Search results for: risk perception

Authors: Jiamin Chen, Liping Yang

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In 2007, sociologist Putnam proposed a pessimistic forecast in the United States' "Social Capital Community Benchmark Survey," suggesting that "ethnic diversity would challenge social unity and undermine social cohesion." If this pessimistic assumption were proven true, it would indicate a risk of division in diverse societies. China, with 56 ethnic groups, is a multi-ethnic country. On May 26, 2014, General Secretary Xi Jinping proposed "building ethnically inter-embedded communities to promote deeper development in interactions, exchanges, and integration among ethnic groups." Researchers unanimously agree that ethnic inter-embedded communities can serve as practical arenas and pathways for solidifying the sense of the Chinese national community However, there is no research providing evidence that ethnic inter-embedded communities can foster the sense of the Chinese national community, and the influencing factors remain unclear. This study adopts a constructivist grounded theory research approach. Convenience sampling and snowball sampling were used in the study. Data were collected in three communities in Kunming City. Twelve individuals were eventually interviewed, and the transcribed interviews totaled 187,000 words. The research has obtained ethical approval from the Ethics Committee of Nanjing Normal University (NNU202310030). The research analyzed the data and constructed theories, employing strategies such as coding, constant comparison, and theoretical sampling. The study found that: firstly, ethnic inter-embedded communities exhibit characteristics of diversity, including ethnic diversity, cultural diversity, and linguistic diversity. Diversity has positive functions, including increased opportunities for contact, promoting self-expansion, and increasing happiness; negative functions of diversity include highlighting ethnic differences, causing ethnic conflicts, and reminding of ethnic boundaries. Secondly, individuals typically engage in interactions within the community using active embedding and passive embedding strategies. Active embedding strategies include maintaining openness, focusing on similarities, and pro-diversity beliefs, which can increase external group identification, intergroup relational identity, and promote ethnic integration. Individuals using passive embedding strategies tend to focus on ethnic stereotypes, perceive stigmatization of their own ethnic group, and adopt an authoritarian-oriented approach to interactions, leading to a perception of more identity threats and ultimately rejecting ethnic integration. Thirdly, the commonality of the Chinese nation is reflected in the 56 ethnic groups as an "identity community" and "interest community," and both active and passive embedding paths affect individual understanding of the commonality of the Chinese nation. Finally, community work and environment can influence the embedding process. The research constructed a social psychological process and mechanism model for solidifying sense of the Chinese national community in ethnic inter-embedded communities. Based on this theoretical model, future research can conduct more micro-level psychological mechanism tests and intervention studies to enhance Chinese national cohesion.

Keywords: diversity, sense of the chinese national community, ethnic inter-embedded communities, ethnic group

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Authors: Xiaoxu Liu, Yuwen Chen

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In this study, we investigated ethnic minority students’ perception of the implementation of preferential policies in China. Using a mixed methods design, we surveyed 320 students from an institute of education for ethnic minorities and conducted further in-depth interviews with seven respondents. Although interviewees were from 30 ethnic groups, most of them were from mainstream high schools. We found that minority students from preparatory classes have an overall positive attitude towards preferential policies and preparatory class but lack sense of belonging to the university for various reasons. Findings indicate that although preparatory class is regarded as being helpful for minority students’ academic development, there are differences of attitude mainly depending on the high schools they graduated from and their ethnic identities. Our analyses suggest that ethnicity, high school graduated from, hometown and family income are more important than gender, religion, and political affiliation when accounting for their perceptions of the implementation of preferential policies in China.

Keywords: Chinese minority education, higher education, preferential policies, survey analysis

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Authors: Ana Avila Bohorquez

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Elite (Netflix, 2018-) is the second original series produced by Netflix in Spain. Premiered in 2018, it became an international success, both critically and among audiences. Reviewers praised its use of teen drama tropes with a more progressive twist. Netflix announced that the first season had been streamed by over 20 million accounts within its first month of release. This paper aims to determine what characteristics led to Elite’s international success, finding the elements of its narrative and visual design that resonate with global audiences. After reviewing the bibliography about transnational fiction, questionnaires sent to international audience members through social media shed light on what these characteristics are. Additionally, interviews with the creative team were performed in order to compare their point of view with the audiences’ perception. Even though Elite can be considered a Spanish show from its inception, it's setting in the “fantasy” world of the rich and its lack of social realism so common among Spanish productions managed to attract global audiences, to whom it has appealed on a more emotional level.

Keywords: elite, global television, Netflix, teen drama, transnational fiction

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Authors: Lawong Damian Bernsah

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Neglected Tropical Diseases (NTDs) are most predominant among the poor and rural populations and are endemic in 149 countries. These diseases are the most prevalent and responsible for infecting 1.4 billion people worldwide. There are 17 neglected tropical diseases recognized by WHO that constitute the fourth largest disease health and economic burden of all communicable diseases. Five of these 17 diseases are considered for the cost analysis of this paper: lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil transmitted helminth infections. WHO has proposed a roadmap for eradication and elimination by 2020 and treatments have been donated through the London Declaration by pharmaceutical manufacturers. The paper estimates the cost of NTD control programme and elimination for each NTD disease and total in Nigeria. This is necessary as it forms the bases upon which programme budget and expenditure could be based. Again, given the opportunity cost the resources for NTD face it is necessary to estimate the cost so as to provide bases for comparison. Cost of NTDs control and elimination programme is estimated using the population at risk for each NTD diseases and for the total. The population at risk is gotten from the national master plan for the 2015 - 2020, while the cost per person was gotten for similar studies conducted in similar settings and ranges from US$0.1 to US$0.5 for Mass Administration of Medicine (MAM) and between US$1 to US$1.5 for each NTD disease. The combined cost for all the NTDs was estimated to be US$634.88 million for the period 2015-2020 and US$1.9 billion for each NTD disease for the same period. For the purpose of sensitivity analysis and for robustness of the analysis the cost per person was varied and all were still high. Given that health expenditure for Nigeria (% of GDP) averages 3.5% for the period 1995-2014, it is very clear that efforts have to be made to improve allocation to the health sector in general which is hoped could trickle to NTDs control and elimination. Thus, the government and the donor partners would need to step-up budgetary allocation and also to be aware of the costs of NTD control and elimination programme since they have alternative uses. Key Words: Neglected Tropical Disease, Cost Analysis, NTD Programme Control and Elimination, Cost per Person

Keywords: Neglected Tropical Disease, Cost Analysis, Neglected Tropical Disease Programme Control and Elimination, Cost per Person

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Authors: Najade Sheriff, Malaz Elsaddig, Kevin Jones

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Background: Death in the first month of life accounts for an increasing proportion of under-five mortality. Advancement to reduce this number is being made across the globe; however, progress is slowest in sub-Saharan Africa. Objectives: The study aims to identify differences between neonatal deaths of inpatient babies born in a hospital facility in rural Uganda to those of neonates admitted from the community and to explore whether they can be used to risk stratify neonatal admissions. Results: A retrospective chart review was conducted on records for neonates admitted to the Special Care Baby Unit (SCBU) Kitovu Hospital from 1st July 2016 to 21st July 2017. A total of 442 babies were admitted and the overall neonatal mortality was 24.8% (40% inpatient, 37% community, 23% hospital referrals). 40% of deaths occurred within 24 hours of admission and the majority were male (63%). 43% of babies were hypothermic upon admission, a significantly greater proportion of which were inpatient babies born in labour ward (P=0.0025). Intrapartum related death accounted for ½ of all inpatient babies whereas complications of prematurity were the predominant cause of death in the community group (37%). Severe infection does not seem like a significant factor of mortality for inpatients (2%) as it does for community admissions (29%). Furthermore, with 52.5% of community admissions weighing < 1500g, very low birth weight (VLBW) may be a significant risk factor for community neonatal death. Conclusion: The neonatal mortality rate in this study is high, and the leading causes of death are all largely preventable. A high rate of inpatient birth asphyxiation indicates the need for good quality facility-based perinatal care as well as a greater focus on the management of hypothermia, such as Kangaroo care. Moreover, a reduction in preterm deliveries is necessary to reduce associated comorbidities, and monitoring for signs of infection is especially important for community admissions.

Keywords: community, mortality, newborn, Uganda

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Authors: Dona Pamoda W. Jayatunga, Veer Bala Gupta, Eugene Hone, Ralph N. Martins

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Being a neurodegenerative disorder, Alzheimer’s disease (AD) affects a majority of the elderly demented worldwide. The key risk factors for AD are age, metabolic syndrome, allele status of APOE gene, head injuries and lifestyle. The progressive nature of AD is characterized by symptoms of multiple cognitive deficits exacerbated over time, leading to death within a decade from clinical diagnosis. However, it is revealed that AD originates via a prodromal phase that spans from one to few decades before symptoms first manifest. The key pathological hallmarks of AD brains are deposition of amyloid beta (Aβ) plaques and neurofibrillary tangles (NFT). However, the yet unknown etiology of the disease fails to distinguish mitochondrial dysfunction between a cause or an outcome. The absence of early diagnosis tools and definite therapies for AD have permitted recruits of nutraceutical-based approaches aimed at reducing the risk of AD by modulating lifestyle or be used as preventive tools during AD prodromal state before widespread neurodegeneration begins. The objective of the present study was to investigate beneficial effects of luteolin, a plant-based flavone compound, against AD. The neuroprotective effects of luteolin on amyloid beta (Aβ) (1-42)-induced neurotoxicity was measured using cultured human neuroblastoma BE(2)-M17 cells. After exposure to 20μM Aβ (1-42) for 48 h, the neuroblastoma cells exhibited marked apoptotic death. Co-treatment of 20μM Aβ (1-42) with luteolin (0.5-5μM) significantly protected the cells against Aβ (1-42)-induced toxicity, as assessed by the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2(4sulfophenyl)-2H-tetrazolium, inner salt; MTS] reduction assay and the lactate dehydrogenase (LDH) cell death assay. The results suggest that luteolin prevents Aβ (1-42)-induced apoptotic neuronal death. However, further studies are underway to determine its protective mechanisms in AD including the activity against tau hyperphosphorylation and mitochondrial dysfunction.

Keywords: Aβ (1-42)-induced toxicity, Alzheimer’s disease, luteolin, neuroblastoma cells

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Authors: Chin-Huang Huang, Chun-Chu Yeh

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Physical activities have a positive impact on individuals’ health and well-being. They also play an important role in promoting quality of life (QoL). The distance running enhances participants’ life satisfaction and provides positive experiences in physical activity. This study aims to measure the perception of QoL and to find the effect on satisfaction and intent to return for distance runners. Exploratory factor analysis is carried out to extract four major factorial dimensions of QoL, including multiple functions, spiritual, physical and cognitive factors. The main factors of QoL will be introduced into the regression function on satisfaction and return intention. The results show that the QoL factors including multiple functions, spiritual, physical and cognitive factors have a positive and significant impact on satisfaction for participants. The multiple functions and physical factors are also significantly positively correlated to the intent of return for runners.

Keywords: quality of life, physical activity, distance running, satisfaction

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Authors: Abdullah Alenezi, Mane Alsudrawi, Rafat Misak

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Kuwait is faced with a potentially wide and harmful range of both natural and anthropogenic hazardous events such as dust storms, floods, fires, nuclear accidents, earthquakes, oil spills, tsunamis and other disasters. For Kuwait can be highly vulnerable to these complex environmental risks, an up-to-date and in-depth understanding of their typology, genesis, and impact on the Kuwaiti society is needed. Adequate anticipation and management of environmental crises further require a comprehensive system of decision support to the benefit of decision makers to further bridge the gap between (technical) risk understanding and public action. For that purpose, the Kuwait Institute for Scientific Research (KISR), intends to establish a decision support center for management of the environmental crisis in Kuwait. The center will support policy makers, stakeholders and national committees with technical information that helps them efficiently and effectively assess, monitor to manage environmental disasters using decision support tools. These tools will build on state of the art quantification and visualization techniques, such as remote sensing information, Geographical Information Systems (GIS), simulation and prediction models, early warning systems, etc. The center is conceived as a central facility which will be designed, operated and managed by KISR in coordination with national authorities and decision makers of the country. Our vision is that by 2035 the center will be recognized as a leading national source of scientific advice on national risk management in Kuwait and build unity of effort among Kuwaiti’s institutions, government agencies, public and private organizations through provision and sharing of information. The project team now focuses on capacity building through upgrading some KISR facilities manpower development, build strong collaboration with international alliance.

Keywords: decision support, environment, hazard, Kuwait

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Giovane Gurgel, Cristina S. Rodrigues, Filipa D. Vieira

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IFRN – Mossoró is a Brazilian technical education institute that develops several activities to encourage entrepreneurship, such as a curricular discipline about enterprise management and the existence of a business incubator. Despite efforts, the business incubator does not produce the expected effects. Therefore, what predisposes students to start their own business? If literature review explores determinant factors like the family and personal characteristics, it can be sustained that entrepreneurship skills can be taught since primary level, until university level. This paper presents the results of research project “Empreende IFRN” to understand the entrepreneurial predisposition and intention of the students from technical level courses. Data from 365 students from technical level courses reveal an increased entrepreneurial intention of students during time (from a 2 years period to someday in the future). The entrepreneurial behaviour of parents affects students’ perception about starting their own business. Students also present a cautions behaviour, preferring bank deposit and investment fund instead starting a business.

Keywords: Brazil, entrepreneurial intention, entrepreneurship, secondary technical students

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Authors: Budi Annisa Sidi

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Present-day Indonesia maintains a narrative of a culturally plural but unified nation. At the same time, multicultural policies extend different degrees of recognition, accommodation, toleration and even discrimination towards different socio-cultural groups. In conjunction with different ethnographic landscapes across regions in Indonesia, this approach leads to a varied experience and understanding of national identity and multiculturalism among people. As a result, governments seeking to maintain national unity while practicing multiculturalism have to juggle different expectations. This situation is examined through the microcosms of university students using questionnaires followed up by focus group discussions and personal interviews. A comparison between university students across four different provinces in Indonesia (Aceh, Jakarta, West Java and the Moluccas) highlights the influence of one’s surroundings on their perception of multiculturalism. Students in the more heterogeneous areas generally show more acceptance towards diversity compared to students in primarily homogenous areas who have little actual experience in dealing with diversity. Regardless of their environment, students claim to have positive feelings and a strong sense of attachment to Indonesia but hold different ideas of what constitutes an ideal Indonesian national identity.

Keywords: Indonesia, multiculturalism, national identity, nationalism

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Authors: Abraham Finkelman

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Computerized Surgical Guides have been proven to be a predictable way to perform dental implants, with a relatively high accuracy in comparison to a treatment plan. When using the CSG Bone supported, it allows us to make the necessary changes of the hard tissue prior to the implant placement and after the implant placement. The CSG gives us an accurate position for the drilling, and during the implant placement it allows us to alter the vertical position of the implant altering the final position of the abutment and avoiding any risk of any damage to the adjacent anatomical structures. Any Changes required to the bone level can be done prior to the fixation of the CSG using a reduction guide, which incur extra surgical fees and the need of a second surgical guide. Any changes of the bone level after the implant placement are at the risk of damaging the implant neck surface. The technique consists of a universal system that allows us to remove the excess bone around the implant sockets prior to the implant placement which then enables us to place the implant in the vertical position with accuracy as planned with the CSG. The systems consist of a hollow pin of different sizes and diameters. Depending on the implant system that we are using. Length sizes are from 6mm-16mm and a diameter of 2.6mm-4.8mm. Upon the completion of the drilling, the pin is then inserted into the implant socket-using the insertion tool. Once the insertion tool has unscrewed the pin, we can continue with the bone reduction. The bone reduction can be done using conventional methods upon the removal of all the excess bone around the pin. The insertion tool is then screwed into the pin and the pin is then removed. We now, have the new bone level at the crest of the implant socket which is our mark for the vertical position of the implant. In some cases, when we are locating the implant very close to anatomical structures, any form of deviation to the vertical position of the implant during the surgery, can cause damage to such anatomical structures, creating irreversible damages such as paresthesia or dysesthesia of the mandibular nerve. If we are planning for immediate loading and we have done our temporary restauration in base of our computerized plan, deviation in the vertical position of the implant will affect the position of the abutment, affecting the accuracy of the temporary prosthesis, extending the working time till we adapt the prosthesis to the new position.

Keywords: bone reduction, computer aided navigation, dental implant placement, surgical guides

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Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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In recent years childhood obesity has increased to pan-epidemic proportions along with a concomitant increase in obesity-associated morbidity. Birth weight is an important determinant of later adult health, with neonates at both ends of the birth weight spectrum at risk of future health complications. Consequently, infants who are born large for gestational age (LGA) are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. Adipose tissue plays a role in linking events in fetal growth to the subsequent development of adult diseases. In addition to its role as a storage depot for fat, adipose tissue produces and secrets a number of hormones of importance in modulating metabolism and energy homeostasis. Cord blood leptin level has been positively correlated with fetal adiposity at birth. It is established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given body mass index indicating a genetic predisposition in the occurrence of obesity. To our knowledge, studies have never been conducted in Sri Lanka to determine the relationship between adipocytokine profile in cord blood and anthropometric parameters in newborns. Thus, the objective of this study is to establish the above relationship for the Sri Lankan population to implement awareness programs to minimize childhood obesity in the future. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of leptin was measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured. Pearson’s correlation was used to assess the relationship between leptin and anthropometric parameters while the Mann-Whitney U test was used to assess the differences in cord blood leptin levels between small for gestational age (SGA), appropriate for gestational age (AGA) and LGA infants. There was a significant difference (P < 0.05) between the cord blood leptin concentrations of LGA infants (12.67 ng/mL ± 2.34) and AGA infants (7.10 ng/mL ± 0.90). However, a significant difference was not observed between leptin levels of SGA infants (8.86 ng/mL ± 0.70) and AGA infants. In both male and female neonates, umbilical leptin levels showed significant positive correlations (P < 0.05) with birth weight of the newborn, pre-pregnancy maternal weight and pre pregnancy BMI between the infants of large and appropriate for gestational ages. Increased concentrations of leptin levels in the cord blood of large for gestational age infants suggest that they may be involved in regulating fetal growth. Leptin concentration of Sri Lankan population was not significantly deviated from published data of Asian populations. Fetal leptin may be an important predictor of neonatal adiposity; however, interventional studies are required to assess its impact on the possible risk of childhood obesity.

Keywords: appropriate for gestational age, childhood obesity, leptin, anthropometry

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Authors: Ajay Gogia, Svs Deo, Dn Sharma, Atul Batra, Ashutash Mishra

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Background and Aims: Breast cancer in women aged less than 25 years (defined as very young breast cancer, VYBC) is rare and accounts for 0.25% of all breast cancer in the West. There is no data available on VYBC from developing countries. The aim of this study was to analyze the clinical, pathological, and prognostic factors and outcomes in VYBC. Methods: This retrospective analysis was performed on 80 patients aged 25 years or less (screened 8000 files of female BC) who were registered at All India Institute of Medical Sciences (AIIMS), New Delhi, India, over a 15-year period between 2011 and 2023. Results: The median age was 21.5 years (range 16-25). A positive family history (siblings and parents) was elicited in 30% of cases, and breast cancer gene (BRCA1/2) mutation was found in 33% of cases patients. Ten patients (12.5%) patients have pregnancy-associated breast cancer (BC detected during pregnancy or 1 year after postpartum period). The TNM stage distribution was Stage I was 0, stage II -30%, stage III –60% and Stage IV -10 %patients. Seventy percent of tumors were high grade, and 90% had pathological node-positive disease. Estrogen, Progesterone, and human epidermal growth factor receptor 2 (HER2)/neu positivity were 25%,25% and 35%, respectively. Triple-negative breast cancer constituted 40% of patients. With a median follow-up of 42 months, 3 years, relapse-free survival (nonmetastatic disease), progression-free survival (metastatic disease) and overall survival were 30%, 15% and 50%, respectively. Conclusions: Very young women constituted 1% of all breast cancer cases. Advanced disease at presentation and high-risk pathological features result in poor outcomes. One-third of VYBCs are associated with BRCA mutation, which requires genetic counseling and risk reduction surgery if required. Due to the aggressive behavior of BC in this age group, need early diagnosis and prompt treatment

Keywords: very young, breast cancer, outcome, developing country, India

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a low-grade inflammatory state. Childhood obesity is a multisystem disease, which is associated with a number of complications as well as potentially negative consequences. Gender is an important universal risk factor for many diseases. Hematological indices differ significantly by gender. This should be considered during the evaluation of obese children. The aim of this study is to detect hematologic indices that differ by gender in morbid obese (MO) children. A total of 134 MO children took part in this study. The parents filled an informed consent form and the approval from the Ethics Committee of Namik Kemal University was obtained. Subjects were divided into two groups based on their genders (64 females aged 10.2±3.1 years and 70 males aged 9.8±2.2 years; p ≥ 0.05). Waist-to-hip as well as head-to-neck ratios and body mass index (BMI) values were calculated. The children, whose WHO BMI-for age and sex percentile values were > 99 percentile, were defined as MO. Hematological parameters [haemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, leukocyte count, neutrophil %, lymphocyte %, monocyte %, eosinophil %, basophil %, platelet count, platelet distribution width, mean platelet volume] were determined by the automatic hematology analyzer. SPSS was used for statistical analyses. P ≤ 0.05 was the degree for statistical significance. The groups included children having mean±SD value of BMI as 26.9±3.4 kg/m² for males and 27.7±4.4 kg/m² for females (p ≥ 0.05). There was no significant difference between ages of females and males (p ≥ 0.05). Males had significantly increased waist-to-hip ratios (0.95±0.08 vs 0.91±0.08; p=0.005) and mean corpuscular hemoglobin concentration values (33.6±0.92 vs 33.1±0.83; p=0.001) compared to those of females. Significantly elevated neutrophil (4.69±1.59 vs 4.02±1.42; p=0.011) and neutrophil-to-lymphocyte ratios (1.70±0.71 vs 1.39±0.48; p=0.004) were detected in females. There was no statistically significant difference between groups in terms of C-reactive protein values (p ≥ 0.05). Adipose tissue plays important roles during the development of obesity and associated diseases such as metabolic syndrom and cardiovascular diseases (CVDs). These diseases may cause changes in complete blood cell count parameters. These alterations are even more important during childhood. Significant gender effects on the changes of neutrophils, one of the white blood cell subsets, were observed. The findings of the study demonstrate the importance of considering gender in clinical studies. The males and females may have distinct leukocyte-trafficking profiles in inflammation. Female children had more circulating neutrophils, which may be the indicator of an increased risk of CVDs, than male children within this age range during the late stage of obesity. In recent years, females represent about half of deaths from CVDs; therefore, our findings may be the indicator of the increasing tendency of this risk in females starting from childhood.

Keywords: children, gender, morbid obesity, neutrophil-to-lymphocyte ratio

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Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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Authors: Purnima K Bajre, Rujula Talloo

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A variety of vehicles are driven on roads such as private vehicles, commercial vehicles, public vehicles, and emergency service vehicles (EMV). Drivers driving different vehicles can have attitude differences towards emergency service vehicles which in turn affects their likelihood to give way to them. The present review aims to understand the factors that mediate this yielding behavior of drivers towards EMVs. Through extensive review of available literature, factors such as effects of lights and sirens, cognitive load, age of the driver, driving general experience, traffic load, drivers’ experience and training with EMVs and drivers’ attitude towards EMV drivers, have emerged as mediating factors. Whereas cognitive load is the most researched area and is observed to be associated negatively with on road drivers’ attitudes towards EMVs, there is a paucity of research to understand the relationships between empathy, pro-social skills, and on road drivers’ attitude towards EMVs.

Keywords: cognitive load, emergency service vehicle, empathy, traffic load

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Authors: Susana Aragoneses Garrido

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Every day, the roads are scenery of numerous accidents involving vehicles, producing thousands of deaths and serious injuries all over the world. Investigations have revealed that Human Factors (HF) are one of the main causes of road accidents in modern societies. Distracted driving (including external or internal aspects of the vehicle), which is considered as a human factor, is a serious and emergent risk to road safety. Consequently, a further analysis regarding this issue is essential due to its transcendence on today’s society. The objectives of this investigation are the detection and assessment of the HF in order to provide solutions (including a better vehicle design), which might mitigate road accidents. The methodology of the project is divided in different phases. First, a statistical analysis of public databases is provided between Spain and The UK. Second, data is classified in order to analyse the major causes involved in road accidents. Third, a simulation between different paths and vehicles is presented. The causes related to the HF are assessed by Failure Mode and Effects Analysis (FMEA). Fourth, different car models are evaluated using the Rapid Upper Body Assessment (RULA). Additionally, the JACK SIEMENS PLM tool is used with the intention of evaluating the Human Factor causes and providing the redesign of the vehicles. Finally, improvements in the car design are proposed with the intention of reducing the implication of HF in traffic accidents. The results from the statistical analysis, the simulations and the evaluations confirm that accidents are an important issue in today’s society, especially the accidents caused by HF resembling distractions. The results explore the reduction of external and internal HF through the global analysis risk of vehicle accidents. Moreover, the evaluation of the different car models using RULA method and the JACK SIEMENS PLM prove the importance of having a good regulation of the driver’s seat in order to avoid harmful postures and therefore distractions. For this reason, a car redesign is proposed for the driver to acquire the optimum position and consequently reducing the human factors in road accidents.

Keywords: analysis vehicles, asssesment, ergonomics, car redesign

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Authors: Mohamed A. Tantawy, Nourelhoda A. Hussein, Moataz A. Mahrous

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New planning and city design theories are continuously debated and optimized for seeking efficiency and adequacy in economic and life quality aspects. Here, we examine the children-city relationship, to reflect on how modern and traditional cities affect the social climate. We adopt children as a proper caliber for urbanism, as for their very young age, they are independent and attached to family. Their fragility offers a chance to gauge how various urban settings directly affect their feeling of safety, containment, and their perception of belonging for home territory. The importance of street play for the child development process is discussed thoroughly. The authority they have on their play (when and what to play) pushes us to our conclusion. A mediocre built environment characterized by spontaneity and human-scale semi-private urban spaces, is irreplaceable by a perfectly designed far away playgrounds. Street play has a huge role in empowering children for a gradual engagement with grown-ups’ urban flow.

Keywords: child's psychology, social activity, street play, urban fabric

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: Xiao Wen Xu

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There exists a challenge of accommodating/integrating people at risk and those from various backgrounds in urban areas. The success of interdependence as a tool for survival largely rests on the mutually beneficial relationships amongst individuals within a given society. One approach to meeting this challenge has been written by Ivan Illich in his book, Tools for Conviviality, where he defines 'conviviality' as interactions that help individuals. With the goal of helping the community and applying conviviality as a principle to actors in both natural and social realms of Moss Park in Toronto, the proposal involves redesigning the park and buildings as a series of different health care, extended learning, employment support, armoury, and recreation facilities that integrate the exterior landscape as treatment, teaching, military, and recreation areas; in other words, the proposal links services with access to park space. While buildings are traditionally known to physically provide shelter, parks embody shelter and act as service, as people often find comfort and relief from being in nature, and Moss Park, in particular, is home to many people at risk. This landscape is not only an important space for the homeless community but also the rest of the neighborhood. The thesis proposes that the federal government rebuilds the current armoury, as it is an obsolete building while acknowledging the extensive future developments proposed by developers and its impact on public space. The neighbourhood is an underserved area, and the new design develops not just a new armoury, but also a complex of interrelated services, which are completely integrated into the park. The armoury is redesigned as an integral component of the community that not only serves as training facilities for reservists but also serves as an emergency shelter in sub-zero temperatures for the homeless community. This paper proposes a new design for Moss Park through examining how 'park buildings', interconnected buildings and parks, can foster empowering relationships that create a supportive public realm.

Keywords: conviviality, natural, social, Ivan Illich

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Authors: Mihail Simion Beldean-Galea, Virginia Coman, Florina Copaciu, Mihaela Vlassa, Radu Mihaiescu, Adina Croitoru, Viorel Arghius, Modest Gertsiuk, Mikola Gertsiuk

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Taking into consideration the huge number of chemicals released into environment compartments a proper environmental risk assessment is difficult to predict due to the gap of legislation and improper toxicological assessment of chemicals compounds. In Romania as well as in many other countries from Europe, the chemical status of the water body is characterized taking into consideration the Water Framework Directive (WFD) and the substances listed in Annex X. This Annex includes 45 substances from different classes of organic compounds and heavy metals for which AA-EQS and MAC-EQS have been established. For other compounds which are not included in Annex X, different methodologies to prioritize chemicals for risk assessment and monitoring has been proposed. These methodologies take into account Predicted No-Effect Concentrations (PNECs) of different classes of chemicals compounds available from existing risk assessments or from read-across models for acute toxicity to the standard test organisms such as Daphnia magna and Selenastrum capricornutum. Our work presents the monitoring results of 30 priority substances including polyaromatic hydrocarbons, pesticides, halogenated compounds, plasticizers and heavy metals and other 34 substances from different classes of pesticides and pharmaceuticals which are not included on the list of priority substances, performed in the Upper Tisza River Watershed from Romania and Ukraine. The obtained monitoring data were used for the establishment of the list of more relevant pollutants in the studied area and to establish the potential river basin specific pollutants. For this purpose, two indicators such as the Frequency of exceedance and Extent of exceedance of Predicted no-Effect Concentration (PNEC) were evaluated. These two indicators are based on maximum environmental concentrations (MECs) of priority substances and for other pollutants is use statistically based averages of obtained measured concentration compared to the lowest PNEC thresholds. From the obtained results it can be concluded that polyaromatic hydrocarbon such as Fluoranthene, Benzo[a]pyrene, Benzo[b]fluorathene, benzo[k]fluoranthene, Benzo(g.h.i)perylene, Indeno(1.2.3-cd)-pyrene, heavy metals such as Cadmium, Lead and Nickel can be considered as river basin specific pollutants, their concentration exceeding the Annual Average EQS concentration. Other compounds such as estrone, estriol, 174-β estradiol, naproxen or some antibiotics (Penicillin G, Tetracycline or Ceftazidime) should be taken into account for a long monitoring, in some cases their concentration exceeding PNEC. Acknowledgements: This work is performed in the frame of NATO SfP Programme, Project no. 984440.

Keywords: prioritization, river basin specific pollutants, Tisza River, water framework directive

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Authors: Vivian Li

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With the rapid development of technology, virtual reality (VR) and augmented reality (AR) are becoming increasingly prominent in our lives. Museums have led the way in digitization, offering their collections to the wider public through the open internet, which is dramatically changing our experience of art. Technology is also being implemented into our physical art-viewing experience, enabling museums to capture historical sites while creating a more immersive experience for patrons. This study takes a qualitative approach, examining secondary sources and synthesizing information from interviews with field professionals to answer the question: to what extent is the contemporary perception of art transformed by the digitization of art museums? The findings establish that museums are becoming increasingly open with their collections, utilizing digitization to spread their intellectual content to people worldwide and to diversify their audiences. The use of VR and AR is also enabling museums to preserve and showcase historical artifacts and sites in a more interactive and user-focused way. Technology is also crafting new forms of art and art museums. Ultimately, the intersection of technology and museums is not changing the definition of art but rather offering new modes for the public to experience and learn about arts and history.

Keywords: art, augmented reality, digitization, museums, technology, virtual reality

Procedia PDF Downloads 127

Authors: Akbarnejad Neda

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A foreign language acquisition occurs when we can tell a joke and understand it. Most jokes are told in slang and common language. In the process of foreign language acquisition, an autonomous learner try to learn the standard language. But there is a colossal divergence between the usage of the different types of language in society. Here, we investigate the french slang and common language and examine the accurate perception of their usage. We illuminate the slang language in the french literature that provide considerably different types of language for an autonomous learner. We provide furthermore evidence from the french novels that demonstrate properly the different types of language and give in one sentence its social meanings. For example, the famous Queneau expression « Doukipudonktant » present the impact of slang language in society. The characters in the novel transfer the slang and the common language and their accurate usages. We present that the language of the autonomous learner depends on the language of the text that is read. Because literature is a vehicle of the culture and the expression demonstrate their real significations and usage in the culture, slang and common language have a crucial role in the culture and all of them are manifested in the oral language.

Keywords: common language, french, humor, slang language

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Authors: Masbubul Ishtiaque Ahmed

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Food chain contamination by heavy metals has become a critical issue in recent years because of their potential accumulation in bio systems through contaminated water, soil and irrigation water. Industrial discharge, fertilizers, contaminated irrigation water, fossil fuels, sewage sludge and municipality wastes are the major sources of heavy metal contamination in soils and subsequent uptake by crops. The main objectives of this project were to determine the levels of minerals, trace elements and heavy metals in major foods and beverages consumed by the poor and non-poor households of Dhaka city and assess the dietary risk exposure to heavy metal and trace metal contamination and potential health implications as well as recommendations for action. Heavy metals are naturally occurring elements that have a high atomic weight and a density of at least 5 times greater than that of water. Their multiple industrial, domestic, agricultural, medical and technological applications have led to their wide distribution in the environment; raising concerns over their potential effects on human health and the environment. Their toxicity depends on several factors including the dose, route of exposure, and chemical species, as well as the age, gender, genetics, and nutritional status of exposed individuals. Because of their high degree of toxicity, arsenic, cadmium, chromium, lead, and mercury rank among the priority metals that are of public health significance. These metallic elements are considered systemic toxicants that are known to induce multiple organ damage, even at lower levels of exposure. This review provides an analysis of their environmental occurrence, production and use, potential for human exposure, and molecular mechanisms of toxicity, and carcinogenicity.

Keywords: food chain, determine the levels of minerals, trace elements, heavy metals, production and use, human exposure, toxicity, carcinogenicity

Procedia PDF Downloads 285

Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki

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Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.

Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions

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Authors: Mustafa Al Sukar, Azzam Sleit, Abdullatif Abu-Dalhoum, Bassam Al-Kasasbeh

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Use and abuse of drugs by teens is very common and can have dangerous consequences. The drugs contribute to physical and sexual aggression such as assault or rape. Some teenagers regularly use drugs to compensate for depression, anxiety or a lack of positive social skills. Teen resort to smoking should not be minimized because it can be "gateway drugs" for other drugs (marijuana, cocaine, hallucinogens, inhalants, and heroin). The combination of teenagers' curiosity, risk taking behavior, and social pressure make it very difficult to say no. This leads most teenagers to the questions: "Will it hurt to try once?" Nowadays, technological advances are changing our lives very rapidly and adding a lot of technologies that help us to track the risk of drug abuse such as smart phones, Wireless Sensor Networks (WSNs), Internet of Things (IoT), etc. This technique may help us to early discovery of drug abuse in order to prevent an aggravation of the influence of drugs on the abuser. In this paper, we have developed a Decision Support System (DSS) for detecting the drug abuse using Artificial Neural Network (ANN); we used a Multilayer Perceptron (MLP) feed-forward neural network in developing the system. The input layer includes 50 variables while the output layer contains one neuron which indicates whether the person is a drug addict. An iterative process is used to determine the number of hidden layers and the number of neurons in each one. We used multiple experiment models that have been completed with Log-Sigmoid transfer function. Particularly, 10-fold cross validation schemes are used to access the generalization of the proposed system. The experiment results have obtained 98.42% classification accuracy for correct diagnosis in our system. The data had been taken from 184 cases in Jordan according to a set of questions compiled from Specialists, and data have been obtained through the families of drug abusers.

Keywords: drug addiction, artificial neural networks, multilayer perceptron (MLP), decision support system

Procedia PDF Downloads 299