts a notable influence on both reactive and proactive searches related to leprosy topics. Reactive searches, driven by campaign stimuli, significantly outnumber proactive searches. Despite the interruption of the campaign due to the pandemic, there was a subsequent resurgence in both types of searches. The recovery observed in reactive and proactive searches post-campaign interruption underscores the effectiveness of such initiatives, particularly at the national level. This suggests that regional campaigns aimed at leprosy awareness can be considered highly successful in stimulating proactive public engagement. The evaluation of internet-based campaign programs proves valuable not only for assessing their impact but also for identifying the needs of vulnerable regions. These programs can play a crucial role in integrating regions and highlighting their needs for assistance services in the context of leprosy awareness.

Keywords: health communication, leprosy, health campaigns, information seeking behavior, Google Trends, reactive searches, proactive searches, leprosy early identification

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Susana Barreto

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This paper explores a pedagogical exercise that employs family photos as catalysts for teaching visual analysis and inspiring academic writing among MA students. The study aimed to achieve two primary objectives: to impart students with the skills of analyzing images or artifacts and to ignite their writing for research purposes. Conducted at Viana Polytechnic in Portugal, the exercise involved two classes on Arts Management and Art Education Master course comprising approximately twenty students from diverse academic backgrounds, including Economics, Design, Fine Arts, and Sociology, among others. The exploratory exercise involved selecting an old family photo, analyzing its content and context, and deconstructing the chosen images in an intuitive and systematic manner. Students were encouraged to engage in photo elicitation, seeking insights from family/friends to gain multigenerational perspectives on the images. The feedback received from this exercise was consistently positive, largely due to the personal connection students felt with the objects of analysis. Family photos, with their emotional significance, fostered deeper engagement and motivation in the learning process. Furthermore, visual analysing family photos stimulated critical thinking as students interpreted the composition, subject matter, and potential meanings embedded in the images. This practice enhanced their ability to comprehend complex visual representations and construct compelling visual narratives, thereby facilitating the writing process. The exercise also facilitated the identification of patterns, similarities, and differences by comparing different family photos, leading to a more comprehensive analysis of visual elements and themes. Throughout the exercise, students found analyzing their own photographs both enjoyable and insightful. They progressed through preliminary analysis, explored content and context, and artfully interwove these components. Additionally, students experimented with various techniques such as converting photos to black and white, altering framing angles, and adjusting sizes to unveil hidden meanings.The methodology employed included observation, documental analysis of written reports, and student interviews. By including students from diverse academic backgrounds, the study enhanced its external validity, enabling a broader range of perspectives and insights during the exercise. Furthermore, encouraging students to seek multigenerational perspectives from family and friends added depth to the analysis, enriching the learning experience and broadening the understanding of the cultural and historical context associated with the family photos Highlighting the emotional significance of these family photos and the personal connection students felt with the objects of analysis fosters a deeper connection to the subject matter. Moreover, the emphasis on stimulating critical thinking through the analysis of composition, subject matter, and potential meanings in family photos suggests a targeted approach to developing analytical skills. This improvement focuses specifically on critical thinking and visual analysis, enhancing the overall quality of the exercise. Additionally, the inclusion of a step where students compare different family photos to identify patterns, similarities, and differences further enhances the depth of the analysis. This comparative approach adds a layer of complexity to the exercise, ultimately leading to a more comprehensive understanding of visual elements and themes. The expected results of this study will culminate in a set of practical recommendations for implementing this exercise in academic settings.

Keywords: visual analysis, academic writing, pedagogical exercise, family photos

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Authors: Marija Mihajlovic Pereira

Abstract:

Teaching and learning a musical instrument is challenging for both teachers and students. Teachers generally use diverse strategies to resolve students' particular issues in a one-to-one context. Considering individual sessions as a supportive educational context, the teacher can play a decisive role in stimulating and promoting self-regulated learning strategies, especially with beginning learners. The teachers who promote self-controlling behaviors, strategic monitoring, and regulation of actions toward goals could expect their students to practice more qualitatively and consciously. When encouraged to adopt self-regulation habits, students' could benefit from greater productivity on a longer path. Founded on Bary Zimmerman's cyclical model that comprehends three phases - forethought, performance, and self-reflection, this work aims to articulate self-regulated and music learning. Self-regulated learning appeals to the individual's attitude in planning, controlling, and reflecting on their performance. Furthermore, this study aimed to present an observation grid for perceiving teaching instructions that encourage students' controlling cognitive behaviors in light of the belief that conscious promotion of self-regulation may motivate strategic actions toward goals in musical performance. The participants, two teachers, and two students have been involved in the social inclusion project in Lisbon (Portugal). The author and one independent inter-observer analyzed six video-recorded string instrument lessons. The data correspond to three sessions per teacher lectured to one (different) student. Violin (f) and violoncello (m) teachers hold a Master's degree in music education and approximately five years of experience. In their second year of learning an instrument, students have acquired reasonable skills in musical reading, posture, and sound quality until then. The students also manifest positive learning behaviors, interest in learning a musical instrument, although their study habits are still inconsistent. According to the grid's four categories (parent codes), in-class rehearsal frames were coded using MaxQda software, version 20, according to the grid's four categories (parent codes): self-regulated learning, teaching verbalizations, teaching strategies, and students' in-class performance. As a result, selected rehearsal frames qualitatively describe teaching instructions that might promote students' body and hearing awareness, such as "close the eyes while playing" or "sing to internalize the pitch." Another analysis type, coding the short video events according to the observation grid's subcategories (child codes), made it possible to perceive the time teachers dedicate to specific verbal or non-verbal strategies. Furthermore, a coding overlay analysis indicated that teachers tend to stimulate. (i) Forethought – explain tasks, offer feedback and ensure that students identify a goal, (ii) Performance – teach study strategies and encourage students to sing and use vocal abilities to ensure inner audition, (iii) Self-reflection – frequent inquiring and encouraging the student to verbalize their perception of performance. Although developed in the context of individual string instrument lessons, this classroom observation grid brings together essential variables in a one-to-one lesson. It may find utility in a broader context of music education due to the possibility to organize, observe and evaluate teaching practices. Besides that, this study contributes to cognitive development by suggesting a practical approach to fostering self-regulated learning.

Keywords: music education, observation grid, self-regulated learning, string instruments, teaching practices

Procedia PDF Downloads 66

Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

Abstract:

Cardiac hypertrophy arises in response to persistent increases in hemodynamic loads. In comparison, diabetic cardiomyopathy is defined by an abnormal myocardial changes without other cardiac-related risk factors. Pathological cardiac hypertrophy and myocardial remodeling are hallmarks of cardiovascular diseases and are risk factors for heart failure. The transcription factor forkhead box class O (FOXOs) can protect heart tissue by hostile oxidative stress and stimulating apoptosis and autophagy. FOXO proteins, as sensitive elements and mediators in response to environmental changes, have been revealed to prevent and inverse cardiac hypertrophy. FOXOs are inhibited by insulin and are critical mediators of insulin action. Insulin deficiency and uncontrolled diabetes lead to a catabolic state. FOXO1 acts downstream of the insulin-dependent pathways, which are dysregulated in diabetes. It regulates cardiomyocyte hypertrophy downstream of IGF1R/PI3K/Akt activation, which are critical regulators of cardiac hypertrophy. The complex network of signaling pathways comprising insulin/IGF-1 signaling, AMPK, JNK, and Sirtuins regulate the development of cardiovascular dysfunction by modulating the activity of FOXOs. Insulin receptors and IGF1R act via the PI3k/Akt and the MAPK/ERK pathways. Activation of Akt in response to insulin or IGF-1 induces phosphorylation of FOXOs. Increased protein synthesis induced by activation of the IGF-I/Akt/mTOR signaling pathway leads to hypertrophy. This pathway and the myostatin/Smad pathway are potent negative muscle development regulators. In cardiac muscle, insulin receptor substrates (IRS)-1 or IRS-2 activates the Akt signaling pathway and inactivate FOXO1. Under metabolic stress, p38 MAPK promotes degradation of IRS-1 and IRS-2 in cardiac myocytes and activates FOXO1, leading to cardiomyopathy. Sirt1 and FOXO1 interaction play an essential role in starvation-induced autophagy in cardiac metabolism. Inhibition of Angiotensin-II induced cardiomyocyte hypertrophy is associated with reduced FOXO1 acetylation and activation of Sirt1. The NF-κB, ERK, and FOXOs are de-acetylated by SIRT1. De-acetylation of FOXO1 induces the expression of genes involved in autophagy and stimulates autophagy flux. Therefore, under metabolic stress, FOXO1 can cause diabetic cardiomyopathy. The overexpression of FOXO1 leads to decreased cardiomyocyte size and suppresses cardiac hypertrophy through inhibition of the calcineurin–NFAT pathway. Diabetes mellitus is associated with elevation of O-GlcNAcylation. Some of its binding partners regulate the substrate selectivity of O-GlcNAc transferase (OGT). O-GlcNAcylation of essential contractile proteins may inhibit protein-protein interactions, reduce calcium sensitivity, and modulate contractile function. Uridine diphosphate (UDP)-GlcNAc is the obligatory substrate of OGT, which catalyzes a reversible post-translational protein modification. The increase of O-GlcNAcylation is accompanied by impaired cardiac hypertrophy in diabetic hearts. Inhibition of O-GlcNAcylation blocks activation of ERK1/2 and hypertrophic growth. O-GlcNAc modification on NFAT is required for its translocation from the cytosol to the nucleus, where NFAT stimulates the transcription of various hypertrophic genes. Inhibition of O-GlcNAcylation dampens NFAT-induced cardiac hypertrophic growth. Transcriptional activity of FOXO1 is enriched by improved O-GlcNAcylation upon high glucose stimulation or OGT overexpression. In diabetic conditions, the modification of FOXO1 by O-GlcNAc is promoted in cardiac troponin I and myosin light chain 2. Therefore targeting O-GlcNAcylation represents a potential therapeutic option to prevent hypertrophy in the diabetic heart.

Keywords: diabetes, cardiac hypertrophy, O-GlcNAcylation, FOXO1, Akt, PI3K, AMPK, insulin

Procedia PDF Downloads 81