Search results for: balance in patient

Authors: Florin G. Borcan, Ramona C. Albulescu, Adela Chirita-Emandi

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pH-responsive drug delivery systems are gaining more importance because these systems deliver the drug at a specific time in regards to pathophysiological necessity, resulting in improved patient therapeutic efficacy and compliance. Polyurethane materials are well-known for industrial applications (elastomers and foams used in different insulations and automotive), but they are versatile biocompatible materials with many applications in medicine, as artificial skin for the premature neonate, membrane in the hybrid artificial pancreas, prosthetic heart valves, etc. This study aimed to obtain the physico-chemical characterization of a drug delivery system based on polyurethane microparticles. The synthesis is based on a polyaddition reaction between an aqueous phase (mixture of polyethylene-glycol M=200, 1,4-butanediol and Tween® 20) and an organic phase (lysin-diisocyanate in acetone) combined with simultaneous emulsification. Different active agents (omeprazole, amoxicillin, metoclopramide) were used to verify the release profile of the macromolecular particles in different pH mediums. Zetasizer measurements were performed using an instrument based on two modules: a Vasco size analyzer and a Wallis Zeta potential analyzer (Cordouan Technol., France) in samples that were kept in various solutions with different pH and the maximum absorbance in UV-Vis spectra were collected on a UVi Line 9,400 Spectrophotometer (SI Analytics, Germany). The results of this investigation have revealed that these particles are proper for a prolonged release in gastric medium where they can assure an almost constant concentration of the active agents for 1-2 weeks, while they can be disassembled faster in a medium with neutral pHs, such as the intestinal fluid.

Keywords: lysin-diisocyanate, nanostructures, polyurethane, Zetasizer

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Authors: Z. Wang, F. Pashaei Kamali, J. A. Posada Duque, P. Osseweijer

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Globally, the aviation sector is seeking for sustainable solutions to comply with the pressure to reduce greenhouse gas emissions. Jet fuels derived from biomass are generally perceived as a sustainable alternative compared with their fossil counterparts. However, the establishment of jet biofuels supply chains will have impacts on environment, economy, and society. While existing studies predominantly evaluated environmental impacts and techno-economic feasibility of jet biofuels, very few studies took the social / socioeconomic aspect into consideration. Therefore, this study aims to provide a focused evaluation of social sustainability for aviation biofuels with a supply chain perspective. Three potential jet biofuel supply chains based on different feedstocks, i.e. sugarcane, eucalyptus, and macauba were analyzed in the context of Brazil. The assessment of social sustainability is performed with a process-based approach combined with input-output analysis. Over the supply chains, a set of social sustainability issues including employment, working condition (occupational accident and wage level), labour right, education, equity, social development (GDP and trade balance) and food security were evaluated in a (semi)quantitative manner. The selection of these social issues is based on two criteria: (1) the issues are highly relevant and important to jet biofuel production; (2) methodologies are available for assessing these issues. The results show that the three jet biofuel supply chains lead to a differentiated level of social effects. The sugarcane-based supply chain creates the highest number of jobs whereas the biggest contributor of GDP turns out to be the macauba-based supply chain. In comparison, the eucalyptus-based supply chain stands out regarding working condition. It is also worth noting that biojet fuel supply chain with high level of social benefits could result in high level of social concerns (such as occupational accident, violation of labour right and trade imbalance). Further research is suggested to investigate the possible interactions between different social issues. In addition, the exploration of a wider range of social effects is needed to expand the comprehension of social sustainability for biofuel supply chains.

Keywords: biobased supply chain, jet biofuel, social assessment, social sustainability, socio-economic impacts

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Authors: Mojtaba Eshraghi Arani

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According to the international conventions for the carriage of goods by sea, the consignee is the person who is entitled to take delivery of the cargo from the carrier. Such a person is usually named in the relevant box of the bill of lading unless the latter is issued “To Order” or “To Bearer”. However, there are some cases in which the apparent consignee, as above, was not intended to take delivery of cargo, like the L/C issuing bank or the freight forwarder who are named as consignee only for the purpose of security or acceleration of transit process. In such cases as well as the BL which is issued “To Order”, the so-called “real consignee” can be found out in the “Notify Party” box. The dispute revolves around the choice between apparent consignee and real consignee for being entitled not only to take delivery of the cargo but also to sue the carrier for any damages or loss. While it is a generally accepted rule that only the apparent consignee shall be vested with such rights, some courts like France’s Cour de Cassation have declared that the “Notify Party”, as the real consignee, was entitled to sue the carrier and in some cases, the same court went far beyond and permitted the real consignee to take suit even where he was not mentioned on the BL as a “Notify Party”. The main argument behind such reasoning is that the real consignee is the person who suffered the loss and thus had a legitimate interest in bringing action; of course, the real consignee must prove that he incurred a loss. It is undeniable that the above-mentioned approach is contrary to the position of the international conventions on the express definition of consignee. However, international practice has permitted the use of BL in a different way to meet the business requirements of banks, freight forwarders, etc. Thus, the issue is one of striking a balance between the international conventions on the one hand and existing practices on the other hand. While the latest convention applicable for sea transportation, i.e., the Rotterdam Rules, dealt with the comparable issue of “shipper” and “documentary shipper”, it failed to cope with the matter being discussed. So a new study is required to propose the best solution for amending the current conventions for carriage of goods by sea. A qualitative method with the concept of interpretation of data collection has been used in this article. The source of the data is the analysis of domestic and international regulations and cases. It is argued in this manuscript that the judge is not allowed to recognize any one as real consignee, other than the person who is mentioned in the “Consingee” box unless the BL is issued “To Order” or “To Bearer”. Moreover, the contract of carriage is independent of the sale contract and thus, the consignee must be determined solely based on the facts of the BL itself, like “Notify Party” and not any other contract or document.

Keywords: real consignee, cargo, delivery, to order, notify the party

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Authors: Haaris Khan, Farhad Udwadia

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South Asians are the fastest-growing immigrant population in Canada and are 3-4 times more likely to develop diabetes. In a primary care setting, language barriers continue to persist as a prominent obstacle when delivering crucial health information. Given the abundance of languages in the South Asian community and the varying levels of English fluency, there is compelling evidence that these language barriers can adversely impact health outcomes. The microvascular and macrovascular complications of poor diabetic management are well established and universally recognized. However, these are often difficult concepts to grasp for even individuals fluent in English. In order to lessen the burden of language barriers, we developed a comprehensive guide in various languages that discuss the complications and screening guidelines for diabetic and prediabetic patients. The guide is presented in the form of a pamphlet, with an electronic version being constructed as well, that provides basic information on diabetic retinopathy, neuropathy and nephropathy as well as the screening recommendations. We also conducted a review of the literature around the topic and incorporated our findings into our project. Our goal is for primary care physicians to have this resource and to be able to provide the link or pamphlet to patients in need. Our presentation also provides a comprehensive overview of some of the other barriers that individuals in the South Asian community face when seeking care. Given the staggering number of individuals in the South Asian community with diabetes and the morbidity and mortality associated with diabetes and its complications, effective community-specific strategies are needed to mitigate the potential consequences of poor diabetes management.

Keywords: diabetes, patient education, ophthalmology, vascular surgery

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Authors: C. Busuioc, G. Voicu, S. I. Jinga

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The field of tissue engineering brings new challenges in terms of proposing original solutions for ongoing medical issues, improving the biological performances of existing clinical systems and speeding the healing process for a faster recovery and a more comfortable life as patient. In this context, we propose the obtaining of 3D porous scaffolds of mineral nature, dedicated to bone repairing and regeneration purposes or employed as bioactive filler for bone cements. Thus, bacterial cellulose - calcium phosphates composite materials have been synthesized by successive immersing of the polymeric membranes in the precursor solution containing Ca2+ and [PO4]3- ions. The mineral phase deposited on the surface of biocellulose fibers was varied as amount through the number of immersing cycles. The intermediary composites were subjected to thermal treatments at different temperatures in order to remove the organic part and provide the formation of a self-sustained 3D architecture. The resulting phase composition consists of common phosphates, while the morphology largely depends on the preparation parameters. Thus, the aspect of the 3D mineral scaffolds can be tuned from a loose microstructure composed of large grains connected via monocrystalline nanorods to a trabecular pattern crossed by parallel internal channels, just like the natural bone. The bioactivity and biocompatibility of the obtained materials have been also assessed, with encouraging results in the clinical use direction. In conclusion, the compositional, structural, morphological and biological characterizations sustain the suitability of the reported biostructures for integration in hard tissue engineering applications.

Keywords: bacterial cellulose, bone reconstruction, calcium phosphates, mineral scaffolds

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Authors: Mina Rouhollahi, J. Boland

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Changes in cities’ heat balance due to rapid urbanization and the urban heat island (UHI) have increased energy demands for space cooling and have resulted in uncomfortable living conditions for urban residents. Climate resilience and comfortable living spaces can be addressed through well-designed urban development. The sustainable housing can be more effective in controlling high levels of urban heat. In Australia, to mitigate the effects of UHIs and summer heat waves, one solution to sustainable housing has been the trend to compact housing design and the construction of energy efficient dwellings. This paper analyses whether current housing configurations and orientations are effective in avoiding increased demands for air conditioning and having an energy efficient residential neighborhood. A significant amount of energy is consumed to ensure thermal comfort in houses. This paper reports on the modelling of heat transfer within the homes using the measurements of radiation, convection and conduction between exterior/interior wall surfaces and outdoor/indoor environment respectively. The simulation was tested on selected 7.5-star energy efficient houses constructed of typical material elements and insulation in Adelaide, Australia. The chosen design dwellings were analyzed in extremely hot weather through one year. The data were obtained via a thermal circuit to accurately model the fundamental heat transfer mechanisms on both boundaries of the house and through the multi-layered wall configurations. The formulation of the Lumped capacitance model was considered in discrete time steps by adopting a non-linear model method. The simulation results focused on the effects of orientation of the solar radiation on the dynamic thermal characteristics of the houses orientations. A high star rating did not necessarily coincide with a decrease in peak demands for cooling. A more effective approach to avoid increasing the demands for air conditioning and energy may be to integrate solar–climatic data to evaluate the performance of energy efficient houses.

Keywords: energy-efficient residential building, heat transfer, neighborhood orientation, solar–climatic data

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Authors: Apurva Patil, Sujatha Srinivasan

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Reducing actuator loads is important for applications in which human effort is required for actuation. The potential benefit of applying spring balancing to rehabilitation devices which work against gravity on a nonhorizontal plane is well recognized, but practical applications have been elusive. Although existing methods provide exact spring balance, they require additional masses or auxiliary links, or all the springs used originate from the ground, which makes the resulting device bulky and space-inefficient. This paper uses a method of static balancing of mechanisms with conservative loads such as gravity and spring loads using non-zero-free-length springs and no auxiliary links. Application of this method to a manually operated swimming pool lift mechanism which lowers and raises the physically challenged users into or out of the swimming pool is presented here. Various possible configurations using extension and compression springs as well as gas spring in the mechanism are compared. This work involves approximate spring balancing of the mechanism using minimization of potential energy variance. It uses the approach of flattening the potential energy distribution over the workspace and fuses it with numerical optimization. The results show the considerable reduction in actuator torque requirement with practical spring design and arrangement. Although the method provides only an approximate balancing, it is versatile, flexible in choosing appropriate control variables that are relevant to the design problem and easy to implement. The true potential of this technique lies in the fact that it uses a very simple optimization to find the spring constant, free length of the spring and the optimal attachment points subject to the optimization constraints. Also, it uses physically realizable non-zero-free-length springs directly, thereby reducing the complexity involved in simulating zero-free-length springs from non-zero-free-length springs. This method allows springs to be attached inside the mechanism, which makes the implementation of spring balancing practical. Because auxiliary linkages can be avoided, the resultant swimming pool lift mechanism is compact. The cost benefits and reduced complexity can be significant advantages in the development of this user-actuated swimming pool lift for developing countries.

Keywords: gas spring, rehabilitation device, spring balancing, swimming pool lift

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Authors: Epameinondas Xanthakis, Erik Kaunisto, Alain Le-Bail, Lilia Ahrné

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Fruits and vegetables are characterized as perishable food matrices due to their short shelf life as several deterioration mechanisms are being involved. Prior to the common preservation methods like freezing or canning, fruits and vegetables are being blanched in order to inactivate deteriorative enzymes. Both conventional blanching pretreatments and conventional freezing methods hide drawbacks behind their beneficial impacts on the preservation of those matrices. Conventional blanching methods may require longer processing times, leaching of minerals and nutrients due to the contact with the warm water which in turn leads to effluent production with large BOD. An important issue of freezing technologies is the size of the formed ice crystals which is also critical for the final quality of the frozen food as it can cause irreversible damage to the cellular structure and subsequently to degrade the texture and the colour of the product. Herein, the developed microwave blanching methodology and the results regarding quality aspects and enzyme inactivation will be presented. Moreover, heat transfer phenomena, mass balance, temperature distribution, and enzyme inactivation (such as Pectin Methyl Esterase and Ascorbic Acid Oxidase) of our microwave blanching approach will be evaluated based on measurements and computer modelling. The present work is part of the COLDμWAVE project which aims to the development of an innovative environmentally sustainable process for blanching and freezing of fruits and vegetables with improved textural and nutritional quality. In this context, COLDµWAVE will develop tailored equipment for MW blanching of vegetables that has very high energy efficiency and no water consumption. Furthermore, the next steps of this project regarding the development of innovative pathways in MW assisted freezing to improve the quality of frozen vegetables, by exploring in depth previous results acquired by the authors, will be presented. The application of MW assisted freezing process on fruits and vegetables it is expected to lead to improved quality characteristics compared to the conventional freezing. Acknowledgments: COLDμWAVE has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grand agreement No 660067.

Keywords: blanching, freezing, fruits, microwave blanching, microwave

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Authors: A. V. Chandewar, Sanjay Bais

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Backgound: In India, drugs of herbal origin have been used in traditional systems of medicines such as Unani and Ayurveda since ancient times. WHO limit for Escherichia coli is 101/gm cfu, for Staphylococus aureus 105/gm cfu, and for Pseudomonas aeruginosa 103/gm cfu and for Salmonella species nil cfu. WHO mentions maximum permissible limits in raw materials only for arsenic, cadmium, and lead, which amount to 1.0, 0.3, and 10 ppm, respectively. Aim: The main purpose of the investigation was to document evidence for the users, and practitioners of marketed haematinic herbal formulations. In the present study haematinic herbal formulations marketed in Yavatmal India were determined for the presence of microbial and heavy metal content. Method: The investigations were performed by using specific medias and atomic absorption spectrometry. Result: The present work indicates the presence of heavy metal contents in herbal formulations selected for study. It was found that arsenic content in formulations was below the permissible limit in all formulations. The cadmium and lead content in six formulations were above the permissible limits. Such formulations are injurious to health of patient if consumed regularly. The specific medias were used to determining the presence of Escherichia coli 4 samples, Staphylococcus aureus 3 samples, and P. aeruginosa 4 samples. The data indicated suggest that there is requirement of in process improvement to provide better quality for consumer health in order to be competitive in international markets. Summary/Conclusion: The presence of microbial and heavy metal content above WHO limits indicates that the GMP was not followed during manufacturing of herbal formulations marketed in India.

Keywords: toxicological standardization, heavy metals, microbial contamination, haematinic herbal formulations

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Authors: Ben J. Lippe

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Consult Liaison Psychology services are overgrowing, given the robust empirical support of the utility of this service in hospital settings. These psychological services, including clinical assessment, applied psychotherapy, and consultation with other healthcare providers, have been shown to improve health outcomes for patients and bolster important areas of administrative interest such as decreased length of patient admission. However, there is little descriptive literature outlining the process and mechanisms of building or developing a Consult Liaison Psychology service. The main findings of this current conceptual work are intended to be clear in nature to elucidate the essential methods involved in developing consult liaison psychology programs, including thorough reviews of relevant behavioral health literature and inclusion of experiential outcomes. The diverse range of hospital settings and healthcare systems makes a “blueprint” method of program development challenging to define, yet important structural frameworks presented here based on the relevant literature and applied practice can help lay critical groundwork for program development in this growing area of psychological service. This conceptual approach addresses the prominent processes, as well as common programmatic and clinical pitfalls, involved in the event of a Consult Liaison Psychology service. This paper, including a systematic review of relevant literature, is intended to serve as a key program development reference for the development of Consult Liaison Psychology services, other related behavioral health programs, and to help inform further research efforts.

Keywords: behavioral health, consult liaison, health psychology, psychology program development

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Authors: Ingrid Ruzbarska, Martin Zvonar, Piotr Oleśniewicz, Julita Markiewicz-Patkowska, Krzysztof Widawski, Daniel Puciato

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Obese children will probably become obese adults, consequently exposed to an increased risk of comorbidity and premature mortality. Body weight may be indirectly determined by continuous development of coordination and motor skills. The level of motor skills and abilities is an important factor that promotes physical activity since early childhood. The aim of the study is to thoroughly understand the internal relations between motor coordination abilities and the somatic development of prepubertal children and to determine the effect of excess body weight on motor coordination by comparing the motor ability levels of children with different body mass index (BMI) values. The data were collected from 436 children aged 7–10 years, without health limitations, fully participating in school physical education classes. Body height was measured with portable stadiometers (Harpenden, Holtain Ltd.), and body mass—with a digital scale (HN-286, Omron). Motor coordination was evaluated with the Kiphard-Schilling body coordination test, Körperkoordinationstest für Kinder. The normality test by Shapiro-Wilk was used to verify the data distribution. The correlation analysis revealed a statistically significant negative association between the dynamic balance and BMI, as well as between the motor quotient and BMI (p<0.01) for both boys and girls. The results showed no effect of gender on the difference in the observed trends. The analysis of variance proved statistically significant differences between normal weight children and their overweight or obese counterparts. Coordination abilities probably play an important role in preventing or moderating the negative trajectory leading to childhood overweight and obesity. At this age, the development of coordination abilities should become a key strategy, targeted at long-term prevention of obesity and the promotion of an active lifestyle in adulthood. Motor performance is essential for implementing a healthy lifestyle in childhood already. Physical inactivity apparently results in motor deficits and a sedentary lifestyle in children, which may be accompanied by excess energy intake and overweight.

Keywords: childhood, KTK test, physical education, psychomotor competence

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Authors: Fayomi Oluyemi, Ajayi Lady

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This article raises the question of political leadership in the context of womens' roles and responsibilities in Nigeria. The leadership question in Nigeria is disquieting to both academics and policy actors. In a democratic society like Nigeria, the parameters for a well-deserved leadership position is characterised by variables of equity, competence, transparency, accountability, selflessness, and commitment to the tenets of democracy, but the failure of leadership is pervasive in all spheres of socio-political sectors in Nigeria. The paper appraises the activities of Nigerian women in the socio-political arena in Nigeria. It traces their leadership roles from pre-colonial through post-colonial eras with emphasis on 1914 till date. It is argued in the paper that gender imbalance in leadership is a bane to peaceful co-existence and development in Nigeria. It is a truism that gender-blind and gender biased political agendas can distort leadership activities. The extent of their contributions of the few outstanding women’s relative tranquility is highlighted in the theoretical discourse. The methodology adopted for this study is an exploratory study employing the extended case method (ECM). The study was carried out among some selected Nigerian women politicians and academics. Because of ECM's robustness as a qualitative research design, it has helped this study in identifying the challenges of these women thematically and also in constructing valid and reliable measures of the constructs. The study made use of ethnography and triangulation, the latter of which is used by qualitative researchers to check and establish validity in their studies by analyzing a research question from multiple perspectives, specifically Investigator triangulation which involves using several different investigators in the analysis process. Typically, this manifests as the evaluation team consisting of colleagues within a field of study wherein each investigator examines the question of political leadership with the same qualitative method (interview, observation, case study, or focus groups). In addition, data was collated through documentary sources like journals, books, magazines, newspapers, and internet materials. The arguments of this paper center on gender equity of both sexes in socio-political representation and effective participation. The paper concludes with the need to effectively maintain gender balance in leadership in order to enhance lasting peace and unity in Nigeria.

Keywords: gender, politics, leadership, women

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Authors: Muhammad Farhan Ul Moazzam, Tamkeen Urooj Paracha, Ghani Rahman, Byung Gul Lee, Nasir Farid, Adnan Arshad

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The novel coronavirus pandemic disease (COVID-19) affected the whole globe, though there is a lack of clinical studies and its epidemiological features. But as per the observation, it has been seen that most of the COVID-19 infected patients show mild to moderate symptoms, and they get better without any medical assistance due to a better immune system to generate antibodies against the novel coronavirus. In this study, the active cases, serious cases, recovered cases, deaths and total confirmed cases had been analyzed using the geospatial inverse distance weightage technique (IDW) within the time span of 2nd March to 3rd June 2020. As of 3rd June, the total number of COVID-19 cases in Italy were 231,238, total deaths 33,310, serious cases 350, recovered cases 158,951, and active cases were 39,177, which has been reported by the Ministry of Health, Italy. March 2nd-June 3rd, 2020 a sum of 231,238 cases has been reported in Italy out of which 38.68% cases reported in the Lombardia region with a death rate of 18%, which is high from its national mortality rate followed by Emilia-Romagna (14.89% deaths), Piemonte (12.68% deaths), and Vento (10% deaths). As per the total cases in the region, the highest number of recoveries has been observed in Umbria (92.52%), followed by Basilicata (87%), Valle d'Aosta (86.85%), and Trento (84.54%). The COVID-19 evolution in Italy has been particularly found in the major urban area, i.e., Rome, Milan, Naples, Bologna, and Florence. Geospatial technology played a vital role in this pandemic by tracking infected patient, active cases, and recovered cases. Geospatial techniques are very important in terms of monitoring and planning to control the pandemic spread in the country.

Keywords: COVID-19, public health, geospatial analysis, IDW, Italy

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Authors: Jinan Fiaidhi, Hashmath Shaik

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Breaking the barrier for practicing evidence-based medicine relies on effective methods for rapidly identifying relevant evidence from the body of biomedical literature. An important challenge confronted by medical practitioners is the long time needed to browse, filter, summarize and compile information from different medical resources. Deep learning can help in solving this based on automatic question answering (Q&A) and transformers. However, Q&A and transformer technologies are not trained to answer clinical queries that can be used for evidence-based practice, nor can they respond to structured clinical questioning protocols like PICO (Patient/Problem, Intervention, Comparison and Outcome). This article describes the use of deep learning techniques for Q&A that are based on transformer models like BERT and GPT to answer PICO clinical questions that can be used for evidence-based practice extracted from sound medical research resources like PubMed. We are reporting acceptable clinical answers that are supported by findings from PubMed. Our transformer methods are reaching an acceptable state-of-the-art performance based on two staged bootstrapping processes involving filtering relevant articles followed by identifying articles that support the requested outcome expressed by the PICO question. Moreover, we are also reporting experimentations to empower our bootstrapping techniques with patch attention to the most important keywords in the clinical case and the PICO questions. Our bootstrapped patched with attention is showing relevancy of the evidence collected based on entropy metrics.

Keywords: automatic question answering, PICO questions, evidence-based medicine, generative models, LLM transformers

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Authors: S. Saeed, T. Butt, M. Rehan, S. Khaliq

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Objective: To determine the frequency of pre-analytical errors in samples taken from patients for various lab tests at Fauji Foundation Hospital, Rawalpindi. Material and Methods: All the lab specimens for diagnostic purposes received at the lab from Fauji Foundation hospital, Rawalpindi indoor and outdoor patients were included. Total number of samples received in the lab is recorded in the computerized program made for the hospital. All the errors observed for pre-analytical process including patient identification, sampling techniques, test collection procedures, specimen transport/processing and storage were recorded in the log book kept for the purpose. Results: A total of 476616 specimens were received in the lab during the period of study including 237931 and 238685 from outdoor and indoor patients respectively. Forty-one percent of the samples (n=197976) revealed pre-analytical discrepancies. The discrepancies included Hemolyzed samples (34.8%), Clotted blood (27.8%), Incorrect samples (17.4%), Unlabeled samples (8.9%), Insufficient specimens (3.9%), Request forms without authorized signature (2.9%), Empty containers (3.9%) and tube breakage during centrifugation (0.8%). Most of these pre-analytical discrepancies were observed in samples received from the wards revealing that inappropriate sample collection by the medical staff of the ward, as most of the outdoor samples are collected by the lab staff who are properly trained for sample collection. Conclusion: It is mandatory to educate phlebotomists and paramedical staff particularly performing duties in the wards regarding timing and techniques of sampling/appropriate container to use/early delivery of the samples to the lab to reduce pre-analytical errors.

Keywords: pre analytical lab errors, tertiary care hospital, hemolyzed, paramedical staff

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Authors: Seema Paul, John Mango Magero, Prosun Bhattacharya, Zahra Kalantari, Steve W. Lyon

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The purpose of this review paper is to develop an understanding of lake hydrodynamics and the potential climate impact on the Lake Victoria (LV) catchment scale. This paper briefly discusses the main problems of lake hydrodynamics and its’ solutions that are related to quality assessment and climate effect. An empirical methodology in modeling and mapping have considered for understanding lake hydrodynamic and visualizing the long-term observational daily, monthly, and yearly mean dataset results by using geographical information system (GIS) and Comsol techniques. Data were obtained for the whole lake and five different meteorological stations, and several geoprocessing tools with spatial analysis are considered to produce results. The linear regression analyses were developed to build climate scenarios and a linear trend on lake rainfall data for a long period. A potential evapotranspiration rate has been described by the MODIS and the Thornthwaite method. The rainfall effect on lake water level observed by Partial Differential Equations (PDE), and water quality has manifested by a few nutrients parameters. The study revealed monthly and yearly rainfall varies with monthly and yearly maximum and minimum temperatures, and the rainfall is high during cool years and the temperature is high associated with below and average rainfall patterns. Rising temperatures are likely to accelerate evapotranspiration rates and more evapotranspiration is likely to lead to more rainfall, drought is more correlated with temperature and cloud is more correlated with rainfall. There is a trend in lake rainfall and long-time rainfall on the lake water surface has affected the lake level. The onshore and offshore have been concentrated by initial literature nutrients data. The study recommended that further studies should consider fully lake bathymetry development with flow analysis and its’ water balance, hydro-meteorological processes, solute transport, wind hydrodynamics, pollution and eutrophication these are crucial for lake water quality, climate impact assessment, and water sustainability.

Keywords: climograph, climate scenarios, evapotranspiration, linear trend flow, rainfall event on LV, concentration

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Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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Authors: Xiang Shijie, Zhou Dong, Tian Dan

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This paper focuses on the application of real-time semantic segmentation technology in complex road condition recognition, aiming to address the critical issue of how to improve segmentation accuracy while ensuring real-time performance. Semantic segmentation technology has broad application prospects in fields such as autonomous vehicle navigation and remote sensing image recognition. However, current real-time semantic segmentation networks face significant technical challenges and optimization gaps in balancing speed and accuracy. To tackle this problem, this paper conducts an in-depth study and proposes an innovative Guided Image Reconstruction Module. By resampling high-resolution images into a set of low-resolution images, this module effectively reduces computational complexity, allowing the network to more efficiently extract features within limited resources, thereby improving the performance of real-time segmentation tasks. In addition, a dual-branch network structure is designed in this paper to fully leverage the advantages of different feature layers. A novel Hybrid Attention Mechanism is also introduced, which can dynamically capture multi-scale contextual information and effectively enhance the focus on important features, thus improving the segmentation accuracy of the network in complex road condition. Compared with traditional methods, the proposed model achieves a better balance between accuracy and real-time performance and demonstrates competitive results in road condition segmentation tasks, showcasing its superiority. Experimental results show that this method not only significantly improves segmentation accuracy while maintaining real-time performance, but also remains stable across diverse and complex road conditions, making it highly applicable in practical scenarios. By incorporating the Guided Image Reconstruction Module, dual-branch structure, and Hybrid Attention Mechanism, this paper presents a novel approach to real-time semantic segmentation tasks, which is expected to further advance the development of this field.

Keywords: hybrid attention mechanism, image reconstruction, real-time, road status recognition

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Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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Authors: Gerard Bray, Derek Mao, Arya Bahadori, Sachinka Ranasinghe

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The EAU currently recommends partial nephrectomy as the preferred management for localised cT1 renal tumours, irrespective of surgical approach. With the advent of robotic assisted partial nephrectomy, there is growing evidence that warm ischaemia time may be reduced compared to the traditional laparoscopic approach. There is still no clear differences between the two approaches with regards to other peri-operative and oncological outcomes. Current limitations in the field denote the lack of single surgeon series to compare the two approaches as other studies often include multiple operators of different experience levels. To the best of our knowledge, this study is the first single surgeon series comparing peri-operative outcomes of robotic assisted and laparoscopic PN. The current study aims to reduce intra-operator bias while maintaining an adequate sample size to assess the differences in outcomes between the two approaches. We retrospectively compared patient demographics, peri-operative outcomes, and renal function derangements of all partial nephrectomies undertaken by a single surgeon with experience in both laparoscopic and robotic surgery. Warm ischaemia time, length of stay, and acute renal function deterioration were all significantly reduced with robotic partial nephrectomy, compared to laparoscopic nephrectomy. This study highlights the benefits of robotic partial nephrectomy. Further prospective studies with larger sample sizes would be valuable additions to the current literature.

Keywords: partial nephrectomy, robotic assisted partial nephrectomy, warm ischaemia time, peri-operative outcomes

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Authors: Ossama Salman

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Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.

Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS

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Authors: Valentina Narvaez Gaitan, Paula K. Rodriguez Ramirez, Derian D. Espinosa

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Corrective orthosis has great importance in orthopedic treatments providing assistance in improving mobility and stability in order to improve the quality of life for a different patient. The corrective orthosis studied in this article can correct deformities, reduce pain, and improve the ability to perform daily activities. This work describes the design and evaluation of a corrective orthosis for knee hyperextension. This orthosis is capable of generating a progressive and variable alignment of the joint, limiting the range of motion according to medical criteria. The main objective was to design a corrective knee orthosis capable of correcting knee hyperextension progressively to return to its natural angle with greater economic affordability and adjustable size. The limiting mechanism is based on a goniometer to determine the desired angles. The orthosis was made of acrylic to reduce costs and maintenance; neoprene is also used to make comfortable contact; additionally, Velcro was used in order to adjust the orthosis for various sizes. Simulations of static and fatigue analysis of the mechanism were performed to verify its resistance and durability under normal conditions. A biomechanical gait study of gait was carried out on 10 healthy subjects without the orthosis and limiting their knee extension capacity in a normal gait cycle with the orthosis to observe the efficiency of the proposed system. In the results obtained, the knee angle curves show that the maximum extension angle was the established angle by the orthosis. Showing the efficiency of the proposed design for different leg sizes.

Keywords: biomechanical study, corrective orthosis, efficiency, goniometer, knee hyperextension.

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Authors: Khushboo Shah

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Categorical bans on the death penalty and life-without-parole sentences for juvenile offenders in a growing number of countries have established a new era in juvenile jurisprudence. This has been brought about by integration of the growing knowledge in cognitive neuroscience and appreciation of the inherent differences between adults and adolescents over the last ten years. This evolving understanding of being a child in the criminal system can be aptly reflected through policies that incorporate the mitigating traits of youth. First, the presentation will delineate the structures in cognitive neuroscience and in particular, focus on the prefrontal cortex, the amygdala, and the basal ganglia. These key anatomical structures in the brain are linked to three mitigating adolescent traits—an underdeveloped sense of responsibility, an increased vulnerability to negative influences, and transitory personality traits—that establish why juveniles have a lessened culpability. The discussion will delve into the details depicting how an underdeveloped prefrontal cortex results in the heightened emotional angst, high-energy and risky behavior characteristic of the adolescent time period or how the amygdala, the emotional center of the brain, governs different emotional expression resulting in why teens are susceptible to negative influences. Based on this greater understanding, it is incumbent that policies adequately reflect the adolescent physiology and psychology in the criminal system. However, it is important to ensure that these views are appropriately weighted while considering the jurisprudence for the treatment of children in the law. To ensure this balance is appropriately stricken, policies must incorporate the distinctive traits of youth in sentencing and legal considerations and yet refrain from the potential fallacies of absolving a juvenile offender of guilt and culpability. Accordingly, three policies will demonstrate how these results can be achieved: (1) eliminate housing of juvenile offenders in the adult prison system, (2) mandate fitness hearings for all transfers of juveniles to adult criminal court, and (3) use the post-disposition review as a type of rehabilitation method for juvenile offenders. Ultimately, this interdisciplinary approach of science and law allows for a better understanding of adolescent psychological and social functioning and can effectuate better legal outcomes for juveniles tried as adults.

Keywords: criminal law, Juvenile Justice, interdisciplinary, neuroscience

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Authors: Ahmad Jawad Fardin

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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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Authors: Mojtaba Mirmontazemi, Habibollah Dadgar

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Bone is the most common metastasis site in some advanced malignancies, such as prostate and breast cancer. Bone metastasis generally indicates fewer prognostic factors in these patients. Different radiological and molecular imaging modalities are used for detecting bone lesions. Molecular imaging including computed tomography, magnetic resonance imaging, planar bone scintigraphy, single-photon emission tomography, and positron emission tomography as noninvasive visualization of the biological occurrences has the potential to exact examination, characterization, risk stratification and comprehension of human being diseases. Also, it is potent to straightly visualize targets, specify clearly cellular pathways and provide precision medicine for molecular targeted therapies. These advantages contribute implement personalized treatment for each patient. Currently, NaF PET/CT has significantly replaced standard bone scintigraphy for the detection of bone metastases. On one hand, 68Ga-PSMA PET/CT has gained high attention for accurate staging of primary prostate cancer and restaging after biochemical recurrence. On the other hand, FDG PET/CT is not commonly used in osseous metastases of prostate and breast cancer as well as its usage is limited to staging patients with aggressive primary tumors or localizing the site of disease. In this article, we examine current studies about FDG, NaF, and PSMA PET/CT images in bone metastases diagnostic utility and assess response to treatment in patients with breast and prostate cancer.

Keywords: skeletal metastases, fluorodeoxyglucose, sodium fluoride, molecular imaging, precision medicine, prostate cancer (68Ga-PSMA-11)

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Authors: Shreya Srivastava, Sagnik Dey

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Aerosol direct radiative forcing (ADRF) refers to the alteration of the Earth's energy balance from the scattering and absorption of solar radiation by aerosol particles. India experiences substantial ADRF due to high aerosol loading from various sources. These aerosols' radiative impact depends on their physical characteristics (such as size, shape, and composition) and atmospheric distribution. Quantifying ADRF is crucial for understanding aerosols’ impact on the regional climate and the Earth's radiative budget. In this study, we have taken radiation data from Clouds and the Earth’s Radiant Energy System (CERES, spatial resolution=1ox1o) for 22 years (2000-2021) over the Indian subcontinent. Except for a few locations, the short-wave DARF exhibits aerosol cooling at the TOA (values ranging from +2.5 W/m2 to -22.5W/m2). Cooling due to aerosols is more pronounced in the absence of clouds. Being an aerosol hotspot, higher negative ADRF is observed over the Indo-Gangetic Plain (IGP). Aerosol Forcing Efficiency (AFE) shows a decreasing seasonal trend in winter (DJF) over the entire study region while an increasing trend over IGP and western south India during the post-monsoon season (SON) in clear-sky conditions. Analysing atmospheric heating and AOD trends, we found that only the aerosol loading is not governing the change in atmospheric heating but also the aerosol composition and/or their vertical profile. We used a Multi-angle Imaging Spectro-Radiometer (MISR) Level-2 Version 23 aerosol products to look into aerosol composition. MISR incorporates 74 aerosol mixtures in its retrieval algorithm based on size, shape, and absorbing properties. This aerosol mixture information was used for analysing long-term changes in aerosol composition and dominating aerosol species corresponding to the aerosol forcing value. Further, ADRF derived from this method is compared with around 35 studies across India, where a plane parallel Radiative transfer model was used, and the model inputs were taken from the OPAC (Optical Properties of Aerosols and Clouds) utilizing only limited aerosol parameter measurements. The result shows a large overestimation of TOA warming by the latter (i.e., Model-based method).

Keywords: aerosol radiative forcing (ARF), aerosol composition, MISR, CERES, SBDART

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Authors: Ana-Katarina Nikich

Abstract:

Background: The kinesiotaping method is often used in physiotherapy and rehabilitation. The purpose of this study was to evaluate the effectiveness of taping in the rehabilitation process of patients. Materials and methods: The study involved 90 male and female patients (the average age was 40-50 years) with various conditions requiring rehabilitation, such as injuries of the musculoskeletal system, sports injuries and other ailments. All patients were divided into two groups: experimental (n=40) and control (n=50). Both groups received 20 days of standard rehabilitation. In the experimental group, kinesiotaping methods were used, taking into account the individual characteristics of each patient. The control group performed regular exercises and physical therapy, but without using kinesiotape. During the study, physical parameters were monitored, interviews were conducted and the conditions of patients from both groups were compared. Results and discussion: The use of the kinesiotaping method in the rehabilitation process led to a significant improvement in physical parameters and pain reduction in patients. Significant improvement (p <0.005) was observed in all evaluated parameters among the patients of the experimental group. The control group also showed sufficient improvement (p <0.005), but the percentage of the experimental group was higher. As a result of the observation, the patients of the experimental group showed faster and more complete rehabilitation compared to the control group. The use of the kinesiotaping method allows to reduce the load on the damaged areas, improve blood circulation and lymphatic drainage, as well as increase stability and coordination of movements. Conclusions: Kinesiotaping as one of the modern therapeutic methods has shown its effectiveness in the rehabilitation process, contributing to the optimal recovery of patients with various conditions requiring rehabilitation. The use of tapes should be included in a comprehensive rehabilitation program to achieve the best results and reduce recovery time.

Keywords: kinesiotaping, rehabilitation, therapy, pain

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Authors: Mandy W. M. Chan, Samantha Y. N. Shek, Chi K. Yeung, Taro Kono, Henry H. L. Chan

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Fractional radiofrequency devices have shown to improve skin texture such as smoothness, rhytides, brightness as well as atrophic acne scars by increasing dermal thickness, dermal collagen content and dermal fibrillin content. The objective of the study is to assess the efficacy and adverse effects of this device on Asian patients with skin textural changes. In this study, 20 Chinese patients (ranging from 21-60 years old) with irregularities of skin texture, rhytides and acne scars were recruited. Patients received six treatments at 2-4 week intervals. Treatment was initiated with maximum energy tolerated and was adjustable during treatment if patients felt excessive discomfort. A total of two passes were delivered at each session. Physician assessment and standardized photographs were taken at baseline, all treatment visits and at one, two, and six month after final treatment. As a result, 17 patients were recruited and completed the study according to the study protocol. One patient withdrew after the first treatment due to reaction to local anesthesia and two patients were lost to follow-up. At six months follow-up, 71% of the patients were satisfied and 24% were very satisfied, while treatment physician reported various degrees of improvement based on the global assessment scale in 60% of the subjects. Anticipated side effects including erythema, edema, pinpoint bleeding, scabs formation and flare of acne were recorded, but there were no serious adverse effects noted. Conclude up, the use of fractional radiofrequency improves skin texture and appears to be safe in Asian patients. No long-term serious adverse effect was noted.

Keywords: Asian, fractional radiogrequency, skin, texture

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Authors: Mayuresh Thombre, Prajyot Borkar, Mangirish Bhobe

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New advancement of technology and never satisfying demands of the civilization are putting huge pressure on the natural fuel resources and these resources are at a constant threat to its sustainability. To get the best out of the automobile, the optimum balance between performance and fuel economy is important. In the present state of art, either of the above two aspects are taken into mind while designing and development process which puts the other in the loss as increase in fuel economy leads to decrement in performance and vice-versa. In-depth observation of the vehicle dynamics apparently shows that large amount of energy is lost during braking and likewise large amount of fuel is consumed to reclaim the initial state, this leads to lower fuel efficiency to gain the same performance. Current use of Kinetic Energy Recovery System is only limited to sports vehicles only because of the higher cost of this system. They are also temporary in nature as power can be squeezed only during a small time duration and use of superior parts leads to high cost, which results on concentration on performance only and neglecting the fuel economy. In this paper Kinetic Energy Recovery System for storing the power and then using the same while accelerating has been discussed. The major storing element in this system is a Flat Spiral Spring that will store energy by compression and torsion. The use of spring ensure the permanent storage of energy until used by the driver unlike present mechanical regeneration system in which the energy stored decreases with time and is eventually lost. A combination of internal gears and spur gears will be used in order to make the energy release uniform which will lead to safe usage. The system can be used to improve the fuel efficiency by assisting in overcoming the vehicle’s inertia after braking or to provide instant acceleration whenever required by the driver. The performance characteristics of the system including response time, mechanical efficiency and overall increase in efficiency are demonstrated. This technology makes the KERS (Kinetic Energy Recovery System) more flexible and economical allowing specific application while at the same time increasing the time frame and ease of usage.

Keywords: electric control unit, energy, mechanical KERS, planetary gear system, power, smart braking, spiral spring

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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