Search results for: technology based environment

Authors: Priyanshu Sharma

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Urban development mechanism has evolved over the years in India, and various planning models and tools have been adopted by different states. Large cities have been able to make and implement plans with the varied degree. However, it has been observed these mechanisms face challenges to gain the momentum in small and medium towns. Gujarat has a very robust legislation that empowers planning authorities to prepare development plans (DP) and town planning scheme (TPS). The DP- TPS planning methods are quite popular for large cities in Gujarat. However, it has been observed that in the smaller towns these methods of plan preparation are facing severe agitations. Recently, development authorities of many small towns like Himmatnagar, Nadiad, and Junagadh, etc. have faced serious protest from local residents. This is because of the large amount of land deduction under the provisions of DP and TPS. And this number of opposition has been increasing since 2012 in Gujarat. This study aims to understand in detail the reasons for agitation against the plans prepared by smaller towns. It will further try to see whether the current framework of urban planning (DP and TPS) are really suitable for these towns. After understanding the development concerns and background, the aim and objectives of the study were outlined: Aim: To evaluate the suitability and acceptability of the current urban development mechanism for the small and medium towns. Objectives: (i) To review the GTPUD Act and identify the provision related to small and medium towns (ii) To understand preparation process of development plan and town planning scheme and issues related to it (iii) To understand the issues raised by the different stakeholder w.r.t plan because of which the plan and authority was agitated (iv) To find out the possible option through which these plans can be made suitable and acceptable to the stakeholder. The approach of this study is more qualitative based with the intention to understand the time frame process of preparation of development plan and town planning scheme and issues related to it. On the basis of literature study, the three towns were selected, and the detailed questionnaire was prepared for the stakeholders (development authorities and local residents) which include the time process taken in the preparation of DP and TPS and what were issues faced during the process and who all were involved. Lastly, the study looks into aspects of the land value of original plots and readjusted plots by concluding the argument whether this TP scheme model really worked in small and medium towns. Because the land deduction under TP scheme is allowed up to 50% as per the act and there is no distinct provision for small and medium towns under the act, so how this could be justified to smaller towns where the market value have not changed over the years. After analyzing the issues and reason behind the agitation against the DP and TPS in these small and medium towns. The broader recommendation has been given which can make these plans acceptable and suitable for the stakeholder.

Keywords: development plans, medium towns, small towns, town planning schemes

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Authors: Septiany Trisnaningtyas

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Purpose: This research aims to examine the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia. A sharp decline in the number of patients coming to the hospital for treatment during the pandemic has an impact on the growth of the pharmaceutical sector and brought major changes in financial position and business performance. Pharmaceutical companies that provide products related to the Covid-19 pandemic can survive and continue to grow. This study investigates the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia associated with the number of Covid-19 cases. Design/methodology/approach: This study uses panel-data regression models to evaluate the influence of the number of Covid-19 confirmed cases on profitability of ninelisted pharmaceuticalcompanies in Indonesia. This research is based on four independent variables that were empirically examined for their relationship with profitability. These variables are liquidity (current ratio), growth rate (sales growth), firm size (total sales), and market power (the Lerner index). Covid-19 case is used as moderating variable. Data of nine pharmaceutical companies listed on the Indonesia Stock Exchange covering the period of 2018–2021 were extracted from companies’ quarterly annual reports. Findings: In the period during Covid-19, company growth (sales growth) and market power (lerner index) have a positive and significant relationship to ROA and ROE. Total of confirmed Covid-19 cases has a positive and significant relationship to ROA and is proven to have a moderating effect between company’s growth (sales growth) to ROA and ROE and market power (Lerner index) to ROA. Research limitations/implications: Due to data availability, this study only includes data from nine listed pharmaceutical companies in Indonesian Stock exchange and quarterly annual reportscovering the period of 2018-2021. Originality/value: This study focuses onpharmaceutical companies in Indonesia during Covid-19 pandemic. Previous study analyzes the data from pharmaceutical companies’ annual reports since 2014 and focus on universal health coverage (national health insurance) implementation from the Indonesian government. This study analyzes the data using fixed effect panel-data regression models to evaluate the influence of Covid-19 confirmed cases on profitability. Pooled ordinary least squares regression and fixed effects were used to analyze the data in previous study. This study also investigate the moderating effect of Covid-19 confirmed cases to profitability in relevant with the pandemic situation.

Keywords: profitability, indonesia, pharmaceutical, Covid-19

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Authors: Alper Tolga Kumtepe, Erdem Erdogdu, M. Recep Okur, Eda Kaypak, Ozlem Kaya, Serap Ugur, Deniz Dincer, Hakan Yildirim

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Interaction is one of the most important components of open and distance learning. According to Moore, who proposed one of the keystones on interaction types, there are three basic types of interaction: learner-teacher, learner-content, and learner-learner. From these interaction types, learner-content interaction, without doubt, can be identified as the most fundamental one on which all education is based. Efficacy, efficiency, and attraction of open and distance learning systems can be achieved by the practice of effective learner-content interaction. With the development of new technologies, interactive e-learning materials have been commonly used as a resource in open and distance learning, along with the printed books. The intellectual engagement of the learners with the content that is course materials may also affect their satisfaction for the open and distance learning practices in general. Learner satisfaction holds an important place in open and distance learning since it will eventually contribute to the achievement of learning outcomes. Using the learner-content interaction activities in course materials, Anadolu University, by its Open Education system, tries to involve learners in deep and meaningful learning practices. Especially, during the e-learning material design and production processes, identifying appropriate learner-content interaction activities within the context of learning outcomes holds a big importance. Considering the lack of studies adopting this approach, as well as its being a study on the use of e-learning materials in Open Education system, this research holds a big value in open and distance learning literature. In this respect, the present study aimed to investigate a) which learner-content interaction activities included in interactive courses are the most effective in learners’ achievement of verbal information learning outcomes and b) to what extent distance learners are satisfied with these learner-content interaction activities. For this study, the quasi-experimental research design was adopted. The 120 participants of the study were from Anadolu University Open Education Faculty students living in Eskişehir. The students were divided into 6 groups randomly. While 5 of these groups received different learner-content interaction activities as a part of the experiment, the other group served as the control group. The data were collected mainly through two instruments: pre-test and post-test. In addition to those tests, learners’ perceived learning was assessed with an item at the end of the program. The data collected from pre-test and post-test were analyzed by ANOVA, and in the light of the findings of this approximately 24-month study, suggestions for the further design of e-learning materials within the context of learner-content interaction activities will be provided at the conference. The current study is planned to be an antecedent for the following studies that will examine the effects of activities on other learning domains.

Keywords: interaction, distance education, interactivity, online courses

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Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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Authors: Tjipta Lesmana

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Terrorist attacks quickly penetrated Indonesia following the downfall of Soeharto regime in May 1998. Reform era was officially proclaimed. Indonesia turned to 'heaven state' from 'authoritarian state'. For the first time since 1966, the country experienced a full-scale freedom of expression, including freedom of the press, and heavy acknowledgement of human rights practice. Some religious extremists previously run away to neighbor countries to escape from security apparatus secretly backed home. Quickly they consolidated the power to continue their long aspiration and dream to establish 'Shariah Indonesia', Indonesia based on Khilafah ideology. Bali bombings I which shocked world community occurred on 12 October 2002 in the famous tourist district of Kuta on the Indonesian island of Bali, killing 202 people (including 88 Australians, 38 Indonesians, and people from more than 20 other nationalities). In the capital, Jakarta, successive bombings were blasted in Marriott hotel, Australian Embassy, residence of the Philippine Ambassador and stock exchange office. A 'drunken Indonesia' is far from ready to combat nationwide sudden and massive terrorist attacks. Police Detachment 88 (Densus 88) Indonesian counter-terrorism squad, was quickly formed following 2002 Bali Bombing. Anti-terrorism Provisional Act was immediately erected, as well, due to urgent need to fight terrorism. Some Bali bombings criminals were deadly executed after sentenced by the court. But a series of terrorist suicide attacks and another Bali bombings (the second one) in Bali, again, shocked world community. Terrorism network is undoubtedly spreading nationwide. Suspicion is high that they had close connection with Al Qaeda’s groups. Even 'Afghanistan alumni' and 'Syria alumni' returned to Indonesia to back up the local mujahidins in their fights to topple Indonesia constitutional government and set up Islamic state (Khilafah). Supported by massive aids from friendly nations, especially Australia and United States, Indonesia launched large scale operations to crush terrorism consisted of various radical groups such as JAD, JAS, and JAADI. Huge energy, money, and souls were dedicated. Terrorism is, however, persistently entrenched. High ranking officials from Detachment 88 squad and military intelligence believe that terrorism is still one the most deadly enemy of Indonesia.

Keywords: counter-radicalization, de-radicalization, Khalifah, Union State, Al Qaedah, ISIS

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Authors: Vilma Sasyte, Vilma Viliene, Agila Dauksiene, Asta Raceviciute-Stupeliene, Romas Gruzauskas, Saulius Alijosius

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The eight-week feeding trial was conducted involving 27-wk-old Isa brown laying hens to study the effect of dry extrusion processing on partial reduction in total glucosinolates content of locally produced rapeseed and on productivity and eggs quality parameters of laying hens. Thirty-six hens were randomly assigned one of three treatments (CONTR, AERS and HERS), each comprising 12, individual caged layers. The main composition of the diets was the same, but extruded soya bean seed were replaced with 2.5% of the extruded rapeseed in the AERS group and 4.5 % in the HERS group. Rapeseed was extruded together with faba beans. Due to extrusion process the glucosinolates content was reduced by 7.83 µmol/g of rapeseed. The results of conducted trial shows, that during all experimental period egg production parameters, such as the average feed intake (6529.17 vs. 6257 g/hen/14 day; P < 0.05) and laying intensity (94.35% vs. 89.29; P < 0.05) were statistically different for HERS and CONTR laying hens respectively. Only the feed conversion ratio to produce 1 kg of eggs, kg in AERS group was by 11 % lower compared to CONTR group (P < 0.05). By analysing the effect of extruded rapeseed on egg mass, the statistical differences between treatments were no determined. The dietary treatments did not affect egg weight, albumen height, haugh units, albumen and yolk pH. However, in the HERS group were get eggs with the more intensive yolk color, higher redness (a) and yellowness (b) values. The inclusion of full-fat extruded rapeseed had no effect on egg shell quality parameters, i.e. shell breaking strength, shell weight with and without coat and shell index, but in the experimental groups were get eggs with the thinner shell (P < 0.05). The internal egg quality analysis showed that with higher content of extruded rapeseed (4.5 %) level in the diet, the total cholesterol in the eggs yolk decreased by 1.92 mg/g in comparison with CONTR group (P < 0.05). Eggs laid by hens fed the diet containing 2.5% and 4.5% had increasing ∑PNRR/∑SRR ratio and decreasing ∑(n-6)/∑(n-3) ratio values of eggs yolk fatty acids than in CONTR group. Eggs of hens fed different amount of extruded rapeseed presented an n-6 : n-3 ratio changed from 5.17 to 4.71. The analysis of the relationship between hypocholesteremia/ hypercholesterolemia fatty acids (H/H), which is based on the functional properties of fatty acids, found that the value of it ratio is significant higher in laying hens fed diets supplemented with 4.5% extruded rapeseed than the CONTR group, demonstrating the positive effects of extruded rapeseed on egg quality. The results of trial confirmed that extruded full fat rapeseed to the 4.5% are suitable to replace soyabean in the compound feed of laying hens.

Keywords: egg quality, extruded full-fat rapeseed, laying hens, productivity

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Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: children, inflammation, insulin resistance, metabolic syndrome, obesity

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Authors: Nijanthan Mohan, Rolf Gross, Fabian Theis

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The conventional method used in the construction industries often resulted in significant rework since most of the decisions were taken onsite under the pressure of project deadlines and also due to the improper information flow, which results in ineffective coordination. However, today’s architecture, engineering, and construction (AEC) stakeholders demand faster and accurate deliverables, efficient buildings, and smart processes, which turns out to be a tall order. Hence, the building information modelling (BIM) concept was developed as a solution to fulfill the above-mentioned necessities. Even though BIM is successfully implemented in most of the world, it is still in the early stages in Germany, since the stakeholders are sceptical of its reliability and efficiency. Due to the huge capital requirement, the small and medium-sized construction companies are still reluctant to implement BIM workflow in their projects. The purpose of this paper is to analyse the opportunities and obstacles to implementing BIM for prefabrication. Among all other advantages of BIM, pre-fabrication is chosen for this paper because it plays a vital role in creating an impact on time as well as cost factors of a construction project. The positive impact of prefabrication can be explicitly observed by the project stakeholders and participants, which enables the breakthrough of the skepticism factor among the small scale construction companies. The analysis consists of the development of a process workflow for implementing prefabrication in building construction, followed by a practical approach, which was executed with two case studies. The first case study represents on-site prefabrication, and the second was done for off-site prefabrication. It was planned in such a way that the first case study gives a first-hand experience for the workers at the site on the BIM model so that they can make much use of the created BIM model, which is a better representation compared to the traditional 2D plan. The main aim of the first case study is to create a belief in the implementation of BIM models, which was succeeded by the execution of offshore prefabrication in the second case study. Based on the case studies, the cost and time analysis was made, and it is inferred that the implementation of BIM for prefabrication can reduce construction time, ensures minimal or no wastes, better accuracy, less problem-solving at the construction site. It is also observed that this process requires more planning time, better communication, and coordination between different disciplines such as mechanical, electrical, plumbing, architecture, etc., which was the major obstacle for successful implementation. This paper was carried out in the perspective of small and medium-sized mechanical contracting companies for the private building sector in Germany.

Keywords: building information modelling, construction wastes, pre-fabrication, small and medium sized company

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Orkide Donma, Mustafa M. Donma

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Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices

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Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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Authors: M. S. Stepanova, V. V. Zakharov, P. D. Khavlyuk, I. D. Skurlov, A. Y. Dubovik, A. L. Rogach

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Carbon dots are small carbon-based spherical nanoparticles, which are typically less than 10 nm in size that can be modified with surface passivation and heteroatoms doping. The light-absorbing ability of carbon dots has attracted a significant amount of attention in photoluminescence for bioimaging and fluorescence sensing applications owing to their advantages, such as tunable fluorescence emission, photo- and thermostability and low toxicity. In this study, carbon dots were synthesized by the solvothermal method from citric acid and ethylenediamine dissolved in water. The solution was heated for 5 hours at 200°C and then cooled down to room temperature. The carbon dots films were obtained by evaporation from a high-concentration aqueous solution. The increase of both luminescence intensity and light transmission was obtained as a result of a 405 nm laser exposure to a part of the carbon dots film, which was detected using a confocal laser scanning microscope (LSM 710, Zeiss). Blueshift up to 35 nm of the luminescence spectrum is observed as luminescence intensity, which is increased more than twofold. The exact value of the shift depends on the time of the laser exposure. This shift can be caused by the modification of surface groups at the carbon dots, which are responsible for long-wavelength luminescence. In addition, a shift of the absorption peak by 10 nm and a decrease in the optical density at the wavelength of 350 nm is detected, which is responsible for the absorption of surface groups. The obtained sample was also studied with time-resolved confocal fluorescence microscope (MicroTime 100, PicoQuant), which made it possible to receive a time-resolved photoluminescence image and construct emission decays of the laser-exposed and non-exposed areas. 5 MHz pulse rate impulse laser has been used as a photoluminescence excitation source. Photoluminescence decay was approximated by two exhibitors. The laser-exposed area has the amplitude of the first-lifetime component (A1) twice as much as before, with increasing τ1. At the same time, the second-lifetime component (A2) decreases. These changes evidence a modification of the surface groups of carbon dots. The detected effect can be used to create thermostable fluorescent marks, the physical size of which is bounded by the diffraction limit of the optics (~ 200-300 nm) used for exposure and to improve the optical properties of carbon dots or in the field of optical encryption. Acknowledgements: This work was supported by the Ministry of Science and Higher Education of Russian Federation, goszadanie no. 2019-1080 and financially supported by Government of Russian Federation, Grant 08-08.

Keywords: carbon dots, photoactivation, optical properties, photoluminescence and absorption spectra

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Authors: Vibha Devi, Shabina Khanam

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Hemp (Cannabis sativa) possesses a rich content of ω-6 linoleic and ω-3 linolenic essential fatty acid in the ratio of 3:1, which is a rare and most desired ratio that enhances the quality of hemp oil. These components are beneficial for the development of cell and body growth, strengthen the immune system, possess anti-inflammatory action, lowering the risk of heart problem owing to its anti-clotting property and a remedy for arthritis and various disorders. The present study employs supercritical fluid extraction (SFE) approach on hemp seed at various conditions of parameters; temperature (40 - 80) °C, pressure (200 - 350) bar, flow rate (5 - 15) g/min, particle size (0.430 - 1.015) mm and amount of co-solvent (0 - 10) % of solvent flow rate through central composite design (CCD). CCD suggested 32 sets of experiments, which was carried out. As SFE process includes large number of variables, the present study recommends the application of resampling techniques for cross-validation of the obtained data. Cross-validation refits the model on each data to achieve the information regarding the error, variability, deviation etc. Bootstrap and jackknife are the most popular resampling techniques, which create a large number of data through resampling from the original dataset and analyze these data to check the validity of the obtained data. Jackknife resampling is based on the eliminating one observation from the original sample of size N without replacement. For jackknife resampling, the sample size is 31 (eliminating one observation), which is repeated by 32 times. Bootstrap is the frequently used statistical approach for estimating the sampling distribution of an estimator by resampling with replacement from the original sample. For bootstrap resampling, the sample size is 32, which was repeated by 100 times. Estimands for these resampling techniques are considered as mean, standard deviation, variation coefficient and standard error of the mean. For ω-6 linoleic acid concentration, mean value was approx. 58.5 for both resampling methods, which is the average (central value) of the sample mean of all data points. Similarly, for ω-3 linoleic acid concentration, mean was observed as 22.5 through both resampling. Variance exhibits the spread out of the data from its mean. Greater value of variance exhibits the large range of output data, which is 18 for ω-6 linoleic acid (ranging from 48.85 to 63.66 %) and 6 for ω-3 linoleic acid (ranging from 16.71 to 26.2 %). Further, low value of standard deviation (approx. 1 %), low standard error of the mean (< 0.8) and low variance coefficient (< 0.2) reflect the accuracy of the sample for prediction. All the estimator value of variance coefficients, standard deviation and standard error of the mean are found within the 95 % of confidence interval.

Keywords: resampling, supercritical fluid extraction, hemp oil, cross-validation

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Authors: Mohit Kumar, Beklashwar Salona, Shiv Murti, Mukesh Singh

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We report here a case of five-months old male baby, born as second child of non-consanguineous parents with no considerable history of genetic abnormality which was referred to our cytogenetic laboratory for chromosomal analysis. Physical dysmorphic facial features including mongoloid face, cleft palate, simian crease, and developmental delay were observed. We present this case with unique balanced autosomal translocation of t(3;10)(p21;p13). The risk of phenotypic abnormalities based on de novo balanced translocation was estimated to be 7%. The association of balanced chromosomal rearrangement with Down syndrome features such as multiple congenital anomalies, facial dysmorphism and congenital heart anomalies are very rare in a 5-months old male child. Trisomy-21 is not uncommon in chromosomal abnormality with the birth defect and balanced translocations are frequently observed in patients with secondary infertility or recurrent spontaneous abortion (RSA). Two ml heparinized peripheral blood cells cultured in RPMI-1640 for 72 hours supplemented with 20% fetal bovine serum, phytohemagglutinin (PHA), and antibiotics were used for chromosomal analysis. A total 30 metaphases images were captured using Olympus-BX51 microscope and analyzed using Bio-view karyotyping software through GTG-banding (G bands by trypsin and Giemsa) according to International System for Human Cytogenetic Nomenclature 2016. The results showed balanced translocation between short arm of chromosome # 3 and short arm of chromosome # 10. The karyotype of the child was found to be 46,XY,t(3;10)(p21; p13). Chromosomal abnormalities are one of the major causes of birth defect in new born babies. Also, balanced translocations are frequently observed in patients with secondary infertility or recurrent spontaneous abortion. The index case presented with dysmorphic facial features and had a balanced translocation 46,XY,t(3;10)(p21;p13). This translocation with break points at (p21; p13) has not been reported in the literature in a child with facial dysmorphism. To the best of our knowledge, this is the first report of novel balanced translocation t(3;10) with break points in a child with dysmorphic features. We found balanced chromosomal translocation instead of any trisomy or unbalanced aberrations along with some phenotypic abnormalities. Therefore, we suggest that such novel balanced translocation with abnormal phenotype should be reported in order to enable the pathologist, pediatrician, and gynecologist to have a better insight into the intricacies of chromosomal abnormalities and their associated phenotypic features. We hypothesized that dysmorphic features as seen in this case may be the result of change in the pattern of genes located at the breakpoint area in balanced translocations or may be due to deletion or mutation of genes located on the p-arm of chromosome # 3 and p-arm of chromosome # 10.

Keywords: balanced translocation, karyotyping, phenotypic abnormalities, facial dimorphisms

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Authors: Kanti Sapkota, Do Hyun Lee, Sung Soo Han

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Nanocomposites have been widely used in various fields such as electronics, catalysis, and in chemical, biological, biomedical and optical fields. They display broad biomedical properties like antidiabetic, anticancer, antioxidant, antimicrobial and antibacterial activities. Moreover, nanomaterials have been used for wastewater treatment. Particularly, bimetallic hybrid nanocomposites exhibit unique features as compared to their monometallic components. Hybrid nanomaterials not only afford the multifunctionality endowed by their constituents but can also show synergistic properties. In addition, these hybrid nanomaterials have noteworthy catalytic and optical properties. Notably, Au−Ag based nanoparticles can be employed in sensor and catalysis due to their characteristic composition-tunable plasmonic properties. Due to their importance and usefulness, various efforts were developed for their preparation. Generally, chemical methods have been described to synthesize such bimetallic nanocomposites. In such chemical synthesis, harmful and hazardous chemicals cause environmental contamination and increase toxicity levels. Therefore, ecologically benevolent processes for the synthesis of nanomaterials are highly desirable to diminish such environmental and safety concerns. In this regard, here we disclose a simple, cost-effective, external additive free and eco-friendly method for the synthesis of Au-Ag@AgCl nanocomposites using Nephrolepis cordifolia root extract. Au-Ag@AgCl NCs were obtained by the simultaneous reduction of cationic Ag and Au into AgCl in the presence of plant extract. The particle size of 10 to 50 nm was observed with the average diameter of 30 nm. The synthesized nanocomposite was characterized by various modern characterization techniques. For example, UV−visible spectroscopy was used to determine the optical activity of the synthesized NCs, and Fourier transform infrared (FT-IR) spectroscopy was employed to investigate the functional groups present in the biomolecules that were responsible for both reducing and capping agents during the formation of nanocomposites. Similarly, powder X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), thermogravimetric analysis (TGA) and energy-dispersive X-ray (EDX) spectroscopy were used to determine crystallinity, size, oxidation states, thermal stability and weight loss of the synthesized nanocomposites. As a synthetic application, the synthesized nanocomposite exhibited excellent catalytic activity for the multicomponent synthesis of biologically interesting quinoline molecules via domino annulation-aromatization reaction of aniline, arylaldehyde, and phenyl acetylene derivatives. Interestingly, the nanocatalyst was efficiently recycled for five times without substantial loss of catalytic properties.

Keywords: nanoparticles, catalysis, multicomponent, quinoline

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Authors: Clementine Colpaert, Boris L. Nikitenko

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The Upper Jurassic foraminiferal assemblages of the East European Platform have been strongly investigated through the 20th century with biostratigraphical and in smaller degree palaeoecological and palaeobiogeographical purposes. Over the Late Jurassic, the platform was a shallow epicontinental sea that extended from Tethys to the Artic through the Pechora Sea and further toward the northeast in the West Siberian Sea. Foraminiferal assemblages of the Russian Sea were strongly affected by sea-level changes and were controlled by alternated Boreal to Peritethyan influences. The central part of the East European Platform displays very rich and diverse foraminiferal assemblages. Two sections have been analyzed; the Makar'yev Section in the Moscow Depression and the Gorodishi Section in the Yl'yanovsk Depression. Based on the evolution of foraminiferal assemblages, palaeoenvironment has been reconstructed, and sea-level changes have been refined. The aim of this study is to understand palaeoceanographical changes throughout the Oxfordian – Kimmeridgian of the central part of the Russian Sea. The Oxfordian was characterized by a general transgressive event with intermittency of small regressive phases. The platform was connected toward the south with Tethys and Peritethys. During the Middle Oxfordian, opening of a pathway of warmer water from the North-Tethys region to the Boreal Realm favoured the migration of planktonic foraminifera and the appearance of new benthic taxa. It is associated with increased temperature and primary production. During the Late Oxfordian, colder water inputs associated with the microbenthic community crisis may be a response to the closure of this warm-water corridor and the disappearance of planktonic foraminifera. The microbenthic community crisis is probably due to the increased sedimentation rate in the transition from the maximum flooding surface to a second-order regressive event, increasing productivity and inputs of organic matter along with sharp decrease of oxygen into the sediment. It is following during the Early Kimmeridgian by a replacement of foraminiferal assemblages. The almost all Kimmeridgian is characterized by the abundance of many common with Boreal and Subboreal Realm. Connections toward the South began again dominant after a small regressive event recorded during the Late Kimmeridgian and associated with the abundance of many common taxa with Subboreal Realm and Peritethys such as Crimea and Caucasus taxa. Foraminiferal assemblages of the East European Platform are strongly affected by palaeoecological changes and may display a very good model for biofacies typification under Boreal and Subboreal environments. The East European Platform appears to be a key area for the understanding of Upper Jurassic big scale palaeoceanographical changes, being connected with Boreal to Peritethyan basins.

Keywords: foraminifera, palaeoceanography, palaeoecology, upper jurassic

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Authors: Juan-Pedro Rica-Peromingo

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Nowadays, corpus linguistics has become a key research methodology for Translation Studies, which broadens the scope of cross-linguistic studies. In the case of the study presented here, the approach used focuses on learners with little or no experience to study, at an early stage, general mistakes and errors, the correct or incorrect use of translation strategies, and to improve the translational competence of the students. Led by Sylviane Granger and Marie-Aude Lefer of the Centre for English Corpus Linguistics of the University of Louvain, the MUST corpus (MUltilingual Student Translation Corpus) is an international project which brings together partners from Europe and worldwide universities and connects Learner Corpus Research (LCR) and Translation Studies (TS). It aims to build a corpus of translations carried out by students including both direct (L2 > L1) an indirect (L1 > L2) translations, from a great variety of text types, genres, and registers in a wide variety of languages: audiovisual translations (including dubbing, subtitling for hearing population and for deaf population), scientific, humanistic, literary, economic and legal translation texts. This paper focuses on the work carried out by the Spanish team from the Complutense University (UCMA), which is part of the MUST project, and it describes the specific features of the corpus built by its members. All the texts used by UCMA are either direct or indirect translations between English and Spanish. Students’ profiles comprise translation trainees, foreign language students with a major in English, engineers studying EFL and MA students, all of them with different English levels (from B1 to C1); for some of the students, this would be their first experience with translation. The MUST corpus is searchable via Hypal4MUST, a web-based interface developed by Adam Obrusnik from Masaryk University (Czech Republic), which includes a translation-oriented annotation system (TAS). A distinctive feature of the interface is that it allows source texts and target texts to be aligned, so we can be able to observe and compare in detail both language structures and study translation strategies used by students. The initial data obtained point out the kind of difficulties encountered by the students and reveal the most frequent strategies implemented by the learners according to their level of English, their translation experience and the text genres. We have also found common errors in the graduate and postgraduate university students’ translations: transfer errors, lexical errors, grammatical errors, text-specific translation errors, and cultural-related errors have been identified. Analyzing all these parameters will provide more material to bring better solutions to improve the quality of teaching and the translations produced by the students.

Keywords: corpus studies, students’ corpus, the MUST corpus, translation studies

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Authors: L. Sierra, N. Gambetta, M. A. Garcia-Benau, M. Orta

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Financial scandals and financial crisis have led to an international debate on the value of auditing. In recent years there have been significant legislative reforms aiming to increase markets’ confidence in audit services. In particular, there has been a significant debate on the need to improve the communication of auditors with audit reports users as a way to improve its informative value and thus, to improve audit quality. The International Auditing and Assurance Standards Board (IAASB) has proposed changes to the audit report standards. The International Standard on Auditing 701, Communicating Key Audit Matters (KAM) in the Independent Auditor's Report, has introduced new concepts that go beyond the auditor's opinion and requires to disclose the risks that, from the auditor's point of view, are more significant in the audited company information. Focusing on the companies included in the Financial Times Stock Exchange 100 index, this study aims to focus on the analysis of the determinants of the number of KAM disclosed by the auditor in the audit report and moreover, the analysis of the determinants of the different type of KAM reported during the period 2013-2015. To test the hypotheses in the empirical research, two different models have been used. The first one is a linear regression model to identify the client’s characteristics, industry sector and auditor’s characteristics that are related to the number of KAM disclosed in the audit report. Secondly, a logistic regression model is used to identify the determinants of the number of each KAM type disclosed in the audit report; in line with the risk-based approach to auditing financial statements, we categorized the KAM in 2 groups: Entity-level KAM and Accounting-level KAM. Regarding the auditor’s characteristics impact on the KAM disclosure, the results show that PwC tends to report a larger number of KAM while KPMG tends to report less KAM in the audit report. Further, PwC reports a larger number of entity-level risk KAM while KPMG reports less account-level risk KAM. The results also show that companies paying higher fees tend to have more entity-level risk KAM and less account-level risk KAM. The materiality level is positively related to the number of account-level risk KAM. Additionally, these study results show that the relationship between client’s characteristics and number of KAM is more evident in account-level risk KAM than in entity-level risk KAM. A highly leveraged company carries a great deal of risk, but due to this, they are usually subject to strong capital providers monitoring resulting in less account-level risk KAM. The results reveal that the number of account-level risk KAM is strongly related to the industry sector in which the company operates assets. This study helps to understand the UK audit market, provides information to auditors and finally, it opens new research avenues in the academia.

Keywords: FTSE 100, IAS 701, key audit matters, auditor’s characteristics, client’s characteristics

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Authors: Abrar Almutairi, Alyaa Farouk, Amal Gouda

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Background: Social capital is a factor that helps in bonding in a social network. The individual and the neighborhood social capital affect the health status of members of a particular society. In addition, to the influence of social health on the health of the population, social health has a significant effect on women, especially those with pregnancy. Study objective was to assess the impact of the social capital on the health status of pregnant women Design: A descriptive crosssectional correlational design was utilized in this study. Methods: A convenient sample of 210 pregnant women who attended the outpatient antenatal clinicsfor follow-up in King Fahad hospital (Ministry of National Guard Health Affairs/Riyadh) and King Abdullah bin Abdelaziz University Hospital (KAAUH, Ministry of Education /Riyadh) were included in the study. Data was collected using a self-administered questionnaire that was developed by the researchers based on the “World Bank Social Capital Assessment Tool” and SF-36 questionnaire (Short Form Health Survey). The questionnaire consists of 4 parts to collect information regarding socio-demographic data, obstetric and gynecological history, general scale of health status and social activity during pregnancy and the social capital of the study participants, with different types of questions such as multiple-choice questions, polar questions, and Likert scales. Data analysis was carried out by using Statistical Package for the Social Sciences version 23. Descriptive statistic as frequency, percentage, mean, and standard deviation was used to describe the sample characteristics, and the simple linear regression test was used to assess the relationship between the different variables, with level of significance P≤0.005. Result: This study revealed that only 31.1% of the study participants perceived that they have good general health status. About two thirds (62.8%) of the participants have moderate social capital, more than one ten (11.2٪) have high social capital and more than a quarter (26%) of them have low social capital. All dimensions of social capital except for empowerment and political action had positive significant correlations with the health status of pregnant women with P value ranging from 0.001 to 0.010in all dimensions. In general, the social capital showed high statistically significant association with the health status of the pregnant (P=0.002). Conclusion: Less than one third of the study participants had good perceived health status, and the majority of the study participants have moderate social capital, with only about one ten of them perceived that they have high social capital. Finally, neighborhood residency area, family size, sufficiency of income, past medical and surgical history and parity of the study participants were all significantly impacting the assessed health domains of the pregnant women.

Keywords: impact, social capital, health status, pregnant women

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Authors: Andrew Green, Jiaming Liu, Kellathur Srinivasan, Raymond Chua

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Introduction: The size of Singapore’s online health product (HP) market (e-commerce) is largely unknown. However, it is recognized that a large majority comes from overseas and thus, unregulated. As buying HP from unauthorized sources significantly compromises public health safety, understanding e-commerce users’ demographics and their perceptions on online HP purchasing becomes a pivotal first step to form a basis for recommendations in Singapore’s pharmacovigilance efforts. Objective: To assess the prevalence of online HP purchasing behaviour among Singaporean e-commerce users. Methodology: This is a cross-sectional study targeting Singaporean e-commerce users recruited from various local websites and online forums. Participants were not randomized into study arms but instead stratified by random sampling method based on participants’ age. A self-administered anonymous questionnaire was used to explore participants' demographics, online HP purchasing behaviour, knowledge and attitude. The association of different variables with online HP purchasing behaviour was analysed using logistic regression statistics. Main outcome measures: Prevalence of HP e-commerce users in Singapore (%) and variables that contribute to the prevalence (adjusted prevalent ratio). Results: The study recruited 372 complete and valid responses. The prevalence of online HP consumers among e-commerce users in Singapore is estimated to be 55.9% (1.7 million consumers). Online purchasing of complementary HP (46.9%) was the most prevalent, followed by medical devices (21.6%) and Western medicine (20.5%). Multivariate analysis showed that age is an independent variable that correlates with the likelihood of buying HP online. The prevalence of HP e-commerce users is highest in the 35-44 age group (64.1%) and lowest among the 16-24 age group (36.4%). The most bought HP through the internet are vitamins and minerals (21.5%), non-herbal (15.9%), herbal (13.9%), weight loss (8.7%) and sports (8.4%) supplements. While the top 3 products are distributed equally between the genders, there is a skew towards female respondents (12.4% in females vs. 4.9% in males) for weight loss supplements and towards males (13.2% in males vs. 3.7% in females) for sports supplements. Even though online consumers are in the younger age brackets, our study found that up to 72.0% of HP bought online are bought for others (buyer’s family and/or friends). Multivariate analysis showed a statistically significant association between purchasing HP through online means and the perceptions that 'internet is safe' (adjusted Prevalence Ratio=1.15, CI 1.03-1.28), 'buying HP online is time saving' (PR=1.17, CI 1.01-1.36), and 'recognition of HP brand' (PR=1.21 CI 1.06-1.40). Conclusions: This study has provided prevalence data for online HP market in Singapore, and has allowed the country’s regulatory body to formulate a targeted pharmacovigilance approach to this growing problem.

Keywords: e-commerce, pharmaceuticals, pharmacovigilance, Singapore

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Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara

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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.

Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka

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Authors: Sara Saboonian, Pierre Filion

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There are two distinct planning approaches attempting to transform the North American suburb so as to reduce its adverse environmental impacts. The first one, the recentralization approach, proposes intensification, multi-functionality and more reliance on public transit and walking. It thus offers an alternative to the prevailing low-density, spatial specialization and automobile dependence of the North American suburb. The second approach concentrates instead on the provision of green infrastructure, which rely on natural systems rather than on highly engineered solutions to deal with the infrastructure needs of suburban areas. There are tensions between these two approaches as recentralization generally overlooks green infrastructure, which can be space consuming (as in the case of water retention systems), and thus conflicts with the intensification goals of recentralization. The research investigates three Canadian planned suburban centres in the Greater Toronto Area, where recentralization is the current planning practice, despite rising awareness of the benefits of green infrastructure. Methods include reviewing the literature on green infrastructure planning, a critical analysis of the Ontario provincial plans for recentralization, surveying residents’ preferences regarding alternative suburban development models, and interviewing officials who deal with the local planning of the three centres. The case studies expose the difficulties in creating planned suburban centres that accommodate green infrastructure while adhering to recentralization principles. Until now, planners have been mostly focussed on recentralization at the expense of green infrastructure. In this context, the frequent lack of compatibility between recentralization and the space requirements of green infrastructure explains the limited presence of such infrastructures in planned suburban centres. Finally, while much attention has been given in the planning discourse to the economic and lifestyle benefits of recentralization, much less has been made of the wide range of advantages of green infrastructure, which explains limited public mobilization over the development of green infrastructure networks. The paper will concentrate on ways of combining recentralization with green infrastructure strategies and identify the aspects of the two approaches that are most compatible with each other. The outcome of such blending will marry high density, public-transit oriented developments, which generate walkability and street-level animation, with the presence of green space, naturalized settings and reliance on renewable energy. The paper will advance a planning framework that will fuse green infrastructure with recentralization, thus ensuring the achievement of higher density and reduced reliance on the car along with the provision of critical ecosystem services throughout cities. This will support and enhance the objectives of both green infrastructure and recentralization.

Keywords: environmental-based planning, green infrastructure, multi-functionality, recentralization

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Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

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Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

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Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

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Authors: Caroline Mendes, Mary McNamara, Orla Howe

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For chemotherapy, a drug delivery system should be able to specifically target cancer cells and deliver the therapeutic dose without affecting normal cells. Folate receptors (FR) can be considered key targets since they are commonly over-expressed in cancer cells and they are the molecular marker used in this study. Here, cyclodextrin (CD) has being studied as a vehicle for delivering the chemotherapeutic drug, methotrexate (MTX). CDs have the ability to form inclusion complexes, in which molecules of suitable dimensions are included within the CD cavity. In this study, β-CD has been modified using folic acid so as to specifically target the FR molecular marker. Thus, the system studied here for drug delivery consists of β-CD, folic acid and MTX (CDEnFA:MTX). Cellular uptake of folic acid is mediated with high affinity by folate receptors while the cellular uptake of antifolates, such as MTX, is mediated with high affinity by the reduced folate carriers (RFCs). This study addresses the gene (mRNA) and protein expression levels of FRs and RFCs in the cancer cell lines CaCo-2, SKOV-3, HeLa, MCF-7, A549 and the normal cell line BEAS-2B, quantified by real-time polymerase chain reaction (real-time PCR) and flow cytometry, respectively. From that, four cell lines with different levels of FRs, were chosen for cytotoxicity assays of MTX and CDEnFA:MTX using the MTT assay. Real-time PCR and flow cytometry data demonstrated that all cell lines ubiquitously express moderate levels of RFC. These experiments have also shown that levels of FR protein in CaCo-2 cells are high, while levels in SKOV-3, HeLa and MCF-7 cells are moderate. A549 and BEAS-2B cells express low levels of FR protein. FRs are highly expressed in all the cancer cell lines analysed when compared to the normal cell line BEAS-2B. The cell lines CaCo-2, MCF-7, A549 and BEAS-2B were used in the cell viability assays. 48 hours treatment with the free drug and the complex resulted in IC50 values of 93.9 µM ± 9.2 and 56.0 µM ± 4.0 for CaCo-2 for free MTX and CDEnFA:MTX respectively, 118.2 µM ± 10.8 and 97.8 µM ± 12.3 for MCF-7, 36.4 µM ± 6.9 and 75.0 µM ± 8.5 for A549 and 132.6 µM ± 12.1 and 288.1 µM ± 16.3 for BEAS-2B. These results demonstrate that MTX is more toxic towards cell lines expressing low levels of FR, such as the BEAS-2B. More importantly, these results demonstrate that the inclusion complex CDEnFA:MTX showed greater cytotoxicity than the free drug towards the high FR expressing CaCo-2 cells, indicating that it has potential to target this receptor, enhancing the specificity and the efficiency of the drug.

Keywords: cyclodextrins, cancer treatment, drug delivery, folate receptors, reduced folate carriers

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Authors: Gyaltsen Dakpa, K. J. Senthil Kumar, Nai-Wen Tsao, Sheng-Yang Wang

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Context: Coronavirus disease 2019 (COVID-19) is a severe respiratory illness caused by the SARS-CoV-2 virus. One of the hallmarks of COVID-19 is a change in metabolism, which can lead to increased severity and mortality. The mechanism of SARS-CoV-2-mediated perturbations of metabolic pathways has yet to be fully understood. Research Aim: This study aimed to investigate the metabolic alteration caused by SARS-CoV-2 spike protein in Phorbol 12-myristate 13-acetate (PMA)-induced human monocytes (THP-1) and to examine the regulatory effect of natural compounds like Antcins A on SARS-CoV-2 spike protein-induced metabolic alteration. Methodology: The study used a combination of proton nuclear magnetic resonance (1H-NMR) and MetaboAnalyst 5.0 software. THP-1 cells were treated with SARS-CoV-2 spike protein or control, and the metabolomic profiles of the cells were compared. Antcin A was also added to the cells to assess its regulatory effect on SARS-CoV-2 spike protein-induced metabolic alteration. Findings: The study results showed that treatment with SARS-CoV-2 spike protein significantly altered the metabolomic profiles of THP-1 cells. Eight metabolites, including glycerol-phosphocholine, glycine, canadine, sarcosine, phosphoenolpyruvic acid, glutamine, glutamate, and N, N-dimethylglycine, were significantly different between control and spike-protein treatment groups. Antcin A significantly reversed the changes in these metabolites. In addition, treatment with antacid A significantly inhibited SARS-CoV-2 spike protein-mediated up-regulation of TLR-4 and ACE2 receptors. Theoretical Importance The findings of this study suggest that SARS-CoV-2 spike protein can cause significant metabolic alterations in THP-1 cells. Antcin A, a natural compound, has the potential to reverse these metabolic alterations and may be a potential candidate for developing preventive or therapeutic agents for COVID-19. Data Collection: The data for this study was collected from THP-1 cells that were treated with SARS-CoV-2 spike protein or a control. The metabolomic profiles of the cells were then compared using 1H-NMR and MetaboAnalyst 5.0 software. Analysis Procedures: The metabolomic profiles of the THP-1 cells were analyzed using 1H-NMR and MetaboAnalyst 5.0 software. The software was used to identify and quantify the cells' metabolites and compare the control and spike-protein treatment groups. Questions Addressed: The question addressed by this study was whether SARS-CoV-2 spike protein could cause metabolic alterations in THP-1 cells and whether Antcin A can reverse these alterations. Conclusion: The findings of this study suggest that SARS-CoV-2 spike protein can cause significant metabolic alterations in THP-1 cells. Antcin A, a natural compound, has the potential to reverse these metabolic alterations and may be a potential candidate for developing preventive or therapeutic agents for COVID-19.

Keywords: SARS-CoV-2-spike, ¹H-NMR, metabolomics, antcin-A, taiwanofungus camphoratus

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Authors: Begum Koru, Isik Aybay, Demet Celik Ulusoy

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The discipline of law is quite complex and has its own terminology. Apart from written legal rules, there is also living law, which refers to legal practice. Basic legal rules aim at the happiness of individuals in social life and have different characteristics in different branches such as public or private law. On the other hand, law is a national phenomenon. The law of one nation and the legal system applied on the territory of another nation may be completely different. People who are experts in a particular field of law in one country may have insufficient expertise in the law of another country. Today, in addition to the local nature of law, international and even supranational law rules are applied in order to protect basic human values and ensure the protection of human rights around the world. Systems that offer algorithmic solutions to legal problems using artificial intelligence (AI) tools will perhaps serve to produce very meaningful results in terms of human rights. However, algorithms to be used should not be developed by only computer experts, but also need the contribution of people who are familiar with law, values, judicial decisions, and even the social and political culture of the society to which it will provide solutions. Otherwise, even if the algorithm works perfectly, it may not be compatible with the values of the society in which it is applied. The latest developments involving the use of AI techniques in legal systems indicate that artificial law will emerge as a new field in the discipline of law. More AI systems are already being applied in the field of law, with examples such as predicting judicial decisions, text summarization, decision support systems, and classification of documents. Algorithms for legal systems employing AI tools, especially in the field of prediction of judicial decisions and decision support systems, have the capacity to create automatic decisions instead of judges. When the judge is removed from this equation, artificial intelligence-made law created by an intelligent algorithm on its own emerges, whether the domain is national or international law. In this work, the aim is to make a general analysis of this new topic. Such an analysis needs both a literature survey and a perspective from computer experts' and lawyers' point of view. In some societies, the use of prediction or decision support systems may be useful to integrate international human rights safeguards. In this case, artificial law can serve to produce more comprehensive and human rights-protective results than written or living law. In non-democratic countries, it may even be thought that direct decisions and artificial intelligence-made law would be more protective instead of a decision "support" system. Since the values of law are directed towards "human happiness or well-being", it requires that the AI algorithms should always be capable of serving this purpose and based on the rule of law, the principle of justice and equality, and the protection of human rights.

Keywords: AI and law, artificial law, protection of human rights, AI tools for legal systems

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

Procedia PDF Downloads 106