Search results for: group Setting

Authors: Gamith Mendis

Abstract:

Even though the doctors are knowledgeable, there's a gap between knowing and being ethical. This is a barrier to establish an ethical doctor-patient relationship. Current health system has oriented in a way that gives a meaning to both the doctor and the patient through intermediate entities. For the doctor, the meaning of the doctor-patient relationship is given through the financial benefits, promotions, and social status. For the patient, the meaning is given through curing of the disease. It is obvious that both are independent entities between the doctor and the patient. As the philosophers like Husserl and Heidegger have pointed out, our subjective world will give the immediate meaningfulness to us. We should seek this immediate meaningfulness of the doctor-patient relationship. The present research has used the existential methodology as guided self-reflections on the lived experiences of a doctor and his students. In this approach, two important aspects have been understood. The first is, establishing the fact that being ethical is itself giving meaningfulness to the doctor’s being without any mediate entities. Simply, it is enjoying being an honest being. The second is by being-with-the-patient while treating the disease; both the doctor and the patient can enjoy the meaningfulness of their human relationship. The medical students and the doctors should focus on this meaningfulness. For that, this discussion should be actively incorporated into the medical curriculum with programs of practical guidance to medical students and should be discussed in patient-care reviews in the health setting within a satisfactory framework.

Keywords: doctor-patient relationship, medical education, medical ethics, medical humanities, qualitative health research

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Authors: Mosab Aljeri, Ali Abdulraheem

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The water quality of five water types at Al-Wuhaib farm, Al-Wafra area, was studies through onsite field measurements, including pH, temperature, electrical conductivity (EC), and dissolved oxygen (DO), for four different water types. Biweekly samples were collected and analyzed for two months to obtain data of chemicals, nutrients, organics, and heavy metals. The field and laboratory results were compared with irrigation standards of Kuwait Environmental Public Authority (KEPA). The pH values of the five samples sites were within the maximum and minimum limits of KEPA standards. Based on EC values, two groups of water types were observed. The first group represents freshwater quality originated from freshwater Ministry of Electricity & Water & Renewable Energy (MEWRE) line or from freshwater tanks or treated wastewater. The second group represents brackish water type originated from groundwater or treated water mixed with groundwater. The study indicated that all nitrogen forms (ammonia, Total Kjeldahl nitrogen (TKN), Total nitrogen (TN)), total phosphate concentrations and all tested heavy metals for the five water types were below KEPA standards. These macro and micro nutrients are essential for plant growth and can be used as fertilizers. The study suggest that the groundwater should be treated and disinfected in the farming area. Also, these type of studies shall be carried out routinely to all farm areas to ensure safe water use and safe agricultural produce.

Keywords: salinity, heavy metals, ammonia, phosphate

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Authors: Syamimi Shamsuddin, Hanafiah Yussof, Fazah Akhtar Hanapiah, Salina Mohamed, Nur Farah Farhan Jamil, Farhana Wan Yunus

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Robot-based intervention for children with autism is an evolving research niche in human-robot interaction (HRI). Recent studies in this area mostly covered the role of robots in the clinical and experimental setting. Our previous work had shown that interaction with a robot pose no adverse effects on the children. Also, the presence of the robot, together with specific modules of interaction was associated with less autistic behavior. Extending this impact on school-going children, interactions that are in-tune with special education lessons are needed. This methodological paper focuses on how a robot can be incorporated in a current learning environment for autistic children. Six interaction scenarios had been designed based on the existing syllabus to teach communication skills, using the Applied Behavior Analysis (ABA) technique as the framework. Development of the robotic experience in class also covers the required set-up involving participation from teachers. The actual research conduct involving autistic children, teachers and robot shall take place in the next phase.

Keywords: autism spectrum disorder, ASD, humanoid robot, communication skills, robot-assisted learning

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Shin-Mei Hsu, Yin-Tzu Lin, Chi Wu

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Background: Obstructive Sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. In addition, Body parameters were identified high predictive importance for OSAS severity. However, the effects of body parameters on OSAS severity remain unclear. Objective: In this study, the objective is to establish a prediction model for OSAS by using body parameters and investigate the effects of body parameters in OSAS. Methodologies: Severity was quantified as the polysomnography and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI) with American Academy of Sleep Medicine (AASM) guideline. Body parameters, including neck circumference, waist size, and body mass index (BMI) were obtained from questionnaire. Next, dividing the collecting subjects into two groups: training and testing groups. The training group was used to establish the random forest (RF) to predicting, and test group was used to evaluated the accuracy of classification. Results: There were 3330 subjects recruited in this study, whom had been done polysomnography for evaluating severity for OSAS. A RF of 1000 trees achieved correctly classified 79.94 % of test cases. When further evaluated on the test cohort, RF showed the waist and BMI as the high import factors in OSAS. Conclusion It is possible to provide patient with prescreening by body parameters which can pre-evaluate the health risks.

Keywords: apnea and hypopnea index, Body parameters, obstructive sleep apnea syndrome, Random Forest

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Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

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Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

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Authors: Sawitree Wongkittirungrueang

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The objectives of this research were: 1) to study the effect of social stories on social interaction of students with autism. The sample was Pratomsuksa level 5 student with autism, Khon Kaen University Demonstration School, who was diagnosed by the Physician as High Functioning Autism since he was able to read, write, calculate and was studying in inclusive classroom. However, he still had disability in social interaction to participate in social activity group and communication. He could not learn how to develop friendship or create relationship. He had inappropriate behavior in social context. He did not understand complex social situations. In addition, he did seemed not know time and place. He was not able to understand feeling of oneself as well as the others. Consequently, he could not express his emotion appropriately. He did not understand or express his non-verbal language for communicating with friends. He lacked of common interest or emotion with nearby persons. He greeted inappropriately or was not interested in greeting. In addition, he did not have eye contact. He used inadequate language etc. He was elected by Purposive Sampling. His parents were willing to allow them to participate in this study. The research instruments were the lesson plan of social stories, and the picture book of social stories. The instruments used for data collection, were the social interaction evaluation of autistic students. This research was Quasi Experimental Research as One Group Pre-test, Post-test Design. For the Pre-test, the experiment was conducted by social stories. Then, the Post-test was implemented. The statistic used for data analysis, included the Mean, and Standard Deviation. The research findings were shown by Graph. The findings revealed hat the autistic students taught by social stories indicated better social interaction after being taught by social stories.

Keywords: social story, autism spectrum disorder (ASD), autism, social interaction

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Authors: Jia Guo, Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Kin Cheung, Jyu-Lin Chen

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Context: Mothers with abdominal obesity, particularly in China, face challenges in managing their health due to family responsibilities. Existing diabetes prevention programs do not cater specifically to this demographic. Research Aim: To assess the feasibility, acceptability, and efficacy of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in reducing weight-related variables and diabetes risk. Methodology: A randomized controlled trial was conducted in Changsha, China, where the mHealth group received personalized modules and health messages, while the control group received general health education. Data were collected at baseline, 3 months, and 6 months. Findings: The mHealth intervention significantly improved waist circumference, modifiable diabetes risk scores, daily steps, self-efficacy for physical activity, social support for physical activity, and physical health satisfaction compared to the control group. However, no differences were found in BMI and certain other variables. Theoretical Importance: The study demonstrates the feasibility and efficacy of a tailored mHealth intervention for Chinese mothers with abdominal obesity, emphasizing the potential for such programs to improve health outcomes in this population. Data Collection: Data on various variables including weight-related measures, diabetes risk scores, behavioral and psychological factors were collected at baseline, 3 months, and 6 months from participants in the mHealth and control groups. Analysis Procedures: Generalized estimating equations were used to analyze the data collected from the mHealth and control groups at different time points during the study period. Question Addressed: The study addressed the effectiveness of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in improving various health outcomes compared to traditional general health education approaches. Conclusion: The tailored mHealth intervention proved to be feasible and effective in improving weight-related variables, physical activity, and physical health satisfaction among Chinese mothers with abdominal obesity, highlighting its potential for delivering diabetes prevention programs to this population.

Keywords: type 2 diabetes, mHealth, obesity, prevention, mothers

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Authors: Chatarina Muryani, Sarwono, Sugiyanto Heribentus

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Major part of Grobogan District, Central Java Province, Indonesia, always suffers from drought every year. The drought has implications toward almost all of the community activities, both domestic, agriculture, livestock, and industrial. The aim of this study was to determine (1) the drought distribution area in Grobogan District in 2015; (2) the impact of drought; and (3) the community adaptation toward the drought. The subject of the research was people who were impacted by the drought, purposive sampling technique was used to draw the sample. The data collection method was using field observation and in-depth interview while the data analysis was using descriptive analysis. The results showed that (1) in 2015, there were 14 districts which were affected by the drought and only 5 districts which do not suffer from drought, (2) the drought impacted to the reduction of water for domestic compliance, reduction of agricultural production, reduction of public revenue, (3) community adaptation to meet domestic water need was by making collective deep-wells and building water storages, adaptation in agriculture was done by setting the cropping pattern, while adaptation on economics was by allocating certain amount of funds for the family in anticipation of drought, which was mostly to purchase water.

Keywords: adaptation, distribution, drought, impacts

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Authors: Mitakshara Sharma, S. K. Nema

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Diabetes mellitus (DM) is metabolic disorder prevalent in pandemic proportions, incurring significant morbidity and mortality due to associated vascular angiopathies. Platelet related thrombogenesis plays key role in pathogenesis of these complications. Most patients with type II DM suffer from preventable vascular complications and early diagnosis can help manage these successfully. These complications are attributed to platelet activation which can be recognised by the increase in Platelet Volume Indices(PVI) viz. Mean Platelet Volume(MPV) and Platelet Distribution Width(PDW). This study was undertaken with the aim of finding a relationship between PVI and vascular complications of Diabetes mellitus, their importance as a causal factor in these complications and use as markers for early detection of impending vascular complications in patients with poor glycaemic status. This is a cross-sectional study conducted for 2 years with total 930 subjects. The subjects were segregated in 03 groups on basis of glycosylated haemoglobin (HbA1C) as: - (a) Diabetic, (b) Non-Diabetic and (c) Subjects with Impaired fasting glucose(IFG) with 300 individuals in IFG and non-diabetic group & 330 individuals in diabetic group. The diabetic group was further divided into two groups: - (a) Diabetic subjects with diabetes related vascular complications (b) Diabetic subjects without diabetes related vascular complications. Samples for HbA1C and platelet indices were collected using Ethylene diamine tetracetic acid(EDTA) as anticoagulant and processed on SYSMEX-XS-800i autoanalyser. The study revealed stepwise increase in PVI from non-diabetics to IFG to diabetics. MPV and PDW of diabetics, IFG and non diabetics were 17.60 ± 2.04, 11.76 ± 0.73, 9.93 ± 0.64 and 19.17 ± 1.48, 15.49 ± 0.67, 10.59 ± 0.67 respectively with a significant p value 0.00 and a significant positive correlation (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r =-0.164). MPV & PDW of subjects with and without diabetes related complications were (15.14 ± 1.04) fl & (17.51±0.39) fl and (18.96 ± 0.83) fl & (20.09 ± 0.98) fl respectively with a significant p value 0.00.The current study demonstrates raised platelet indices & reduced platelet counts in association with rising glycaemic levels and diabetes related vascular complications across various study groups & showed that platelet morphology is altered with increasing glycaemic levels. These changes can be known by measurements of PVI which are important, simple, cost effective, effortless tool & indicators of impending vascular complications in patients with deranged glycaemic control. PVI should be researched and explored further as surrogate markers to develop a clinical tool for early recognition of vascular changes related to diabetes and thereby help prevent them. They can prove to be more useful in developing countries with limited resources. This study is multi-parameter, comprehensive with adequately powered study design and represents pioneering effort in India on account of the fact that both Platelet indices (MPV & PDW) along with platelet count have been evaluated together for the first time in Diabetics, non diabetics, patients with IFG and also in the diabetic patients with and without diabetes related vascular complications.

Keywords: diabetes, HbA1C, IFG, MPV, PDW, PVI

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Authors: Dalal Alghawas, Jetty Lee, Kaisa Poutanen, Hani El-Nezami

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Oat β-glucan a water soluble non starch linear polysaccharide has been approved as a cholesterol lowering agent by various food safety administrations and is commonly used to reduce the risk of heart disease. The molecular weight of oat β-glucan can vary depending on the extraction and fractionation methods. It is not clear whether the molecular weight has a significant impact at reducing the acceleration of atherosclerosis. The aim of this study was to investigate three different oat β-glucan fractionations on the development of atherosclerosis in vivo. With special focus on plaque stability and the intestinal barrier function. To test this, ApoE-/- female mice were fed a high fat diet supplemented with oat bran, high molecular weight (HMW) oat β-glucan fractionate and low molecular weight (LMW) oat β-glucan fractionate for 16 weeks. Atherosclerosis risk markers were measured in the plasma, heart and aortic tree. Plaque size was measured in the aortic root and aortic tree. ICAM-1, VCAM-1, E-Selectin, P-Selectin, protein levels were assessed from the aortic tree to determine plaque stability at 16 weeks. The expression of p22phox at the aortic root was evaluated to study the NADPH oxidase complex involved in nitric oxide bioavailability and vascular elasticity. The tight junction proteins E-cadherin and beta-catenin from western blot analyses were analysed as an intestinal barrier function test. Plasma LPS, intestinal D-lactate levels and hepatic FMO gene expression were carried out to confirm whether the compromised intestinal barrier lead to endotoxemia. The oat bran and HMW oat β-glucan diet groups were more effective than the LMW β-glucan diet group at reducing the plaque size and showed marked improvements in plaque stability. The intestinal barrier was compromised for all the experimental groups however the endotoxemia levels were higher in the LMW β-glucan diet group. The oat bran and HMW oat β-glucan diet groups were more effective at attenuating the development of atherosclerosis. Reasons for this could be due to the LMW oat β-glucan diet group’s low viscosity in the gut and the inability to block the reabsorption of cholesterol. Furthermore the low viscosity may allow more bacterial endotoxin translocation through the impaired intestinal barrier. In future food technologists should carefully consider how to incorporate LMW oat β-glucan as a health promoting food.

Keywords: Atherosclerosis, beta glucan, endotoxemia, intestinal barrier function

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Authors: Iqra Khan, Ghousia Saeed, Salman Jamil

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Fashion is the soul of styles. People of all times want to look trendy, eye catching and unique among all. For this reason, people always adopt different flairs in their outfits including their clothes, shoes, bags and other accessories. However, unfortunately, there is lack of opportunity for accommodating the fashion exposure activities expressed with the folk dances of different regions so as to exhibit the fashion of Pakistan to the world. The paper focuses on the vibrant setting of the whole building according to the social patterns, folk and local trends and existing environment of Lahore. This is done by studying each of the aspect obtained from objectives through research questions evolved from the objectives. The answers to these questions are found through case studies and the existing theories in the world in relevance to the topic. The paper finds out how the geometry of dance works with design principles to create transparent geometry of fashion building. This all creates the fiesta environment taken from the locality of the region from the local and cultural lifestyles of the locals and then assembling it together to create a full festivity experience throughout the building.

Keywords: fashion, folk dance, geometry, local trends, social patterns, transparent

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Authors: Emilie Zimet

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During networking and NCCD moderation meetings, best practices for identifying students who require Literacy Intervention are often discussed. Once these students are identified, consideration is given to the most effective process for prioritising those who have the greatest need for Literacy Support and the allocation of resources, tracking of intervention effectiveness and communicating with teachers/external providers/parents. Through a workshop, the group will investigate best practices to identify students who require literacy support and strategies to communicate and track their progress. In groups, participants will examine what they do in their settings and then compare with other models, including the researcher’s model, to decide the most effective path to identification and communication. Participants will complete a worksheet at the beginning of the session to deeply consider their current approaches. The participants will be asked to critically analyse their own identification processes for Literacy Intervention, ensuring students are not overlooked if they fall into the borderline category. A cut-off for students to access intervention will be considered so as not to place strain on already stretched resources along with the most effective allocation of resources. Furthermore, communicating learning needs and differentiation strategies to staff is paramount to the success of an intervention, and participants will look at the frequency of communication to share such strategies and updates. At the end of the session, the group will look at creating or evolving models that allow for best practices for the identification and communication of Literacy Interventions. The proposed outcome for this research is to develop a model of identification of students requiring Literacy Intervention that incorporates the allocation of resources and communication to key stakeholders. This will be done by pooling information and discussing a variety of models used in the participant's school settings.

Keywords: identification, student selection, communication, special education, school policy, planning for intervention

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Authors: M. Akhlaque Ahmed, Maliha Afshan Siddiqui

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A study has been carried out to see the prospect of wind power potential of southern Sindh namely Karachi, Hawksbay, Norriabad, Hyderabad, Ketibander and Shahbander using local wind speed data. The monthly average wind speed for these area ranges from 4.5m/sec to 8.5m/sec at 30m height from ground. Extractable wind power, wind energy and Weibul parameter for above mentioned areas have been examined. Furthermore, the power output using fast and slow wind machine using different blade diameter along with the 4Kw and 20 Kw aero-generator were examined to see the possible use for deep well pumping and electricity supply to remote villages. The analysis reveals that in this wind corridor of southern Sindh Hawksbay, Ketibander and Shahbander belongs to wind power class-3 Hyderabad and Nooriabad belongs to wind power class-5 and Karachi belongs to wind power class-2. The result shows that the that higher wind speed values occur between June till August. It was found that considering maximum wind speed location, Hawksbay,Noriabad are the best location for setting up wind machines for power generation.

Keywords: wind energy generation, Southern Sindh, seasonal change, Weibull parameter, wind machines

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Authors: Nasrin Galehdar, Sedigheh Nadri, Elham Nazari, Isan Darvishi, Abouzar Mohammadi

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Background and aim:Nausea and vomiting are complications of cesarean section. The pharmacological and non-pharmacological approaches were applied to decrease postoperative nausea and vomiting. The aim of the present study was to compare the effects of Ondansetron and acupressure on postoperative nausea and vomiting in patients undergone an elective cesarean section. Materials and method: The study was designed as a randomized clinical trial. A total of 120 patients were allocated to two equal groups. Four mgs of Ondansetron was administered for the Ondansetron group after clamping the umbilical cord. The acupressure bracelets were fastened in the PC6 point for acupressure group for 15 minutes. The patients were monitored in terms of incidence, severity, and episodes of nausea and vomiting. The data obtained were analyzed by SPSS software version 18 with a significance level of 0.05. Results: There was no significant statistical difference in nausea severity among the groups intra-operatively, in the recovery and surgery wards. The incidence and episodes of vomiting were significantly higher in patients undergone acupressure intra-operatively, in the recovery and surgery wards (P< 0.05). No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Conclusion: No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Thus, it is suggested to perform the studies with larger size and comparing the effects of acupressure with other antiemetic medications.

Keywords: ondansetron, acupressure, nausea, vomiting

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Authors: Esra Sengul, R. G. Aktas, M. E. Sitar, H. Isan

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Hepatocellular carcinoma (HCC) is a hepatocellular tumor commonly found on the surface of the chronic liver. HepG2 is the most commonly used cell type in HCC studies. The main proteins remaining in the blood serum after separation of plasma fibrinogen are albumin and globulin. The fact that the albumin showed hepatocellular damage and reflect the synthesis capacity of the liver was the main reason for our use. Alpha-Fetoprotein (AFP) is an albumin-like structural embryonic globulin found in the embryonic cortex, cord blood, and fetal liver. It has been used as a marker in the follow-up of tumor growth in various malign tumors and in the efficacy of surgical-medical treatments, so it is a good protein to look at with albumins. We have seen the morphological changes of dimethyl sulfoxide (DMSO) on HepG2 and decided to investigate its biochemical effects. We examined the effects of DMSO, which is used in cell cultures, on albumin, AFP and total protein at low doses. Material Method: Cell Culture: Medium was prepared in cell culture using Dulbecco's Modified Eagle Media (DMEM), Fetal Bovine Serum Dulbecco's (FBS), Phosphate Buffered Saline and trypsin maintained at -20 ° C. Fixation of Cells: HepG2 cells, which have been appropriately developed at the end of the first week, were fixed with acetone. We stored our cells in PBS at + 4 ° C until the fixation was completed. Area Calculation: The areas of the cells are calculated in the ImageJ (IJ). Microscope examination: The examination was performed with a Zeiss Inverted Microscope. Daytime photographs were taken at 40x, 100x 200x and 400x. Biochemical Tests: Protein (Total): Serum sample was analyzed by a spectrophotometric method in autoanalyzer. Albumin: Serum sample was analyzed by a spectrophotometric method in autoanalyzer. Alpha-fetoprotein: Serum sample was analyzed by ECLIA method. Results: When liver cancer cells were cultured in medium with 1% DMSO for 4 weeks, a significant difference was observed when compared with the control group. As a result, we have seen that DMSO can be used as an important agent in the treatment of liver cancer. Cell areas were reduced in the DMSO group compared to the control group and the confluency ratio increased. The ability to form spheroids was also significantly higher in the DMSO group. Alpha-fetoprotein was lower than the values of an ordinary liver cancer patient and the total protein amount increased to the reference range of the normal individual. Because the albumin sample was below the specimen value, the numerical results could not be obtained on biochemical examinations. We interpret all these results as making DMSO a caretaking aid. Since each one was not enough alone we used 3 parameters and the results were positive when we refer to the values of a normal healthy individual in parallel. We hope to extend the study further by adding new parameters and genetic analyzes, by increasing the number of samples, and by using DMSO as an adjunct agent in the treatment of liver cancer.

Keywords: hepatocellular carcinoma, HepG2, dimethyl sulfoxide, cell culture, ELISA

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Authors: Devam Sheth

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Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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Authors: Paresh Patel, Priya Patel, Vaidehi Sorathiya, Navin Sheth

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The aim of present work was to fabricate Salmeterol Xinafoate (SX) metered dose inhaler (MDI) for asthma and to evaluate the SX loaded solid lipid nanoparticles (SLNs) for pulmonary delivery. Solid lipid nanoparticles can be used to deliver particles to the lungs via MDI. A modified solvent emulsification diffusion technique was used to prepare Salmeterol Xinafoate loaded solid lipid nanoparticles by using compritol 888 ATO as lipid, tween 80 as surfactant, D-mannitol as cryoprotecting agent and L-leucine was used to improve aerosolization behaviour. Box-Behnken design was applied with 17 runs. 3-D surface response plots and contour plots were drawn and optimized formulation was selected based on minimum particle size and maximum % EE. % yield, in vitro diffusion study, scanning electron microscopy, X-ray diffraction, DSC, FTIR also characterized. Particle size, zeta potential analyzed by Zetatrac particle size analyzer and aerodynamic properties was carried out by cascade impactor. Pre convulsion time was examined for control group, treatment group and compare with marketed group. MDI was evaluated for leakage test, flammability test, spray test and content per puff. By experimental design, particle size and % EE found to be in range between 119-337 nm and 62.04-76.77% by solvent emulsification diffusion technique. Morphologically, particles have spherical shape and uniform distribution. DSC & FTIR study showed that no interaction between drug and excipients. Zeta potential shows good stability of SLNs. % respirable fraction found to be 52.78% indicating reach to the deep part of lung such as alveoli. Animal study showed that fabricated MDI protect the lungs against histamine induced bronchospasm in guinea pigs. MDI showed sphericity of particle in spray pattern, 96.34% content per puff and non-flammable. SLNs prepared by Solvent emulsification diffusion technique provide desirable size for deposition into the alveoli. This delivery platform opens up a wide range of treatment application of pulmonary disease like asthma via solid lipid nanoparticles.

Keywords: salmeterol xinafoate, solid lipid nanoparticles, box-behnken design, solvent emulsification diffusion technique, pulmonary delivery

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Authors: V. Viswanathan, Md. Irshad Ahmad, Prashant K. Singh, Nayeem Ahmad, Pradeep Sharma, Sujata Sharma, Tej P Singh

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Lactoperoxidase (LPO) is a heme containing mammalian enzyme which uses hydrogen peroxide (H2O2) to catalyze the conversion of substrates into oxidized products. LPO is found in body fluids and tissues such as milk, saliva, tears, mucosa and other body secretions. The previous structural studies have shown that LPO converts substrates, thiocyanate (SCN‾) and iodide (I‾) ions into oxidized products, hypothiocyanite (OSCN‾) and hypoiodite (IO‾) ions, respectively. We report here a new structure of the complex of LPO with an oxidized product, nitrite (NO2‾). This product was generated from NO using the two step reaction of LPO by adding hydrogen peroxide (H2O2) in the solution of LPO in 0.1M phosphate buffer at pH 6.8 as the first step. In the second step, NO gas was added to the above mixture. This was crystallized using 20% (w/v) PEG-3350 and 0.2M ammonium iodide at pH 6.8. The structure determination showed the presence of NO2‾ ion in the distal heme cavity of the substrate binding site of LPO. The structure also showed that the propionate group, which is linked to pyrrole ring D of the heme moiety, was disordered. Similarly, the side chain of Asp108, which is covalently linked to heme moiety, was also split into two components. As a result of these changes, the conformation of the side chain of Arg255 was altered, allowing it to form new interactions with the disordered carboxylic group of propionate moiety. These structural changes are indicative of an intermediate state in the catalytic reaction pathway of LPO.

Keywords: lactoperoxidase, structure, nitric oxide, nitrite ion, intermediate, complex

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Authors: Chalermporn Jindapeng

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The main objective of the study of the suitable operating conditions of hot water generators combined with central air package units: a case study of Tipco Building Group was to analyze the suitable operating conditions and energy-related costs in each operating condition of hot water generators combined with central air package units which resulted in water-cooled packages. Thermal energy from vapor form refrigerants at high pressures and temperatures was exchanged with thermal energy of the water in the swimming pool that required suitable temperature control for users with the use of plate heat exchangers before refrigerants could enter the condenser in its function to change the status of vapor form refrigerants at high pressures and temperatures to liquid form at high pressures and temperatures. Thus, if this was used to replace heat pumps it could reduce the electrical energy that was used to make hot water and reduce the cost of the electrical energy of air package units including the increased efficacy of air package units. Of the analyses of the suitable operating conditions by means of the study of the elements involved with actual measurements from the system that had been installed at the Tipco Building Group hot water generators were combined with air package units which resulted in water-cooled packages with a cooling capacity of 75 tonnes. Plate heat exchangers were used in the transfer of thermal energy from refrigerants to one set of water with a heat exchanger area of 1.5 m² which was used to increase the temperature of swimming pool water that has a capacity of 240 m³. From experimental results, it was discovered after continuous temperature measurements in the swimming pool every 15 minutes that swimming pool water temperature increased by 0.78 ⁰C 0.75 ⁰C 0.74 ⁰C and 0.71 ⁰C. The rates of flow of hot water through the heat exchangers were equal to 14, 16, 18 and 20 litres per minute respectively where the swimming pool water temperature was at a constant value and when the rate of flow of hot water increased this caused hot water temperatures to decrease and the coefficient of performance of the air package units to increase from 5.9 to 6.3, 6.7, 6.9 and 7.6 while the rates of flow of hot water were equal to 14, 16, 18 and 20 litres per minute, respectively. As for the cooling systems, there were no changes and the system cooling functions were normal as the cooling systems were able to continuously transfer incoming heat for the swimming pool water which resulted in a constant pressure in the cooling system that allowed its cooling functions to work normally.

Keywords: central air package units, heat exchange, hot water generators, swimming pool

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Authors: Muhamad Azani Yahya, Umi Nadiah Nor Ali, Mohammed Alias Yusof, Norazman Mohamad Nor, Vikneswaran Munikanan

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In construction, concrete is one of the materials that can commonly be used as for structural elements. Concrete consists of cement, sand, aggregate and water. Concrete can be added with admixture in the wet condition to suit the design purpose such as to prolong the setting time to improve workability. For strength improvement, concrete is being added with other hybrid materials to increase strength; this is because the tensile strength of concrete is very low in comparison to the compressive strength. This paper shows the usage of a waterproofing agent in concrete to enhance the tensile strength. High tensile concrete is expensive because the concrete mix needs fiber and also high cement content to be incorporated in the mix. High tensile concrete being used for structures that are being imposed by high impact dynamic load such as blast loading that hit the structure. High tensile concrete can be defined as a concrete mix design that achieved 30%-40% tensile strength compared to its compression strength. This research evaluates the usage of a waterproofing agent in a concrete mix as an element of reinforcement to enhance the tensile strength. According to the compression and tensile test, it shows that the concrete mix with a waterproofing agent enhanced the mechanical properties of the concrete. It is also show that the composite concrete with waterproofing is a high tensile concrete; this is because of the tensile is between 30% and 40% of the compression strength. This mix is economical because it can produce high tensile concrete with low cost.

Keywords: high tensile concrete, waterproofing agent, concrete, rheology

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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Authors: Asma Alhuqail, Nagwa Aref

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Programmed cell death resembles a real nature active defense in Datura metel against TMV after three days of virus infection. Physiological plant response was assessed for asymptomatic healthy and symptomatic infected detached leaves. The results indicated H2O2 and Chlorophyll-a as the most potential parameters. Chlorophyll-a was considered the only significant predictor variant for the H2O2 dependent variant with a P value of 0.001 and R-square of 0.900. The plant immune response was measured within three days of virus infection using the cutoff value of H2O2 (61.095 lmol/100 mg) and (63.201 units) for the tail moment in the Comet Assay. Their percentage changes were 255.12% and 522.40% respectively which reflects the stress of virus infection in the plant. Moreover, H2O2 showed 100% specificity and sensitivity in the symptomatic infected group using the receiver-operating characteristic (ROC). All tested parameters in the symptomatic infected group had significant correlations with twenty-five positive and thirty-one negative correlations where the P value was <0.05 and 0.01. Chlorophyll-a parameter had a crucial role of highly significant correlation between total protein and salicylic acid. Contrarily, this correlation with tail moment unit was (r = _0.930, P <0.01) where the P value was < 0.01. The strongest significant negative correlation was between Chlorophyll-a and H2O2 at P < 0.01, while moderate negative significant correlation was seen for Chlorophyll-b where the P value < 0.05. The present study discloses the secret of the three days of rapid transient production of activated oxygen species (AOS) that was enough for having potential quantitative physiological parameters for defensive plant response toward the virus.

Keywords: programmed cell death, plant–adaptive immune response, hydrogen peroxide (H2O2), physiological parameters

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Authors: Shima Mahmoudi, Babak Pourakbari, Setareh Mamishi, Mostafa Teymuri, Majid Marjani

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Although cytokine analysis has greatly contributed to the understanding of tuberculosis (TB) pathogenesis, data on cytokine profiles that might distinguish progression from latency of TB infection are scarce. Since PE/PPE proteins are known to induce strong humoral and cellular immune responses, the aim of this study was to evaluate the diagnostic potential of interleukin-2 (IL-2) as biomarker after specific antigen stimulation with PE35 and PPE68 for the discrimination of active and latent tuberculosis infection (LTBI). The production of IL-2 was measured in the antigen-stimulated whole-blood supernatants following stimulation with recombinant PE35 and PPE68. All the patients with active TB and LTBI had positive QuantiFERON-TB Gold in Tube test. The level of IL-2 following stimulation with recombinant PE35 and PPE68 were significantly higher in LTBI group than in patients with active TB infection or control group. The discrimination performance (assessed by the area under ROC curve) for IL-2 following stimulation with recombinant PE35 and PPE68 between LTBI and patients with active TB were 0.837 (95%CI: 0.72-0.97) and 0.75 (95%CI: 0.63-0.89), respectively. Applying the 12.4 pg/mL cut-off for IL-2 induced by PE35 in the present study population resulted in sensitivity of 78%, specificity of 78%, PPV of 78% and NPV of 100%. In addition, a sensitivity of 81%, specificity of 70%, PPV of 67% and 87% of NPV was reported based on the 4.4 pg/mL cut-off for IL-2 induced by PPE68. In conclusion, peptides of the antigen PE35 and PPE68, absent from commonly used BCG strains, stimulated strong IL-2- positive T cell responses in patients with LTBI. This study confirms IL-2 induced by PE35 and PPE68 as a sensitive and specific biomarker and highlights IL-2 as new promising adjunct markers for discriminating of LTBI and Active TB infection.

Keywords: IL-2, PE35, PPE68, tuberculosis

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Authors: Chiagoziem A. Otuechere, Ebenezer O. Farombi

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The protective effect of dichloromethane: methanol extract of Pterocarpus mildbraedii (PME), a widely consumed Nigerian leafy vegetable, on the toxicity of propanil was investigated in male rats. Animals were distributed into eight groups of five each. Group 1 served as control and received normal saline while rats in groups 2, 3, and 4 received 100 mg/kg, 200 mg/kg, and 400 mg/kg extract doses respectively. Group 5 rats were orally administered 200 mg/kg propanil while groups 6, 7, and 8 rats were given propanil plus extract. Oral administration of propanil elicited a 14.8%, 5%, 122%, and 78% increase in the activity of serum enzymes; alanine aminotransferase (AST), alanine aminotransferase(ALT), Alkaline phoshatase (ALP) and Gamma glutamyl transferase (ﻻGT). There were also increase in Lactate dehydrogenase (LDH) activity, direct bilirubin and lipid peroxidation levels. Furthermore, PME significantly attenuated the marked hepatic oxidative damage that accompanied propanil treatment. The extract significantly decreased LDH activity and bilirubin levels following propanil treatment. Furthermore, propanil-induced alterations in the activities of antioxidant enzymes: Superoxide dismutase (SOD), catalase (CAT) and glutathione s-transferase (GST) in these rats were modulated by the extract. The percentage DPPH Radical Scavenging Activity of the extract was determined as 55% and compared to those of Gallic acid (49%). Hepatic histology examination further confirmed the damage to the liver as it revealed severe periportal cellular infiltration of the hepatocytes. These biochemical and morphological alterations were attenuated in rats pre-treated with 100 mg/kg and 200 mg/kg doses of the extract. These results suggest that PME possesses protective effect against propanil-induced hepatotoxicity.

Keywords: antioxidant, hepatoprotection, Pterocarpus mildbraedii, propanil

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Authors: Sukjai Charoensuk, Penphan Pitaksongkram, Michael Christopher

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Preliminary evidences supported the effectiveness of mindfulness-based interventions in reducing symptoms associated with a variety of medical and psychological conditions. However, the measurements of mindfulness are questionable since they have not been developed based-on Buddhist experiences. The purpose of this qualitative study was to describe meaning and cultivating factors of mindfulness as experienced by Thai females who practice Dhamma. Participants were purposively selected to include 2 groups of Thai females who practice Dhamma. The first group consisted of 6 female Buddhist monks, and the second group consisted of 7 female who practice Dhamma without ordaining. Data were collected using in-depth interview. The instruments used were demographic data questionnaire and guideline for in-depth interview developed by researchers. Content analysis was employed to analyze the data. The results revealed that Thai women who practice Dhamma described their experience in 2 themes, which were meaning and cultivating factors of mindfulness. The meaning composed of 4 categories; 1) Being Present, 2) Self-awareness, 3) Contemplation, and 4) Neutral. The cultivating factors of mindfulness composed of 2 categories; In-personal factors and Ex-personal factors. The In-personal cultivating factors included 4 sub-categories; Faith and Love, the Five Precepts, Sound body, and Practice. The Ex-personal cultivating factors included 2 sub-categories; Serenity, and Learning. These findings increase understanding about meaning of mindfulness and its cultivating factors. These could be used as a guideline to promote mental health and develop nursing interventions using mindfulness based, as well as, develop the instrument for assessing mindfulness in Thai context.

Keywords: cultivating factor, meaning of mindfulness, practice Dhamma, Thai women

Procedia PDF Downloads 331

Authors: M. R. Akshaya, Veena Rao

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Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: behavioral response, design parameters, dog boarding centers, interior environment

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Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

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Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

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Authors: Niesha Douglas, Lisa Merriweather, Cathy Howell, Anna Sancyzk

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Many studies explain that mentoring in an academic setting contributes to student success and retention. However, in the United States, where the population is diverse and filled with multiple ethnic groups, mentoring has become too generalized and fails to offer a unique individualized experience for underrepresented minorities (URM). The purpose of this paper is to describe the findings of an ongoing qualitative study that investigates the relationships among STEM doctoral faculty and URM students. Several faculty from three different predominately white institutions (PWI) in the Southeastern region of the United States were interviewed and engaged in open dialogue about their experiences with mentoring. The data collection included semi-structured interviews that took place in the classroom (pre-COVID-19) as well as virtually. The theoretical framework draws on the idea of Critical Race Theory and how cultural, social constructs interfere with effective mentoring for URM Doctoral STEM students. The findings in this study suggest that though the faculty and several years of experience mentoring students, there were some gaps in understanding the needs of URM students and how mentoring is a unique relationship that should be specialized for each student and should not fit into one mold.

Keywords: culture, critical race theory, mentoring, STEM

Procedia PDF Downloads 175

Authors: Joshua Midha

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The basis for information campaigns and behavioral interventions has long reigned as a tactic. From the Soviet-era propaganda machines to the opinion hijacks in Iran, these measures are now commonplace and are used for dissemination and disassembly. However, the use of these tools for strategic diffusion, specifically in a counter-terrorism setting, has only been explored on the surface. This paper aims to introduce a larger conceptual portion of guided information campaigns into preexisting terror cells and situations. It provides an alternative, low-risk intervention platform for future military strategy. This paper highlights a theoretical framework to lay out the foundationary details and explanations for behavioral interventions and moves into using a case study to highlight the possibility of implementation. It details strategies, resources, circumstances, and risk factors for intervention. It also sets an expanding foundation for offensive PsyOps and argues for tactical diffusion of information to battle extremist sentiment. The two larger frameworks touch on the internal spread of information within terror cells and external political sway, thus charting a larger holistic purpose of strategic operations.

Keywords: terrorism, behavioral intervention, propaganda, SNA, extremism

Procedia PDF Downloads 81