Search results for: group package tour

Authors: Yeliz Karaca, Rana Karabudak

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Multifractal Denoising techniques are used in the identification of significant attributes by removing the noise of the dataset. Magnetic resonance (MR) image technique is the most sensitive method so as to identify chronic disorders of the nervous system such as Multiple Sclerosis. MRI and Expanded Disability Status Scale (EDSS) data belonging to 120 individuals who have one of the subgroups of MS (Relapsing Remitting MS (RRMS), Secondary Progressive MS (SPMS), Primary Progressive MS (PPMS)) as well as 19 healthy individuals in the control group have been used in this study. The study is comprised of the following stages: (i) L2 Norm Multifractal Denoising technique, one of the multifractal technique, has been used with the application on the MS data (MRI and EDSS). In this way, the new dataset has been obtained. (ii) The new MS dataset obtained from the MS dataset and L2 Multifractal Denoising technique has been applied to the K-Means and Fuzzy C Means clustering algorithms which are among the unsupervised methods. Thus, the clustering performances have been compared. (iii) In the identification of significant attributes in the MS dataset through the Multifractal denoising (L2 Norm) technique using K-Means and FCM algorithms on the MS subgroups and control group of healthy individuals, excellent performance outcome has been yielded. According to the clustering results based on the MS subgroups obtained in the study, successful clustering results have been obtained in the K-Means and FCM algorithms by applying the L2 norm of multifractal denoising technique for the MS dataset. Clustering performance has been more successful with the MS Dataset (L2_Norm MS Data Set) K-Means and FCM in which significant attributes are obtained by applying L2 Norm Denoising technique.

Keywords: clinical decision support, clustering algorithms, multiple sclerosis, multifractal techniques

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Authors: Sema Kayapinar, Ismail Karaoglan, Turan Paksoy, Hadi Gokcen

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Green Supply Chain Management is gaining growing interest among researchers and supply chain management. The concept of Green Supply Chain Management is to integrate environmental thinking into the Supply Chain Management. It is the systematic concept emphasis on environmental problems such as reduction of greenhouse gas emissions, energy efficiency, recycling end of life products, generation of solid and hazardous waste. This study is to present a green supply chain network model integrated Internet of Things applications. Internet of Things provides to get precise and accurate information of end-of-life product with sensors and systems devices. The forward direction consists of suppliers, plants, distributions centres and sales and collect centres while, the reverse flow includes the sales and collects centres, disassembled centre, recycling and disposal centre. The sales and collection centre sells the new products are transhipped from factory via distribution centre and also receive the end-of life product according their value level. We describe green logistics activities by presenting specific examples including “recycling of the returned products and “reduction of CO2 gas emissions”. The different transportation choices are illustrated between echelons according to their CO2 gas emissions. This problem is formulated as a mixed integer linear programming model to solve the green supply chain problems which are emerged from the environmental awareness and responsibilities. This model is solved by using Gams package program. Numerical examples are suggested to illustrate the efficiency of the proposed model.

Keywords: green supply chain optimization, internet of things, greenhouse gas emission, recycling

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Authors: Musarrat Jabeen

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Thoughtful intelligence offers a sustainable position to enhance the influence of decision-makers. Thoughtful Intelligence implies the understanding to realize the impact of one’s thoughts, words and actions on the survival, dignity and development of the individuals, groups and nations. Thoughtful intelligence has received minimal consideration in the area of Decision Support Systems, with an end goal to evaluate the quantity of knowledge and its viability. This pattern degraded the imbibed contribution of thoughtful intelligence required for sustainable decision making. Given the concern, this paper concentrates on the question: How to present a model of Thoughtful Decision Support System (TDSS)? The aim of this paper is to appreciate the concepts of thoughtful intelligence and insinuate a Decision Support System based on thoughtful intelligence. Thoughtful intelligence includes three dynamic competencies: i) Realization about long term impacts of decisions that are made in a specific time and space, ii) A great sense of taking actions, iii) Intense interconnectivity with people and nature and; seven associate competencies, of Righteousness, Purposefulness, Understanding, Contemplation, Sincerity, Mindfulness, and Nurturing. The study utilizes two methods: Focused group discussion to count prevailing Decision Support Systems; 70% results of focus group discussions found six decision support systems and the positive inexistence of thoughtful intelligence among decision support systems regarding sustainable decision making. Delphi focused on defining thoughtful intelligence to model (TDSS). 65% results helped to conceptualize (definition and description) of thoughtful intelligence. TDSS is offered here as an addition in the decision making literature. The clients are top leaders.

Keywords: thoughtful intelligence, sustainable decision making, thoughtful decision support system

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Authors: Angela Maria Fenu

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The aim of this study was to better characterize the nature of word association responses in people with aphasia. The participants selected for the experimental group were 4 individuals with mild Broca’s aphasia. The control group consisted of 51 cognitively intact age- and gender-matched individuals. The participants were asked to perform a word association task in which they had to say the first word they thought of when hearing each cue. The cue words (n= 16) were the translation in Italian of the set of English cue words of a published study. The participants from the experimental group were administered the word association test every two weeks for a period of two months when they received speech-language therapy A combination of analytical approaches to measure the data was used. To analyse different patterns of word association responses in both groups, the nature of the relationship between the cue and the response was examined: responses were divided into five categories of association. To investigate the similarity between aphasic and non-aphasic subjects, the stereotypy of responses was examined.While certain stimulus words (nouns, adjectives) elicited responses from Broca’s aphasics that tended to resemble those made by non-aphasic subjects; others (adverbs, verbs) showed the tendency to elicit responses different from the ones given by normal subjects. This suggests that some mechanisms underlying certain types of associations are degraded in aphasics individuals, while others display little evidence of disruption. The high number of paradigmatic associations given in response to a noun or an adjective might imply that the mechanisms, largely semantic, underlying paradigmatic associations are relatively preserved in Broca’s aphasia, but it might also mean that some words are more easily processed depending on their grammatical class (nouns, adjectives). The most significant variation was noticed when the grammatical class of the cue word was an adverb. Unlike the normal individuals, the experimental subjects gave the most idiosyncratic associations, which are often produced when the attempt to give a paradigmatic response fails. In turn, the failure to retrieve paradigmatic responses when the cue is an adverb might suggest that Broca’s aphasics are more sensitive to this grammatical class.The findings from this study suggest that, from research on word associations in people with aphasia, important data can arise concerning the specific lexical retrieval impairments that characterize the different types of aphasia and the various treatments that might positively influence the kinds of word association responses affected by language disruption.

Keywords: aphasia therapy, clinical linguistics, word-association behaviour, mental lexicon

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Authors: Maryam Shahbazi, Amy B. Cerato

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The importance of a systems’ natural frequency (fn) emerges when the vibration force frequency is equivalent to foundation's fn which causes response amplitude (resonance) that may cause irreversible damage to the structure. Several factors such as pile geometry (e.g., length and diameter), soil density, load magnitude, pile condition, and physical structure affect the fn of a soil-pile system; some of these parameters are evaluated in this study. Although experimental and analytical studies have assessed the fn of a soil-pile system, few have included individual and grouped helical piles. Thus, the current study aims to provide quantitative data on dynamic characteristics of helical pile-soil systems from full-scale shake table tests that will allow engineers to predict more realistic dynamic response under motions with variable frequency ranges. To evaluate the fn of single and grouped helical piles in dry dense sand, full-scale shake table tests were conducted in a laminar box (6.7 m x 3.0 m with 4.6 m high). Two different diameters (8.8 cm and 14 cm) helical piles were embedded in the soil box with corresponding lengths of 3.66m (excluding one pile with length of 3.96) and 4.27m. Different configurations were implemented to evaluate conditions such as fixed and pinned connections. In the group configuration, all four piles with similar geometry were tied together. Simulated real earthquake motions, in addition to white noise, were applied to evaluate the wide range of soil-pile system behavior. The Fast Fourier Transform (FFT) of measured time history responses using installed strain gages and accelerometers were used to evaluate fn. Both time-history records using accelerometer or strain gages were found to be acceptable for calculating fn. In this study, the existence of a pile reduced the fn of the soil slightly. Greater fn occurred on single piles with larger l/d ratios (higher slenderness ratio). Also, regardless of the connection type, the more slender pile group which is obviously surrounded by more soil, yielded higher natural frequencies under white noise, which may be due to exhibiting more passive soil resistance around it. Relatively speaking, within both pile groups, a pinned connection led to a lower fn than a fixed connection (e.g., for the same pile group the fn’s are 5.23Hz and 4.65Hz for fixed and pinned connections, respectively). Generally speaking, a stronger motion causes nonlinear behavior and degrades stiffness which reduces a pile’s fn; even more, reduction occurs in soil with a lower density. Moreover, fn of dense sand under white noise signal was obtained 5.03 which is reduced by 44% when an earthquake with the acceleration of 0.5g was applied. By knowing the factors affecting fn, the designer can effectively match the properties of the soil to a type of pile and structure to attempt to avoid resonance. The quantitative results in this study assist engineers in predicting a probable range of fn for helical pile foundations under potential future earthquake, and machine loading applied forces.

Keywords: helical pile, natural frequency, pile group, shake table, stiffness

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Authors: Orish E. Orisakwe, Chinna N. Orish, Anthonet N. Ezejiofor

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African mesquite has been recognized for its antimicrobial, anti-inflammatory, and potential anticarcinogenic activities. However, its neuroprotective benefits against heavy metal-induced neurotoxicity remain largely unexplored. Therefore, the objective of this study was to investigate the neuroprotective properties of African mesquite in the hippocampus and olfactory bulb against common environmental pollutants, including Cd, As, Hg, and Pb. Thirty-five albino Sprague Dawley rats were divided into five groups for the experiment. Group 1 served as the control and did not receive either the heavy metal mixture (HMM) or African mesquite. Group 2 was orally administered HMM, consisting of PbCl2 (20 mg/kg), CdCl2 (1.61 mg/kg), HgCl2 (0.40 mg/kg), and NaAsO3 (10 mg/kg), for 960 days. Meanwhile, groups 3, 4, and 5 were treated with HMM along with African mesquite at doses of 500 mg/kg, 1000 mg/kg, and 1500 mg/kg, respectively. African mesquite reduced heavy metal accumulation in the hippocampus and olfactory bulb. Additionally, Sprague Dawley rats exhibited improved performance in the Passive avoidance and Cincinnati Maze tests. Furthermore, treatment with African mesquite significantly alleviated inflammation macromolecules peroxidation. It also restored the concentrations of SOD, CAT, GSH, GPx, Hmox-1, and reduced the activity of AChE, NRF2 and NFkB and improved histopathological findings. African mesquite exhibits a multifaceted neuroprotective effect with the potential to mitigate various aspects of heavy metal-induced neurotoxicity.

Keywords: African mesquite, heavy metal mixture;, neurotoxicity;, chemoprevention

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Authors: Amal Saafan, Kareem Al Sofy, Sameh AbdelGhani, Magdy Amin

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Background: Acinetobacter spp. resistance towards β-lactam antibiotics is mediated mainly by different classes of β-lactamases production; detection of some genes responsible for production of β-lactamases is the objective of the study. Methods: One hundred fifty bacterial isolates were recovered from blood, sputum, and urine specimens from different hospitals in Egypt. Sixty-nine isolate were identified as Acinetobacter baumannii using traditional biochemical tests, CHROM agar, MicroScan and PCR amplification of blaoxa-51like gene. Acinetobacterbaumannii isolates were grouped into carbapenem resistant group (GP1), cefotaxime, ceftazidime and cefoxitin resistant group (GP2) and carbapenem and cephalosporin non-resistant group (GP3). Carbapenemase activity was screened using modified Hodge test (MHT) for GP1.Metallo-β-lactamases screening was performed for MHT positive isolates using double disk synergy test (DDST) and combined disk test (CDT). Amp C activity was screened using Amp C disk test with Tris-EDTA, DDST, and CDT for GP2. Finally, PCR amplification of blaoxa-51like, blaoxa-23like, blaIMP-like, blaVIM-like, and blaADC-like genes was performed for isolates that showed, at least, two positive results of three for both AmpC and carbapenemases phenotypic screening tests (obvious activity), in addition to GP3 (for comparison). Detection of blaoxa-51like and blaADC-like genes preceded by ISAba1 was also performed. Results: Antibiogram of 69 pure Acinetobacter baumannii isolates resulted in 57, 64, and 2 isolates enrolled into GP1, GP2, and GP3, respectively. Carbapenemase activity was shown by 49(85.9%) isolate using MHT. Metallo-β-lactamases screening revealed 32(65.3%) and 35(71.4%) using DDST and CDT, respectively.AmpC activity was shown by 43(67.2%) and 50 (78.1%) isolates using AmpC disk test with Tris-EDTA, and both DDST and CDT, respectively. Twenty-seven isolates showed obvious activity, all of them (100%) were harboring blaoxa-51like and blaADC-like genes, while blaoxa-23like, blaIMP-like andblaVIM-like genes were harbored by 23(85.2%), 9 (33.%) and no isolate respectively. Only 12 (44.4%) isolates harbored blaoxa-51like and blaADC-like genes preceded by ISAba1. GP3 isolates showed only positive blaoxa-51like and blaADC-like genes. Conclusion: It is not possible to correlate resistance with presence of blaoxa-51like and blaADC-like genes and presence of ISAba1 was immediate as transcriptional promoter. A blaoxa-23like gene played an important role in carbapenem resistance when compared with blaIMP-like and blaVIM-like gene.

Keywords: acinetobacter, beta-lactams, resistance, antimicrobial agents

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Authors: Po-Ting Chen, Santhanamoorthi Nachimuthu, Jyh-Chiang Jiang

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Classical molecular dynamics (CMD) simulations are highly efficient for material simulations but have limited accuracy. In contrast, ab initio molecular dynamics (AIMD) provides high precision by solving the Kohn–Sham equations yet requires significant computational resources, restricting the size of systems and time scales that can be simulated. To address these challenges, we employed NequIP, a machine learning model based on an E(3)-equivariant graph neural network, to accelerate molecular dynamics simulations of a 1M LiPF6 in EC/EMC (v/v 3:7) for Li battery applications. AIMD calculations were initially conducted using the Vienna Ab initio Simulation Package (VASP) to generate highly accurate atomic positions, forces, and energies. This data was then used to train the NequIP model, which efficiently learns from the provided data. NequIP achieved AIMD-level accuracy with significantly less training data. After training, NequIP was integrated into the LAMMPS software to enable molecular dynamics simulations of larger systems over longer time scales. This method overcomes the computational limitations of AIMD while improving the accuracy limitations of CMD, providing an efficient and precise computational framework. This study showcases NequIP’s applicability to electrolyte systems, particularly for simulating the dynamics of LiPF6 ionic mixtures. The results demonstrate substantial improvements in both computational efficiency and simulation accuracy, highlighting the potential of machine learning models to enhance molecular dynamics simulations.

Keywords: lithium-ion batteries, electrolyte simulation, molecular dynamics, neural network

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Authors: Nseabasi Nsikakabasi Etim

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In recent times, there has been a significant shortfall in between the production and supply of animal protein to meet the ever increasing population. To meet the increasing demand for animal protein, there is a need to focus attention on the production of livestock whose nutritional requirement does not put much strain on the limited sources of feed ingredients to which men subscribe. An example of such livestock is the rabbit. Rabbit is a pseudo-ruminant herbivore which utilizes much undigested and unabsorbed feed materials as sources of nutrient for maintenance and production. Thus, this study was conducted to investigate the effects of feeding Aspilia africana as forage on the growth rates of female pseudo-ruminant herbivores (rabbits) at different physiological states. Thirty (30) Dutch breed rabbit does of 5–6 months of age were used for the experiment which was conducted in a completely randomized design for four months. The rabbits were divided into three treatment groups, ten does per treatment group; which consisted of mixed forages (Centrosema pubescent (200g), Panicum maximum (200g) and Ipomea batatas leaves (100g) without Aspilia africana (T1; control), fresh Aspilia africana (500g/dose/day) (T2) and wilted Aspilia africana (500g/dose/day) (T3). Rabbits in all treatment groups received the same concentrate (300g/animal/day) throughout the period of the study and mixed forages from the commencement of the experiment till the does kindled. After parturition, fresh and wilted Aspilia africana were introduced in treatments 2 and three respectively, whereas the control group continued on mixed forages throughout the study. The result of the study revealed that the initial average body weight of the rabbit does was 1.74kg. At mating and gestation periods, the body weights of the does in T2 was significantly higher (P<0.05) than the rest. There were no significant differences (P<0.05) in the body weights of does at kindling between the various treatment groups. During the physiological states of lactation, weaning and re-mating, the control group (T1) had significantly lower body weight than those of the treated groups (T2 and T3). Furthermore, T2 had significantly higher body weight than T3. The study revealed that Aspilia africana; mainly the fresh leaves have greater growth stimulating effects when fed to pseudo-ruminants (rabbits), thereby enhancing body weights of does during lactation and weaning.

Keywords: Aspilia africana, herbivores, pseudo-ruminants, physiological states

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Authors: Paulo Teodoro De Luna Carada, Toru Fujii, Kazuya Okubo

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Natural fibers have wide variety of uses (e.g., rope, paper, and building materials). One specific application of it is in the field of composite materials (i.e., green composites). Huge amount of research are being done in this field due to rising concerns in the harmful effects of synthetic materials to the environment. There are several natural fibers used in this field, one of which can be extracted from a plant called kenaf (Hibiscus cannabinus L.). Kenaf fiber is regarded as a good alternative because the plant is easy to grow and the fiber is easy to extract. Additionally, it has good properties. Treatments, which are classified as mechanical or chemical in nature, can be done in order to improve the properties of the fiber. The aim of this study is to assess the effects of heat treatment in kenaf fiber. It specifically aims to observe the effect in the tensile strength and modulus of the fiber. Kenaf fiber bundles with an average diameter of at most 100μm was used for this purpose. Heat treatment was done using a constant temperature oven with the following heating temperatures: (1) 160̊C, (2) 180̊C, and (3) 200̊C for a duration of one hour. As a basis for comparison, tensile test was first done to kenaf fibers without any heat treatment. For every heating temperature, three groups of samples were prepared. Two groups of which were for doing tensile test (one group was tested right after heat treatment while the remaining group was kept inside a closed container with relative humidity of at least 95% for two days). The third group was used to observe how much moisture the treated fiber will absorb when it is enclosed in a high moisture environment for two days. The results showed that kenaf fiber can retain its tensile strength when heated up to a temperature of 160̊C. However, when heated at a temperature of about 180̊C or higher, the tensile strength decreases significantly. The same behavior was observed for the tensile modulus of the fiber. Additionally, the fibers which were stored for two days absorbed nearly the same amount of moisture (about 20% of the dried weight) regardless of the heating temperature. Heat treatment might have damaged the fiber in some way. Additional test was done in order to see if the damage due to heat treatment is attributed to changes in the viscoelastic property of the fiber. The findings showed that kenaf fibers can be heated for at most 160̊C to attain good tensile strength and modulus. Additionally, heating the fiber at high temperature (>180̊C) causes changes in its viscoelastic property. The results of this study is significant for processes which requires heat treatment not only in kenaf fiber but might also be helpful for natural fibers in general.

Keywords: heat treatment, kenaf fiber, natural fiber, mechanical properties

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Authors: Samira Akdader-Oudahmane; Assia Kamel ; Lynda Lakabi ;Ferroudja Medjdoub; Zohra Hamouli-Said

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Background and Objectives: The relationship between the adrenal axis and the thyroid axis is very complex. Several studies have shown a possible relationship between the activation of the HPA axis and the function of the thyroid gland. The aim of it study was to investigate the structure and activity of the thyroid gland after adrenal activating treatment in female Wistar rats and to evaluate the circulating cortisol in a population of women with thyroid dysfunction. Material and methods: The work was carried out in female Wistar rats divided into two groups: a control group (T) and a treated group (S) receiving a daily intramuscular injection of Cortrosyn at a rate of 0.01 mg/100g of body weight (BW) for 20 days and in a population of women of reproductive age divided into two groups: the control population (C) and the population with thyroid dysfunction (hypothyroidism and hyperthyroidism). Hormone levels are determined by radioimmunoassay and immunoradiometry. The thyroid gland is fixed for histological study. Results : Administration of Cortrosyn to rats at doses of 0.01 mg/100 g BW shows a significant decrease in food and water consumption, resulting in reduced body weight and changes in the structure of the thyroid gland. Significant changes in plasma thyroid hormone levels in our animals and significant changes in plasma cortisol levels in the hyperthyroid were observed with an interrelationship between the two glands. Conclusion: These results demonstrate that activating factors of the HPA axis such as stress can cause structural and hormonal changes in the thyroid gland.

Keywords: thyroid, hyperthyroidism, hypothyroidism, stress, cortisol.

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Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

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Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

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Authors: Mary Cheptanui Sambu

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Teaching practice is an integral component of students who are training to be teachers, as it provides them with an opportunity to gain experience in an actual teaching and learning environment. This study explored the experiences of trainee teachers from a local university in Kenya, undergoing a three-month teaching practice in Special Secondary schools in the country. The main aim of the study was to understand the trainees’ experiences, their expectations, and the realities encountered during the teaching practice period. The study focused on special secondary schools for learners with hearing impairment. A descriptive survey design was employed and a sample size of forty-four respondents from special secondary schools for learners with hearing impairment was purposively selected. A questionnaire was administered to the respondents and the data obtained analysed using the Statistical Package for the Social Sciences (SPSS). Preliminary analysis shows that challenges facing special secondary schools include inadequate teaching and learning facilities and resources, low academic performance among learners with hearing impairment, an overloaded curriculum and inadequate number of teachers for the learners. The study findings suggest that the Kenyan government should invest more in the education of special needs children, particularly focusing on increasing the number of trained teachers. In addition, the education curriculum offered in special secondary schools should be tailored towards the needs and interest of learners. These research findings will be useful to policymakers and curriculum developers, and will provide information that can be used to enhance the education of learners with hearing impairment; this will lead to improved academic performance, consequently resulting in better transitions and the realization of Vision 2030.

Keywords: hearing impairment, special secondary schools, trainee, teaching practice

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Authors: Fanny Soulard

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Today work environment is more multicultural than ever: spatial limits have been blown out, encouraging people and ideas mobility all around the globe. Indeed, opportunities to design with culturally diverse team workers, clients, or end-users, have become within everyone's reach. We enjoy traveling to discover other civilizations, but when it comes to business, we often take for granted that our own work methodology will be generic enough to federate each party and cover the project needs. This paper aims to explore why, by skipping cultural awareness, we often create misunderstandings, frustration, and even counterproductive design. Tree lighting projects successively developed by a French lighting studio, a Vietnamese lighting studio, and an Australian Engineering company will be assessed from their concept stage to completion. All these study cases are based in Vietnam, where the construction market is equally led by local and international consultants. Core criteria such as lighting standard reference, service scope, communication tools, internal team organization, delivery package content, key priorities, and client relationship will help to spot and list when and how cultural diversity has impacted the design output and effectiveness. On the second hand, we will demonstrate through the same selected projects how intercultural intelligence tools and mindset can not only respond positively to previous situations and avoid major clashes but also turn cultural differences into a key added value to generate significant benefits for individuals, teams, and companies. By understanding the major importance of including a cultural factor within any design, intercultural intelligence will quickly turn out as a “must have” skill to be developed and acquired by any designer.

Keywords: intercultural intelligence, lighting design, work methodology, multicultural diversity

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Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

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In the context of developing countries, this study explores a crucial component of economic development by examining the reasons behind the failure of small and medium-sized enterprises (SMEs). SMEs are acknowledged as essential drivers of economic expansion, job creation, and poverty alleviation in emerging countries. This research uses South Africa as a case study to evaluate the reasons why SMEs fail in developing nations. This study explores a quantitative research methodology to investigate the complex causes of SME failures using statistical tools and reliability tests. To ensure the viability of data collection, a sample size of 400 small business owners was chosen using a non-probability selection technique. A closed-ended questionnaire was the primary technique used to obtain detailed information from the participants. Data was analysed and interpreted using computer software packages such as the Statistical Package for the Social Sciences (SPSS). According to the findings, the main reasons why SMEs fail in developing nations are a lack of strategic business planning, a lack of funding, poor management, a lack of innovation, a lack of business research and a low level of education and training. The results of this study show that SMEs can be sustainable and successful as long as they comprehend and use the suggested small business success determining variables into their daily operations. This implies that the more SMEs in developing countries implement the proposed determinant factors of small business success in their business operations the more the businesses are likely to succeed and vice versa.

Keywords: failure, developing countries, SMEs, economic development, South Africa

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Authors: Tom S. Owens, Tom A. Calverley, Benjamin S. Stacey, Christopher J. Marley, George Rose, Lewis Fall, Gareth L. Jones, Priscilla Williams, John P. R. Williams, Martin Steggall, Damian M. Bailey

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Introduction and aims: Sports-related concussion (SRC) represents a significant and growing public health concern in rugby union, yet remains one of the least understood injuries facing the health community today. Alongside increasing SRC incidence rates, there is concern that prior recurrent concussion may contribute to long-term neurologic sequelae in later-life. This may be due to an accelerated decline in cerebral perfusion, a major risk factor for neurocognitive decline and neurodegeneration, though the underlying mechanisms remain to be established. The present study hypothesised that recurrent concussion in current professional rugby union players would result in elevated systemic oxidative-nitrosative stress, reflected by a free radical-mediated reduction in nitric oxide (NO) bioavailability and impaired cerebrovascular and cognitive function. Methodology: A longitudinal study design was adopted across the 2017-2018 rugby union season. Ethical approval was obtained from the University of South Wales Ethics Committee. Data collection is ongoing, and therefore the current report documents result from the pre-season and first half of the in-season data collection. Participants were initially divided into two subgroups; 23 professional rugby union players (aged 26 ± 5 years) and 22 non-concussed controls (27 ± 8 years). Pre-season measurements were performed for cerebrovascular function (Doppler ultrasound of middle cerebral artery velocity (MCAv) in response to hypocapnia/normocapnia/hypercapnia), cephalic venous concentrations of the ascorbate radical (A•-, electron paramagnetic resonance spectroscopy), NO (ozone-based chemiluminescence) and cognition (neuropsychometric tests). Notational analysis was performed to assess contact in the rugby group throughout each competitive game. Results: 1001 tackles and 62 injuries, including three concussions were observed across the first half of the season. However, no associations were apparent between number of tackles and any injury type (P > 0.05). The rugby group expressed greater oxidative stress as indicated by increased A•- (P < 0.05 vs. control) and a subsequent decrease in NO bioavailability (P < 0.05 vs. control). The rugby group performed worse in the Ray Auditory Verbal Learning Test B (RAVLT-B, learning, and memory) and the Grooved Pegboard test using both the dominant and non-dominant hands (visuomotor coordination, P < 0.05 vs. control). There were no between-group differences in cerebral perfusion at baseline (MCAv: 54 ± 13 vs. 59 ± 12, P > 0.05). Likewise, no between-group differences in CVRCO2Hypo (2.58 ± 1.01 vs. 2.58 ± 0.75, P > 0.05) or CVRCO2Hyper (2.69 ± 1.07 vs. 3.35 ± 1.28, P > 0.05) were observed. Conclusion: The present study identified that the rugby union players are characterized by impaired cognitive function subsequent to elevated systemic-oxidative-nitrosative stress. However, this appears to be independent of any functional impairment in cerebrovascular function. Given the potential long-term trajectory towards accelerated cognitive decline in populations exposed to SRC, prophylaxis to increase NO bioavailability warrants consideration.

Keywords: cognition, concussion, mild traumatic brain injury, rugby

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Authors: Leonardo E. Pacheco, Carlos A. Díaz

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An alternative way of addressing the difficult to recover the useless heat is through an ejector refrigeration cycle for vehicles applications. A group of thermo-compressor supply the mechanical compressor function at conventional refrigeration compression system. The thermo-compressor group recovers the thermal energy from waste streams (exhaust gases product in internal combustion motors, gases burned in wellhead among others) to eliminate the power consumption of the mechanical compressor. These types of alternative cooling system (air-conditioners) present a kind of advantages in both the increase in energy efficiency and the improvement of the COP of the system being studied from their its mechanical simplicity (decrease of moving parts). An ejector refrigeration cycle represents a significant step forward in the optimization of the efficient use of energy in the process of air conditioning and an alternative to reduce the environmental impacts. On one side, with the energy recycling decreases the temperature of the gases thrown into the atmosphere, which contributes to the principal beneficiaries of the average temperature of the planet. In parallel, mitigating the environmental impact caused by the production and handling of conventional cooling fluids commonly available in the market, causing the destruction of the ozone layer. This work had studied the operation of the multiejector cooling system for a truck with a 420 HP engine at different rotation speed. The operation condition limits and the COP of multi-ejector cooling systems applied in a truck are analyzed for a variable rpm range from to 800–1800 rpm.

Keywords: ejector system, exhaust gas, multiejector cooling system, recovery energy

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of ANC include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding antenatal care. Methodology: A descriptive KAP study was conducting in public hospitals in Sana'a City-Yemen. The study population was included all pregnant women that intended to the prenatal department and clinical outpatient department, the final sample size was 371 pregnant women, a self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women were had correct answers in total knowledge regarding antenatal care, and about two-thirds (67%) of pregnant women were had performance practice regarding antenatal care and two-third (68%) of pregnant women were had a positive attitude. Conclusions & Recommendations: We concluded that a significant association between overall knowledge and practice level toward antenatal care and demographic characteristics of pregnant women, women (residence place, level of education, did your husband support you in attending antenatal care and place of delivery of the last baby), at (P-value ≤ 0.05). We recommended more education and training courses, lecturers and education sessions in clinical facilitators focused ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: antenatal care, knowledge, practice, attitude, pregnant women

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Authors: Armana Huq

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Railway networks have a significant role in the economy of any country. Similar to other transportation modes, many lives suffer from fatalities or injuries caused by accidents related to the railway. Railway accidents are not as common as roadway accidents yet they are more devastating and damaging than other roadway accidents. Despite that, issues related to railway accidents are not taken into consideration with significant attention as a major threat because of their less frequency compared to other accident categories perhaps. However, the Federal Railroad Administration reported nearly twelve thousand train accidents related to the railroad in the year 2014, resulting in more than eight hundred fatalities and thousands of injuries in the United States alone of which nearly one third fatalities resulted from railway crossing accidents. From an analysis of railway accident data of six years (2005-2010), it has been revealed that 344 numbers of the collision were occurred resulting 200 people dead and 443 people injured in Bangladesh. This paper includes a comprehensive overview of the railway safety situation in Bangladesh from 1998 to 2015. Each year on average, eight fatalities are reported in at-grade level crossings due to railway accidents in Bangladesh. In this paper, the number of railway accidents that occurred in Bangladesh has been presented and a fatality rate of 58.62% has been estimated as the percentage of total at-grade railway level crossing accidents. For this study, analysis of railway accidents in Bangladesh for the period 1998 to 2015 was obtained from the police reported accident database using MAAP (Microcomputer Accident Analysis Package). Investigation of the major contributing factors to the railway accidents has been performed using the Multinomial Logit model. Furthermore, hotspot analysis has been conducted using ArcGIS. Eventually, some suggestions have been provided to mitigate those accidents.

Keywords: safety, human factors, multinomial logit model, railway

Procedia PDF Downloads 156

Authors: Andi Tenri Ayu Rahman, Citrakesumasari, Devintha Virani

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Breast milk is the complex biological fluid mix of macronutrient and micronutrient that are considered as perfect food for babies. Zinc has a role in various biological functions and physical growth. This research aims to know the average zinc (Zn) micronutrients content of breast milk by determinants of infant (birth weight) and mother (nutritional status and food intake) and description of the pattern of mothers breastfeeding. The type of research used is observational analytic with cross-sectional study design. The population was 41 mothers in Kassi-Kassi health center within one month. Sample research is mothers who gave birth at term and breastfed her baby. Sampling was done with random sampling technique involving 37 people. Samples of breast milk were analyzed in the laboratory by using the method of Atomic Absorption Spectrofotometry (AAS). This research find that from the samples (n=37) the average contents of zinc in the breast milk is 0,88±0,54 mg/L with the highest value on the group of low birth weight babies (1,13 ± 0,67mg/L), mothers who had normal nutritional status (0,981 ± 0,514 mg/L) and intake low zinc (0,94 ± 0,54 mg/L). Regarding breastfeeding pattern, 67,6% of the samples had had breastfeeding experience and 81,1% of breastfed more than eight times a day. In summary, the highest average value of the zinc content of breast milk was in the group of low birth weight babies, mother with normal nutritional status, and mothers having relatively low intake pattern.

Keywords: zinc, breastmilk, mother, baby

Procedia PDF Downloads 194

Authors: O. D. Adegbehingbe, S. D. Eyono Obono

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The education sector is constantly faced with rapid changes in technologies in terms of ensuring that the curriculum is up to date and in terms of making sure that students are aware of these technological changes. This challenge can be seen as the motivation for this study, which is to examine the factors affecting computing students’ awareness of the latest Information Technologies (ICTs). The aim of this study is divided into two sub-objectives which are: the selection of relevant theories and the design of a conceptual model to support it as well as the empirical testing of the designed model. The first objective is achieved by a review of existing literature on technology adoption theories and models. The second objective is achieved using a survey of computing students in the four universities of the KwaZulu-Natal province of South Africa. Data collected from this survey is analyzed using Statistical package for the Social Science (SPSS) using descriptive statistics, ANOVA and Pearson correlations. The main hypothesis of this study is that there is a relationship between the demographics and the prior conditions of the computing students and their awareness of general ICT trends and of Digital Switch Over (DSO) a new technology which involves the change from analog to digital television broadcasting in order to achieve improved spectrum efficiency. The prior conditions of the computing students that were considered in this study are students’ perceived exposure to career guidance and students’ perceived curriculum currency. The results of this study confirm that gender, ethnicity, and high school computing course affect students’ perceived curriculum currency while high school location affects students’ awareness of DSO. The results of this study also confirm that there is a relationship between students prior conditions and their awareness of general ICT trends and DSO in particular.

Keywords: education, information technologies, IDT, awareness

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Authors: Emmanuel S. Adeyanju

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This study assessed the effects of continuous training on anthropometric characteristics of adolescents in Kano, Nigeria. The anthropometric measures of per cent body fat (%BF), body mass index (BMI), conicity index (CI) and waist-to-hip ratio (WHR) were selected because of their roles in increased adiposity and favourable cardiovascular disease (CVD) factor profiles in children and adolescence. The international standards and procedures were followed in all the measurements. A total of thirty (30) subjects (M=15; F=15), selected at random, were divided into two groups; one training (M=10; F=10) and the other control (M=5; F=5). Both groups were tested before training, at six (6) and 12 weeks in all the listed variables. The training group had 12 weeks continuous training which involved running round the standard 400 m track of the college following standard procedures; while the control group did not. The findings revealed significant sex-specific reductions in %BF (F=610.482 ˂ 0.05), BMI (F=73.860 ˂ 0.05), WHR (F=49.756 ˂ 0.05); however, no significant training effect on CI (F=1.855 ˃ 0.05) and WHR (F=1.956 ˃ 0.05) was found. Greater modifications found in females than in males (except in CI and WHR) due to training were probably related to their initial level of fitness and enzymatic modifications at subcellular level during training. The result also revealed significant relationship between the modifications in %BF, BMI and WHR but failed to establish any between CI and other adiposity measures. Thus, to avert the consequences of obesity and overweight, the declining fitness level of adolescents should be checked by ensuring they engaged in regular moderate-to-vigorous physical activity (MVPA) programmes. Such a childhood habit of exercise developed early in life will have a carry-over value into adult life and improve the quality of adult population.

Keywords: adiposity, anthropometry, conicity, continuous training

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Authors: Magdalena Maria Rost-Roszkowska, Alina Chachulska-Żymełka, Monika Tarnawska, Maria Augustyniak, Alina Kafel, Agnieszka Babczyńska

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The digestive system of insects is composed of three distinct regions: fore-, mid- and hingut. The middle region (the midgut) is treated as one of the barriers which protects the organism against any stressors which originate from external environment, e.g. toxic metals. Such factors can activate the cell death in epithelial cells to preserve the entire tissue/organs against the degeneration. Different mechanisms involved in homeostasis maintenance have been described, but the studies of animals under field conditions do not give the opportunity to conclude about potential ability of subsequent generation to inherit the tolerance mechanisms. It is possible only by a multigenerational strain of an animal led under laboratory conditions, exposed to a selected toxic factor, present also in polluted ecosystems. The main purpose of the project was to check if changes, which appear in the midgut epithelium after Cd treatment, can be fixed during the following generations of insects with the special emphasis on apoptosis. As the animal for these studies we chose 5th larval stage of the beet armyworm Spodoptera exigua Hübner (Lepidoptera: Noctuidae), which is one of pest of many vegetable crops. Animals were divided into some experimental groups: K, Cd, KCd, Cd1, Cd2, Cd3. A control group (K) fed a standard diet, and was conducted for XX generations, a cadmium group (Cd), fed on standard diet supplemented with cadmium (44 mg Cd per kg of dry weight of food) for XXX generations. A reference Cd group (KCd) has been initiated: control insects were fed with Cd supplemented diet (44 mg Cd per kg of dry weight of food). Experimental groups Cd1, Cd2, Cd3 developed from the control one: 5 mg Cd per kg of dry weight of food, 10 mg Cd per kg of dry weight of food, 20 mg Cd per kg of dry weight of food. We were interested in the activation of apoptosis during following generations in all experimental groups. Therefore, during the 1st year of the experiment, the measurements were done for 6 generations in all experimental group. The intensity and the course of apoptosis have been examined using transmission electron microscope (TEM), confocal microscope and flow cytometry. During apoptosis the cell started to shrink, extracellular spaces appeared between digestive and neighboring cells, the nucleus achieved a lobular shape. Eventually, the apoptotic cells was discharged into the midgut lumen. A quantitative analysis revealed that the number of apoptotic cells depends significantly on the generation, tissue and cadmium concentration in the insect rearing medium. In the following 6 generations, we observed that the percentage of apoptotic cells in the midguts from cadmium-exposed groups decreased gradually according to the following order of strains: Cd1, Cd2, Cd3 and KCd. At the same time, it was still higher than the percentage of apoptotic cells in the same tissues of the insects from the control and multigenerational cadmium strain. The results of our studies suggest that changes caused by cadmium treatment were preserved during 6-generational development of lepidopteran larvae. The study has been financed by the National Science Centre Poland, grant no 2016/21/B/NZ8/00831.

Keywords: cadmium, cell death, digestive system, ultrastructure

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Authors: Xuechen Chen

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The EU-ASEAN relations which can be dated back to 1972 represents one of the oldest group-to-group relationship in international politics. Despite a longstanding dialogue partnership, the EU and ASEAN have long been reluctant to forge deeper and substantial cooperation in political and security domains. However, the year of 2012 witnessed a salient shift in EU-ASEAN relations, with the EU significantly elevating ASEAN's profile in its external relations. Given the limited scholarly attention that has been devoted to this change in ASEAN-EU relations, this article explores why there has been a greater level of engagement and approximation between the EU and ASEAN. In particular, it asks why the EU, which had long been reluctant to recognize ASEAN as a strategic partner, has changed its policy towards ASEAN. Drawing on social constructivism, this article argues that the EU’s and ASEAN’s evolving identity-formation processes have played a significant role in reshaping their mutual perceptions, which subsequently leads to the modification of the interregional policies of both actors. The methodology of this study is based on content analysis of a wide range of official documents and policy papers from the EU and ASEAN, as well as more than 20 in-depth elite interviews with diplomats and experts working on the EU-ASEAN relationship from both organisations. Departing from the existing works which mainly adopt a Eurocentric perspective when analysing the EU-ASEAN interregionalism, this study suggests that the approximation of the EU-ASEAN relationship between 2012 and 2017 is driven by both actors’ adjustment of international identities, together with the internal dynamics and systematic changes within both regions.

Keywords: Association of Southeast Asia Nations, European Union, EU foreign policy, interregionalism

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Authors: Tomaž Tollazzi, Matjaž Šraml, Chiara Gruden, Marko Renčelj

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Motorcycle riders are an increasing group of road users. The intrinsic characteristics of powered two-wheelers (PTW) allow them to be particularly flexible, both in urban and extra-urban environments. Nevertheless, crash statistics indicate that riders involved in road accidents are highly likely to suffer severe injuries, underlining the vulnerability of this group of road users. An element that can greatly affect the safety of PTW users is road design, as roads are usually designed for two-track vehicles (cars, buses, and lorries) and usually do not consider the needs of PTWs. Additionally, handling a motorcycle is quite different from driving a car; thus, the behavior of riders is different from that of drivers. The aim of this research was to compare how different road designs are perceived by riders and drivers and to preliminarily assess if riders’ behavior and attention allocation are related. For this research, an eye-tracking experiment was developed outdoors. Both drivers and riders travelled along a route comprising four different road designs and various road layouts, and the output was analyzed both qualitatively and quantitatively. Although it was not possible to carry out a statistical analysis due to the limited number of participants, the results demonstrate that there is a difference in the gaze behavior of drivers and riders, with the latter being far more focused on the left-hand side of the road and concentrating on defined elements of road design. Furthermore, the experiment demonstrated that a higher number of fixations is related to lower speeds. Finally, it was noted that both kinds of road users focus well on the carriageway, leading to the conclusion that the indications given through road markings may be much more effective than vertical signalization, which has rarely been observed.

Keywords: road safety, powered two-wheelers, eye-tracking, gaze behavior

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Authors: Saifalarab A. Mohmmed, Morgana E. Vianna, Jonathan C. Knowles

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The issue of apical periodontitis has received considerable critical attention. Bacteria is integrated into communities, attached to surfaces and consequently form biofilm. The biofilm structure provides bacteria with a series protection skills against, antimicrobial agents and enhances pathogenicity (e.g. apical periodontitis). Sodium hypochlorite (NaOCl) has become the irrigant of choice for elimination of bacteria from the root canal system based on its antimicrobial findings. The aim of the study was to investigate the effect of different agitation techniques on the efficacy of 2.5% NaOCl to eliminate the biofilm from the surface of the lateral canal using the residual biofilm, and removal rate of biofilm as outcome measures. The effect of canal complexity (lateral canal) on the efficacy of the irrigation procedure was also assessed. Forty root canal models (n = 10 per group) were manufactured using 3D printing and resin materials. Each model consisted of two halves of an 18 mm length root canal with apical size 30 and taper 0.06, and a lateral canal of 3 mm length, 0.3 mm diameter located at 3 mm from the apical terminus. E. faecalis biofilms were grown on the apical 3 mm and lateral canal of the models for 10 days in Brain Heart Infusion broth. Biofilms were stained using crystal violet for visualisation. The model halves were reassembled, attached to an apparatus and tested under a fluorescence microscope. Syringe and needle irrigation protocol was performed using 9 mL of 2.5% NaOCl irrigant for 60 seconds. The irrigant was either left stagnant in the canal or activated for 30 seconds using manual (gutta-percha), sonic and ultrasonic methods. Images were then captured every second using an external camera. The percentages of residual biofilm were measured using image analysis software. The data were analysed using generalised linear mixed models. The greatest removal was associated with the ultrasonic group (66.76%) followed by sonic (45.49%), manual (43.97%), and passive irrigation group (control) (38.67%) respectively. No marked reduction in the efficiency of NaOCl to remove biofilm was found between the simple and complex anatomy models (p = 0.098). The removal efficacy of NaOCl on the biofilm was limited to the 1 mm level of the lateral canal. The agitation of NaOCl results in better penetration of the irrigant into the lateral canals. Ultrasonic agitation of NaOCl improved the removal of bacterial biofilm.

Keywords: 3D printing, biofilm, root canal irrigation, sodium hypochlorite

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Authors: Habte Tadesse Likassa, Bacha Edosa

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Customer’s satisfaction was very important thing that is required for the existence of banks to be more productive and success in any organization and business area. The main goal of the study is assessing and identifying factors that influence customer’s satisfaction in West Shoa Zone of Commercial Bank of Ethiopia (Holeta, Ginchi, Ambo, Gedo and Bako). Stratified random sampling procedure was used in the study and by using simple random sampling (lottery method) 520 customers were drawn from the target population. By using Probability Proportional Size Techniques sample size for each branch of banks were allocated. Both descriptive and inferential statistics methods were used in the study. A binary logistic regression model was fitted to see the significance of factors affecting customer’s satisfaction in this study. SPSS statistical package was used for data analysis. The result of the study reveals that the overall level of customer’s satisfaction in the study area is low (38.85%) as compared those who were not satisfied (61.15%). The result of study showed that all most all factors included in the study were significantly associated with customer’s satisfaction. Therefore, it can be concluded that based on the comparison of branches on their customers satisfaction by using odd ratio customers who were using Ambo and Bako are less satisfied as compared to customers who were in Holeta branch. Additionally, customers who were in Ginchi and Gedo were more satisfied than that of customers who were in Holeta. Since the level of customers satisfaction was low in the study area, it is more advisable and recommended for concerned body works cooperatively more in maximizing satisfaction of their customers.

Keywords: customers, satisfaction, binary logistic, complain handling process, waiting time

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Authors: Rosely Sichieri, Bruna K. Hassan, Michele Sgambato, Barbara S. N. Souza, Rosangela A. Pereira, Edna M. Yokoo, Diana B. Cunha

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Obesity is increasing at a fast rate in low and middle-income countries where few school-based obesity interventions have been conducted. Results of obesity prevention studies are still inconclusive mainly due to underestimation of sample size in cluster-randomized trials and overestimation of changes in body mass index (BMI). The pooled analysis in the present study overcomes these design problems by analyzing 4,448 students (mean age 11.7 years) from three randomized behavioral school-based interventions, conducted in public schools of the metropolitan area of Rio de Janeiro, Brazil. The three studies focused on encouraging students to change their drinking and eating habits over one school year, with monthly 1-h sessions in the classroom. Folders explaining the intervention program and suggesting the participation of the family, such as reducing the purchase of sodas were sent home. Classroom activities were delivered by research assistants in the first two interventions and by the regular teachers in the third one, except for culinary class aimed at developing cooking skills to increase healthy eating choices. The first intervention was conducted in 2005 with 1,140 fourth graders from 22 public schools; the second, with 644 fifth graders from 20 public schools in 2010; and the last one, with 2,743 fifth and sixth graders from 18 public schools in 2016. The result was a non-significant change in BMI after one school year of positive changes in dietary behaviors associated with obesity. Pooled intention-to-treat analysis using linear mixed models was used for the overall and subgroup analysis by BMI status, sex, and race. The estimated mean BMI changes were from 18.93 to 19.22 in the control group and from 18.89 to 19.19 in the intervention group; with a p-value of change over time of 0.94. Control and intervention groups were balanced at baseline. Subgroup analyses were statistically and clinically non-significant, except for the non-overweight/obese group with a 0.05 reduction of BMI comparing the intervention with control. In conclusion, this large pooled analysis showed a very small effect on BMI only in the normal weight students. The results are in line with many of the school-based initiatives that have been promising in relation to modifying behaviors associated with obesity but of no impact on excessive weight gain. Changes in BMI may require great changes in energy balance that are hard to achieve in primary prevention at school level.

Keywords: adolescents, obesity prevention, randomized controlled trials, school-based study

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Authors: Sarah K. Basudan, Ragad I. Al Jazzar, Zeinah Sulaihim, Hanan M. Al-Kadri

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Background: Cesarean section has been increasing in recent years, with a wide range of etiologies contributing to this rise. This study aimed to assess the indications, outcomes, and complications in Riyadh, Saudi Arabia. Methods: A Retrospective Cohort study was conducted at King Abdulaziz medical city. The study includes two cohorts: G1 (2009) and G2 (2020) groups who met the inclusion criteria. The data was transferred to the SPSS (statistical package for social sciences) version 24 for analysis. The initial descriptive statistics were run for all variables, including numerical and categorical data. The numerical data were reported as median, and standard deviation and categorical data were reported as frequencies and percentages. Results: The data were collected from 399 women who were divided into two groups, G1(199) and G2(200). The mean age of all participants is 32+-6​; G1 and G2 had significant differences in age means with 30+-6 and 34+-5, respectively, with a p-value of <0.001, which indicates delayed fertility by four years. Moreover, a breech presentation was less likely to occur in G2 (OR 0.64, CI: 0.21-0.62. P<0.001). Nonetheless, maternal causes such as repeated C-sections and maternal medical conditions were more likely to happen in G2 (OR 1.5, CI: 1.04-2.38, p=0.03) and (OR 5.4, CI: 1.12-23.9, P=0.01), respectively. Furthermore, postpartum hemorrhage showed an increase of 12% in G2 (OR 5.4, CI: 2.2-13.4, p<0.001). G2 was more likely to be admitted to the neonatal intensive care unit (NICU) (OR 16, CI: 7.4-38.7) and to special care baby (SCB) (OR 7.2, CI: 3.9-13.1), both with a p-value<0.001 compared to regular nursery admission. Conclusion: There are multiple factors that are contributing to the increase in c section rate in a Saudi tertiary hospitals. The factors were suggested to be previous c-sections, abnormal fetal heart rate, malpresentation, and maternal or fetal medical conditions.

Keywords: cesarean sections, maternal indications, maternal complications, neonatal condition

Procedia PDF Downloads 95