Search results for: intensive or adapted cognitive behavioural therapy

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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Authors: Briohny H. Spencer, Russ Chess-Williams, Catherine McDermott, Shailendra Anoopkumar-Dukie, David Christie

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Background: Prostate cancer is the second most common cancer diagnosed in men worldwide and the most prevalent in Australian men. In 2015, it was estimated that approximately 18,000 new cases of prostate cancer were diagnosed in Australia. Currently, for localised disease, androgen depravation therapy (ADT) and radiotherapy are a major part of the curative management of prostate cancer. ADT acts to reduce the levels of circulating androgens, primarily testosterone and the locally produced androgen, dihydrotestosterone (DHT), or by preventing the subsequent activation of the androgen receptor. Thus, the growth of the cancerous cells can be reduced or ceased. Radiation techniques such as brachytherapy (radiation delivered directly to the prostate by transperineal implant) or external beam radiation therapy (exposure to a sufficient dose of radiation aimed at eradicating malignant cells) are also common techniques used in the treatment of this condition. Radiotherapy (RT) has significant limitations, including reduced effectiveness in treating malignant cells present in hypoxic microenvironments leading to radio-resistance and poor clinical outcomes and also the significant side effects for the patients. Alpha1-adrenoceptor antagonists are used for many prostate cancer patients to control lower urinary tract symptoms, due to the progression of the disease itself or may arise as an adverse effect of the radiotherapy treatment. In Australia, a significant number (not a majority) of patients receive a α1-ADR antagonist and four drugs are available including prazosin, terazosin, alfuzosin and tamsulosin. There is currently limited published data on the effects of α1-ADR antagonists during radiotherapy, but it suggests these medications may improve patient outcomes by enhancing the effect of radiotherapy. Aim: To determine the impact of α1-ADR antagonists treatments on time to biochemical relapse following radiotherapy. Methods: A retrospective study of male patients receiving radiotherapy for biopsy-proven localised prostate cancer was undertaken to compare cancer outcomes for drug-naïve patients and those receiving α1-ADR antagonist treatments. Ethical approval for the collection of data at Genesis CancerCare QLD was obtained and biochemical relapse (defined by a PSA rise of >2ng/mL above the nadir) was recorded in months. Rates of biochemical relapse, prostate specific antigen doubling time (PSADT) and Kaplan-Meier survival curves were also compared. Treatment groups were those receiving α1-ADR antagonists treatment before or concurrent with their radiotherapy. Data was statistically analysed using One-way ANOVA and results expressed as mean ± standard deviation. Major findings: The mean time to biochemical relapse for tamsulosin, prazosin, alfuzosin and controls were 45.3±17.4 (n=36), 41.5±19.6 (n=11), 29.3±6.02 (n=6) and 36.5±17.6 (n=16) months respectively. Tamsulosin, prazosin but not alfuzosin delayed time to biochemical relapse although the differences were not statistically significant. Conclusion: Preliminary data for the prior and/or concurrent use of tamsulosin and prazosin showed a positive trend in delaying time to biochemical relapse although no statistical significance was shown. Larger clinical studies are indicated and with thousands of patient records yet to be analysed, it may determine if there is a significant effect of these drugs on control of prostate cancer.

Keywords: alpha1-adrenoceptor antagonists, biochemical relapse, prostate cancer, radiotherapy

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Authors: Seonggil Kim, Jeonghun Nam, Chae Seung Lim

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Rapid diagnosis of fungal infections is critical for rapid antifungal therapy. However, it is difficult to detect extremely low concentration fungi in blood sample. To address the limitation, separation and concentration of fungi in blood sample are required to enhance the sensitivity of PCR analysis. In this study, we demonstrated a sheathless separation and concentration of fungi, candida cells using a viscoelastic fluid. To validate the performance of the device, microparticle mixture (2 and 13 μm) was used, and those particles were successfully separated based on the size difference at high flow rate of 100 μl/min. For the final application, successful separation of the Candida cells from the white blood cells (WBCs) was achieved. Based on the viscoelastic lateral migration toward the equilibrium position, Candida cells were separated and concentrated by center focusing, while WBCs were removed by patterning into two streams between the channel center and the sidewalls. By flow cytometric analysis, the separation efficiency and the purity were evaluated as ~99% and ~ 97%, respectively. From the results, the device can be the powerful tool for detecting extremely rare disease-related cells.

Keywords: candida cells, concentration, separation, viscoelastic fluid

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Authors: E. Tutova, Y. Ebzeeva, L. Gishkaeva, Y.Smirnova, N. Dubinina

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We have been working with students from different countries and found it crucial to switch the languages to explain something. Whether it is Russian, or Chinese, explaining in a different language plays an important role for students’ cognitive abilities. In this work we are going to explore how code switching may impact the student’s perception of information. Code-switching is a tool defined by linguists as a switch from one language to another for convenience, explanation of terms unavailable in an initial language or sometimes prestige. In our case, we are going to consider code-switching from the function of convenience. As a rule, students who come to study Russian in a language environment, lack many skills in speaking the language. Thus, it is made harder to explain the rules for them of another language, which is English. That is why switching between English, Russian and Mandarin is crucial for their better understanding. In this work we are going to explore the code-switching as a tool which can help a teacher in a flipped classroom.

Keywords: bilingualism, psychological linguistics, code-switching, social linguistics

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Authors: Nirmal Sugathan, Santosh Maruthy

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Background: A considerable number of studies have evidenced that phonological encoding (PE) and working memory (WM) skills operate differently in adults who stutter (AWS). In order to tap these skills, several paradigms have been employed such as phonological priming, phoneme monitoring, and nonword repetition tasks. This study, however, utilizes a word jumble paradigm to assess both PE and WM using different modalities and this may give a better understanding of phonological processing deficits in AWS. Aim: The present study investigated PE and WM abilities in conjunction with lexical access in AWS using jumbled words. The study also aimed at investigating the effect of increase in cognitive load on phonological processing in AWS by comparing the speech reaction time (SRT) and accuracy scores across various syllable lengths. Method: Participants were 11 AWS (Age range=19-26) and 11 adults who do not stutter (AWNS) (Age range=19-26) matched for age, gender and handedness. Stimuli: Ninety 3-, 4-, and 5-syllable jumbled words (JWs) (n=30 per syllable length category) constructed from Kannada words served as stimuli for jumbled word paradigm. In order to generate jumbled words (JWs), the syllables in the real words were randomly transpositioned. Procedures: To assess PE, the JWs were presently visually using DMDX software and for WM task, JWs were presented through auditory mode through headphones. The participants were asked to silently manipulate the jumbled words to form a Kannada real word and verbally respond once. The responses for both tasks were audio recorded using record function in DMDX software and the recorded responses were analyzed using PRAAT software to calculate the SRT. Results: SRT: Mann-Whitney test results demonstrated that AWS performed significantly slower on both tasks (p < 0.001) as indicated by increased SRT. Also, AWS presented with increased SRT on both the tasks in all syllable length conditions (p < 0.001). Effect of syllable length: Wilcoxon signed rank test was carried out revealed that, on task assessing PE, the SRT of 4syllable JWs were significantly higher in both AWS (Z= -2.93, p=.003) and AWNS (Z= -2.41, p=.003) when compared to 3-syllable words. However, the findings for 4- and 5-syllable words were not significant. Task Accuracy: The accuracy scores were calculated for three syllable length conditions for both PE and PM tasks and were compared across the groups using Mann-Whitney test. The results indicated that the accuracy scores of AWS were significantly below that of AWNS in all the three syllable conditions for both the tasks (p < 0.001). Conclusion: The above findings suggest that PE and WM skills are compromised in AWS as indicated by increased SRT. Also, AWS were progressively less accurate in descrambling JWs of increasing syllable length and this may be interpreted as, rather than existing as a uniform deficiency, PE and WM deficits emerge when the cognitive load is increased. AWNS exhibited increased SRT and increased accuracy for JWs of longer syllable length whereas AWS was not benefited from increasing the reaction time, thus AWS had to compromise for both SRT and accuracy while solving JWs of longer syllable length.

Keywords: adults who stutter, phonological ability, working memory, encoding, jumbled words

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Authors: Sara T. K. Li, Belinda H. J. Chung, Jeffery C. N. Yip, Janet H. Hsiao

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Music notation and text reading both involve statistical learning of music or linguistic structures. However, it remains unclear how music reading expertise influences text reading behavior. The present study examined this issue through an eye-tracking study. Chinese-English bilingual musicians and non-musicians read English sentences, Chinese sentences, musical phrases, and sentences in Tibetan, a language novel to the participants, with their eye movement recorded. Each set of stimuli consisted of two conditions in terms of structural regularity: syntactically correct and syntactically incorrect musical phrases/sentences. They then completed a sentence comprehension (for syntactically correct sentences) or a musical segment/word recognition task afterwards to test their comprehension/recognition abilities. The results showed that in reading musical phrases, as compared with non-musicians, musicians had a higher accuracy in the recognition task, and had shorter reading time, fewer fixations, and shorter fixation duration when reading syntactically correct (i.e., in diatonic key) than incorrect (i.e., in non-diatonic key/atonal) musical phrases. This result reflects their expertise in music reading. Interestingly, in reading Tibetan sentences, which was novel to both participant groups, while non-musicians did not show any behavior differences between reading syntactically correct or incorrect Tibetan sentences, musicians showed a shorter reading time and had marginally fewer fixations when reading syntactically correct sentences than syntactically incorrect ones. However, none of the musicians reported discovering any structural regularities in the Tibetan stimuli after the experiment when being asked explicitly, suggesting that they may have implicitly acquired the structural regularities in Tibetan sentences. This group difference was not observed when they read English or Chinese sentences. This result suggests that music reading expertise facilities reading texts in a novel language (i.e., Tibetan), but not in languages that the readers are already familiar with (i.e., English and Chinese). This phenomenon may be due to the similarities between reading music notations and reading texts in a novel language, as in both cases the stimuli follow particular statistical structures but do not involve semantic or lexical processing. Thus, musicians may transfer their statistical learning skills stemmed from music notation reading experience to implicitly discover structures of sentences in a novel language. This speculation is consistent with a recent finding showing that music reading expertise modulates the processing of English nonwords (i.e., words that do not follow morphological or orthographic rules) but not pseudo- or real words. These results suggest that the modulation of music reading expertise on language processing depends on the similarities in the cognitive processes involved. It also has important implications for the benefits of music education on language and cognitive development.

Keywords: eye movement behavior, eye-tracking, music reading expertise, sentence reading, structural regularity, visual processing

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Authors: Rahim Sarvar, Bahram Azadbakht, Samira Safaee

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The leading goal of all planning is to attain sustainable development, regional balance, suitable distribution of activities, and maximum use of environmental capabilities in the process of development of regions. Intensive concentration of population and activities in one or some limited geographical locality is of main characteristics of most developing countries, especially Iran. Not considering the long-term programs and relying on temporary and superficial plans by people in charge of decision-making to attain their own objectives causes obstacles, resulting in unbalance development. The basic reason for these problems is to establish the development planning while economic aspects are merely considered and any attentions are not paid to social and regional feedbacks, what have been ending up to social and economic inequality, unbalanced distribution of development among the regions as well. In addition to study of special planning and structure of the county of Malekan, this research tries to achieve some other aims, i.e. recognition and introduction of approaches in order to utilize resources optimally, to distribute the population, activities, and facilities in optimum fashion, and to investigate and identify the spatial development potentials of the County. Based on documentary, descriptive, analytical, and field studies, this research employs maps to analyze the data, investigates the variables, and applies SPSS, Auto CAD, and Arc View software. The results show that the natural factors have a significant influence on spatial layout of settlements; distribution of facilities and functions are not equal among the rural districts of the county; and there is a spatial equivalence in the region area between population and number of settlements.

Keywords: development, entropy index, Malekan City, planning, regional equilibrium

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Authors: Shafaq Rubab

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One of the biggest reasons of dropouts from schools is lack of motivation and interest among the students, particularly in mathematics. Many developing countries are facing this problem and this issue is lowering the literacy rate in these developing countries. The best solution for increasing motivation level and interest among the students is using tablet game-based learning. However, a pedagogically sound game required a well-planned instructional design model to enhance learner’s attention and confidence otherwise effectiveness of the learning games suffers badly. This research aims to evaluate the impact of the pedagogically sound instructional design model on students’ motivation by using tablet game-based learning. This research was conducted among the out-of-school-students having an age range from 7 to 12 years and the sample size of two hundred students was purposively selected without any gender discrimination. Qualitative research was conducted by using a survey tool named Instructional Material Motivational Survey (IMMS) adapted from Keller Arcs model. A comparison of results from both groups’ i.e. experimental group and control group revealed that motivation level of the students taught by the game was higher than the students instructed by using conventional methodologies. Experimental group’s students were more attentive, confident and satisfied as compared to the control group’s students. This research work not only promoted the trend of digital game-based learning in developing countries but also supported that a pedagogically sound instructional design model utilized in an educational game can increase the motivation level of the students and can make the learning process a totally immersive and interactive fun loving activity.

Keywords: digital game-based learning, student’s motivation, instructional design model, learning process

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Authors: Rose Virginy S. Bautista, Ida Marie Tabangay-Lim, Helen Bongalon-Amo, Jose Modesto B. Abellera

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Chordomas, particularly those of the spine and the head and neck region, represent a rare and locally aggressive group of malignancies. The complexity of these tumors -given the rarity, location, and involvement of neurovascular structures- imposes a challenge in the diagnosis and management. We herein report a case of spinal cord compression due to a prevertebral cervical chordoma. The patient presented with a gradually enlarging lateral neck mass, with progressive bilateral extremity weakness and urinary incontinence; preoperative biopsy showed chordoma. A multidisciplinary approach for the management of this case was made, involving neurosurgery, head and neck surgery, and radiation oncology services. Surgical collaboration between the two cutting services was done to have a radical excision of the tumor and spinal cord decompression. The patient was then referred for adjuvant radiation therapy. With this collaborative treatment strategy, more comprehensive and quality care could be provided to our patients.

Keywords: chordoma, surgical collaboration, spinal cord compression, neurosurgery, head and neck surgery

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Authors: P. Gil Del Álamo, J. García Pereda, A. Castañeda De La Paz, D. Arazola Lopez, M. D. Cubiles De La Vega, A. Enguíx González, J. M. Muñoz Pichardo

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In the last decades, obesity has more than doubled and is, with overweight, the second leading cause of preventable death. Despite multiple strategies against obesity, no country to date has reduced the number of obese people. To achieve World Health Organization’s target to reverse this tendency we need dramatic and different actions to engage the civil society in creating demand for a healthy style of life. The objective of this study is to demonstrate that a social media as the television can be used to convince the civil society that a healthy nutrition and physical activity are affordable, effective and necessary to prevent and to treat the obesity. Methodology: 61 individuals (34 women and 27 men) with obesity (mean BMI 45,51) were recruited to follow during 22 weeks an intensive lifestyle intervention in order to lose weight in a healthy manner. They were not isolated or moved from their usual environment. This program included endocrinological and nutritional assessment, promotion of physical activity and psychological support. BMI was measured every week. Time to leave obesity between men and women was analyzed with a survival analysis. Results: BMI decreased in all the cases. Analysing Time to leave obesity, around the week 30, 25% of men leave the obesity and around the week 39, 25% of women leave the obesity too. Conclusion: We demonstrate the audience that improving the quality of the diet and increasing the physical activity is a realistic way to lose weight. This evidence can encourage the people to act in their own self-interest changing their style of life in order to prevent or to reduce their overweight.

Keywords: obesity epidemic, obesity prevention, obesity strategies, social media

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Fares Mahdi

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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.

Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Beata Spilakova, Daniel J. Shaw, Radek Marecek, Milan Brazdil

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Hyperscanning affords a unique insight into the brain dynamics underlying human interaction by simultaneously scanning two or more individuals’ brain responses while they engage in dyadic exchange. This provides an opportunity to observe dynamic brain activations in all individuals participating in interaction, and possible interbrain effects among them. The present research aims to provide an experimental paradigm for hyperscanning research capable of delineating among different forms of interaction. Specifically, the goal was to distinguish between two dimensions: (1) interaction structure (concurrent vs. turn-based) and (2) goal structure (competition vs cooperation). Dual-fMRI was used to scan 22 pairs of participants - each pair matched on gender, age, education and handedness - as they played the Pattern Game. In this simple interactive task, one player attempts to recreate a pattern of tokens while the second player must either help (cooperation) or prevent the first achieving the pattern (competition). Each pair played the game iteratively, alternating their roles every round. The game was played in two consecutive sessions: first the players took sequential turns (turn-based), but in the second session they placed their tokens concurrently (concurrent). Conventional general linear model (GLM) analyses revealed activations throughout a diffuse collection of brain regions: The cooperative condition engaged medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC); in the competitive condition, significant activations were observed in frontal and prefrontal areas, insula cortices and the thalamus. Comparisons between the turn-based and concurrent conditions revealed greater precuneus engagement in the former. Interestingly, mPFC, PCC and insulae are linked repeatedly to social cognitive processes. Similarly, the thalamus is often associated with a cognitive empathy, thus its activation may reflect the need to predict the opponent’s upcoming moves. Frontal and prefrontal activation most likely represent the higher attentional and executive demands of the concurrent condition, whereby subjects must simultaneously observe their co-player and place his own tokens accordingly. The activation of precuneus in the turn-based condition may be linked to self-other distinction processes. Finally, by performing intra-pair correlations of brain responses we demonstrate condition-specific patterns of brain-to-brain coupling in mPFC and PCC. Moreover, the degree of synchronicity in these neural signals related to performance on the game. The present results, then, show that different types of interaction recruit different brain systems implicated in social cognition, and the degree of inter-player synchrony within these brain systems is related to nature of the social interaction.

Keywords: brain-to-brain coupling, hyperscanning, pattern game, social interaction

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Authors: Adriana Haulica

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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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Authors: Mohd Anuar Awang Idris, Muhammad Nubli Abdul Wahab, Nora Yusma Mohamed Yusoff

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Wudu’ (Ablution) and Zikr are amongst some of the spiritual tools which may help an individual control his mind, emotion and attitude. These tools are deemed to be able to deliver a positive impact on an individual’s psychophysiology. The main objective of this research is to determine the effects of Wudu’ (Ablution) and Zikr therapy using the biofeedback emWave application and technology. For this research, 13 students were selected as samples from the students’ representative body at the University Tenaga National, Malaysia. The DASS (Depression Anxiety Stress Scale) questionnaire was used to help with the assessment and measurement of each student’s ability in controlling his or her emotions before and after the therapies. The biofeedback emWave technology was utilized to monitor the student’s psychophysiology level. In addition, the data obtained from the Heart rate variability (HRV) test have also been used to affirm that Wudu’ and Zikr had had significant impacts on the student’s success in controlling his or her emotional pressure.

Keywords: biofeedback EmWave, emotion, psychophysiology, wudu’, zikr

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Authors: G. M. B. P. Abeysekara, W. A. D. C. Wijerathna

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Terminal choice from the multiple terminals region is not a simple decision and it is very complex, because shipping lines should consider on influential factors for the terminal choice at once according to their requirement. Therefore, terminal choice is a multiple criterion decision making (MCDM) situation under a specially designed decision hierarchy. Identification of perspective of shipping lines regarding terminal choice is vital important for the decision makers regarding container terminals. Thus this study is evaluated perception on main and feeder shipping lines’ regarding port of Colombo container terminals, and ranked terminals according to shipping lines preference. Analytic Hierarchy Process (AHP) model is adapted to this study, since it has features similar to the MCDM, it is weighted every influential factor by using pair wise comparisons, and consistency of the decision makers’ judgments are checked to evaluate trustworthiness of gathered data. And rating method is used to rank the terminals within Port of Colombo by assigning particular preference values with respect to the criteria and sub criteria. According to the findings of this study, main lines’ mainly concern on water depth of approach channel, depth of berth, handling charges and handling equipment facilities. And feeder lines’ main concerns were handling equipment facilities, loading and discharging efficiency, depth of berth and handling charges. Findings of the study suggested concentrating regarding the emphasized areas in order to enhance the competitiveness of terminals, and to increase number of vessel callings at the Port of Colombo. Application of above finding of the terminals within Port of Colombo lead to a far better competition among terminals and would uplift the overall level of services.

Keywords: AHP, Main and feeder shipping lines, criteria, sub criteria

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Authors: Polychronis Kapalidis

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In recent years, researchers have started to turn their attention to cyber security and maritime security independently, neglecting, in most cases, to examine the areas where these two critical issues are intertwined. The impact of cybersecurity issues on the maritime economy is emerging dramatically. Maritime transport and all related activities are conducted by technology-intensive platforms, which today rely heavily on information systems. The paper’s argument is that when no defense is completely effective against cyber attacks, it is vital to test responses to the inevitable incursions. Hence, preparedness in the form of testing existing cybersecurity structure via different tools for potential attacks is vital for minimizing risks. Traditional criminal activities may further be facilitated and evolved through the misuse of cyberspace. Kidnap, piracy, fraud, theft of cargo and imposition of ransomware are the major of these activities that mainly target the industry’s most valuable asset; the ship. The paper, adopting a case-study analysis, based on stakeholder consultation and secondary data analysis, namely policy and strategic-related documentation, presents the importance of holistic testing in the sector. Arguing that poor understanding of the issue leads to the adoption of ineffective policies the paper will present the level of awareness within the industry and assess the risks and vulnerabilities of ships to these cybercriminal activities. It will conclude by suggesting that testing procedures must be focused on three main pillars within the maritime transport sector: the human factor, the infrastructure, and the procedures.

Keywords: cybercrime, cybersecurity, organized crime, risk mitigation

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Authors: Amani Abdallah, Isam Shahrour

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The quality of drinking water is a major concern of public health. The control of this quality is generally performed in the laboratory, which requires a long time. This type of control is not adapted for accidental pollution from sudden events, which can have serious consequences on population health. Therefore, it is of major interest to develop real-time innovative solutions for the detection of accidental contamination in drinking water systems This paper presents researches conducted within the SunRise Demonstrator for ‘Smart and Sustainable Cities’ with a particular focus on the supervision of the water quality. This work aims at (i) implementing a smart water system in a large water network (Campus of the University Lille1) including innovative equipment for real-time detection of abnormal events, such as those related to the contamination of drinking water and (ii) develop a numerical modeling of the contamination diffusion in the water distribution system. The first step included verification of the water quality sensors and their effectiveness on a network prototype of 50m length. This part included the evaluation of the efficiency of these sensors in the detection both bacterial and chemical contamination events in drinking water distribution systems. An on-line optical sensor integral with a laboratory-scale distribution system (LDS) was shown to respond rapidly to changes in refractive index induced by injected loads of chemical (cadmium, mercury) and biological contaminations (Escherichia coli). All injected substances were detected by the sensor; the magnitude of the response depends on the type of contaminant introduced and it is proportional to the injected substance concentration.

Keywords: distribution system, drinking water, refraction index, sensor, real-time

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Authors: R. Barros, J. Azevedo, P. Padrão, M. Gregório, I. Pádua, C. Almeida, C. Rodrigues, P. Fontes, A. Coelho

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Recent evidence shows a positive association between nutritional literacy and healthy eating. Traditional nutrition education strategies for childhood obesity prevention have shown weak effect. The Nutriscience project aims to create and evaluate an innovative and multidisciplinary strategy for promoting effective and accessible nutritional information to children, their families, and educators. Nutriscience is a one-year prospective follow-up evaluation study including pre-school children (3-5 y), who attend national schools’ network (29). The project is structured around a web-based intervention, using an on-line interactive platform, and focus on increasing fruit and vegetable consumption, and reducing sugar and salt intake. The platform acts as a social network where educational materials, games, and nutritional challenges are proposed in a gamification approach that promotes family and community social ties. A nutrition Massive Online Open Course is developed for educators, and a national healthy culinary contest will be promoted on TV channel. A parental self-reported questionnaire assessing sociodemographic and nutritional literacy (knowledge, attitudes, skills) is administered (baseline and end of the intervention). We expect that results on nutritional literacy from the presented strategy intervention will give us important information about the best practices for health intervention with kindergarten families. This intervention program using a digital interactive platform could be an educational tool easily adapted and disseminated for childhood obesity prevention.

Keywords: childhood obesity, educational tool, nutritional literacy, web-based intervention

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Authors: Harjyot Khosa

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In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

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Authors: Anna Rogozińska-Pawełczyk

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A psychological contract is an agreement between the employer and an employee that covers the parties’ informal and frequently non-verbalized obligations and expectations towards each other. The contract is a cognitive pattern-governing employee’s behaviour in the organization. A gap between employee’s expectations and the organizational reality may lead to difficult-to-solve conflicts or cause the employee to modify their behaviour towards organizational values and goals, if they are willing and ready to verbalize their expectations. The article discusses psychological contracts in the financial institutions in Poland. Its theoretical part outlines the types of psychological contracts in organizations (relational, transactional, and balanced) and shows the process of their verbalization. The purpose of the article is to present how the type of the psychological contract relates to employee’s readiness to verbalize it. The article ends with conclusions arising from the study.

Keywords: customer contact staff in banks, employee expectations, financial institutions, mutual expectations, psychological contract, verbalization of the psychological contract

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Authors: Ayesha Khatun

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In 21st century where markets are unstable, technologies rapidly proliferate, competitors multiply, products and services become obsolete almost overnight and customers demand low cost high value product, leveraging and harnessing knowledge is not just a potential source of competitive advantage rather a necessity in technology based and information intensive industries. Knowledge management focuses on leveraging the available knowledge and sharing the same among the individuals in the organization so that the employees can make best use of it towards achieving the organizational goals. Knowledge is not a discrete object. It is embedded in people and so difficult to transfer outside the immediate context that it becomes a major competitive advantage. However, internal transfer of knowledge among the employees is essential to maximize the use of knowledge available in the organization in an unstructured manner. But as knowledge is the source of competitive advantage for the organization it is also the source of competitive advantage for the individuals. People think that knowledge is power and sharing the same may lead to lose the competitive position. Moreover, the very nature of tacit knowledge poses many difficulties in sharing the same. But sharing tacit knowledge is the vital part of knowledge management process because it is the tacit knowledge which is inimitable. Knowledge management has been made synonymous with the use of software and technology leading to the management of explicit knowledge only ignoring personal interaction and forming of informal networks which are considered as the most successful means of sharing tacit knowledge. Factors responsible for effective sharing of tacit knowledge are grouped into –individual, organizational and technological factors. Different factors under each category have been identified. Creating a positive organizational culture, encouraging personal interaction, practicing reward system are some of the strategies that can help to overcome many of the barriers to effective sharing of tacit knowledge. Methodology applied here is completely secondary. Extensive review of relevant literature has been undertaken for the purpose.

Keywords: knowledge, tacit knowledge, knowledge management, sustainable competitive advantage, organization, knowledge sharing

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Authors: Lindsey Giunta

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This review examines the current literature regarding the impact of COVID-19 on academic functioning and anxiety in children and adolescents. The objective was to determine the ways in which the pandemic affected youth mental health and academics, in addition to the extent that these factors were transformed as a result of the worldwide state of affairs. Twenty papers were selected and reviewed, and data showed long term consequences in youth mental health resulting from the current pandemic. The COVID-19 pandemic and its associated lockdowns led to disrupted childhood education, and data showed that the growth of cognitive executive functions was impacted to varying degrees dependent upon geographic location. The literature recommends supplemental education on the national level, as well as mental health promotion within communities and schools.

Keywords: pandemic, children, adolescents, anxiety, academic functioning

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Authors: John Okanda Okwaro

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Carbon (IV) oxide (CO₂) is emitted majorly from fossil fuel combustion and industrial production. The sources of interest of carbon (IV) oxide in the study area are mining activities, transport systems, and industrial processes. This study is aimed at building models that will help in monitoring the emissions within the study area. Three scenarios were discussed, namely: pessimistic scenario, business-as-usual scenario, and optimistic scenario. The result showed that there was a reduction in carbon dioxide concentration by approximately 50.5 ppm between March 2020 and January 2021 inclusive. This is majorly due to reduced human activities that led to decreased consumption of energy. Also, the CO₂ concentration trend follows the business-as-usual scenario (BAU) path. From the models, the pessimistic, business-as-usual, and optimistic scenarios give CO₂ concentration of about 545.9 ppm, 408.1 ppm, and 360.1 ppm, respectively, on December 31st, 2021. This research helps paint the picture to the policymakers of the relationship between energy sources and CO₂ emissions. Since the reduction in CO₂ emission was due to decreased use of fossil fuel as there was a decrease in economic activities, then if Kenya relies more on green energy than fossil fuel in the post-COVID-19 period, there will be more CO₂ emission reduction. That is, the CO₂ concentration trend is likely to follow the optimistic scenario path, hence a reduction in CO₂ concentration of about 48 ppm by the end of the year 2021. This research recommends investment in solar energy by energy-intensive companies, mine machinery and equipment maintenance, investment in electric vehicles, and doubling tree planting efforts to achieve the 10% cover.

Keywords: forecasting, greenhouse gas, green energy, hierarchical data format

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Authors: Ines Zemni, Maher Slimane, Jamel Ben Hassouna, Khaled Rahal

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Background: Neurofibromatosis type 1 (NF1) is a genetic disease, which is associated with an increased risk of developing different malignancies including breast cancer. The association between NF1 band breast sarcoma is a rare entity. Herein we present a 25-year-old woman with NF1 who had fibrosarcoma of the left breast. Case presentation: The patient has multiple thoraco-abdominal 'café au lait' spots. Clinical examination showed a lump of the left breast measuring 9 cm of diameter, which was noticed for 6 months. There was a left inguinal mass of 6 cm of diameter. The patient underwent first a left lumpectomy. Histopathological exam revealed a high-grade fibrosarcoma of the left breast measuring 7.5 cm. Three months later, the patient underwent a left mastectomy and excision of the inguinal mass, which was a neurofibroma. An adjuvant chemotherapy and radiation therapy were indicated, but not applied because of the timeout. The patient is now alive after a follow up of 6 years, with no loco-regional recurrence or metastasis. Conclusion: The relationship between NF1 and breast cancer need to be more clarified by further studies. Establishing a specific screening program of these patients may help to make an earlier diagnosis of breast cancer.

Keywords: neurofibromatosis, breast, sarcoma, cancer

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Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

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Authors: Salve Alessandria Alcantara, John Armand E. Aquino, Ma. Veronica Aranda, Nikki Francine Balde, Angeli Therese F. Cruz, Elise Danielle Garcia, Antonie Kyna Lim, Divina Gracia Lucero, Nikolai Thadeus Mappatao, Maylan N. Ocat, Jamille Dyanne L. Pajarillo, Jane Mierial A. Pesigan, Grace Kristin Viva, Jasmine Arielle C. Yap, Kathleen Michelle T. Yu, Joanna J. Orejola, Joanna V. Toralba

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Lead is a neurotoxic metallic element that is slowly accumulated in bones and tissues especially if present in products taken in a regular basis such as herbal tea supplements. Although sensitive analytical instruments are already available, the USP limit test for lead is still widely used. However, because of its serious shortcomings, Lang Lang and his colleagues developed a spectrophotometric method for determination of lead in all types of samples. This method was the one adapted in this study. The actual procedure performed was divided into three parts: digestion, extraction and analysis. For digestion, HNO3 and CH3COOH were used. Afterwards, masking agents, 0.003% and 0.001% dithizone in CHCl3 were added and used for the extraction. For the analysis, standard addition method and colorimetry were performed. This was done in triplicates under two conditions. The 1st condition, using 25µg/mL of standard, resulted to very low absorbances with an r2 of 0.551. This led to the use of a higher concentration, 1mg/mL, for condition 2. Precipitation of lead cyanide was observed and the absorbance readings were relatively higher but between 0.15-0.25, resulting to a very low r2 of 0.429. LOQ and LOD were not computed due to the limitations of the Milton-Roy Spectrophotometer. The method performed has a shorter digestion time, and used less but more accessible reagents. However, the optimum ratio of dithizone-lead complex must be observed in order to obtain reliable results while exploring other concentration of standards.

Keywords: herbal tea supplement, lead-dithizone complex, standard addition, visible spectroscopy

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Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

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The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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Authors: Halkiopoulos Constantinos, Koutsopoulou Ioanna, Gkintoni Evgenia, Antonopoulou Hera

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Immunization appears to be an essential part of health care service in times of pandemics such as covid-19 and aims not only to protect the health of the population but also the health and sustainability of the economies of the countries affected. It is reported that more than 3.44 billion doses have been administered so far, which accounts for 45 doses for 100 people. Vaccination programs in various countries have been promoted and accepted by people differently and therefore they proceeded in different ways and speed; most countries directing them towards people with vulnerable chronic or recent health statuses. Large scale restriction measures or lockdown, personal protection measures such as masks and gloves and a decrease in leisure and sports activities were also implemented around the world as part of the protection health strategies against the covid-19 pandemic. This research aims to present an analysis based on variations on people’s attitudes towards vaccination based on demographic, social and epidemiological characteristics, and health status on the one hand and perception of health, health satisfaction, pain, and quality of life on the other hand. 1500 Greek e-consumers participated in the research, mainly through social media who took part in an online-based survey voluntarily. The questionnaires included demographic, social and medical characteristics of the participants, and questions asking people’s willingness to be vaccinated and their opinion on whether there should be a vaccine against covid-19. Other stressor factors were also reported in the questionnaires and participants’ loss of someone close due to covid-19, or staying at home quarantine due to being infected from covid-19. WHOQUOL-BREF and GLOBAL PSYCHOTRAUMA SCREEN- GPS were used with kind permission from WHO and from the International Society for Traumatic Stress Studies in this study. Attitudes towards vaccination varied significantly related to aging, level of education, health status and consumer behavior. Health professionals’ attitudes also varied in relation to age, level of education, profession, health status and consumer needs. Vaccines have been the most common technological aid of human civilization so far in the fight against viruses. The results of this study can be used for health managers and digital marketers of pharmaceutical companies and also other staff involved in vaccination programs and for designing health policy immunization strategies during pandemics in order to achieve positive attitudes towards vaccination and larger populations being vaccinated in shorter periods of time after the break out of pandemic. Health staff needs to be trained, aided and supervised to go through with vaccination programs and to be protected through vaccination programs themselves. Feedback in each country’s vaccination program, short backs, deficiencies and delays should be addressed and worked out.

Keywords: consumer behavior, cognitive models, vaccination policy, pandemic, Covid-19, Greece

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