Search results for: continuous care

Authors: Riya Kartikee, Uday Shankar

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Background –.Happiness refers to a range of the balance of positive and pleasant emotions of joy, pride, contentment, gratitude, and living with ethics. Happiness is an experience combined with a sense that one’s life is good, meaningful, and worth a while, but in the context of orphans who have lost their birthgivers, their parents who play an important role in bringing necessities and comfort to them, but many terms of the above phases are missing in the life of orphan So, stress increases because of lack of love, attention, sympathy, care, they experience many kind of trauma and also in some cases their lives get worst as they face some physiological abuse, sexual abuse, they are forced to have stress at a not only mentally but physically also in the context of Patna, Bihar where many people are below poverty line, lack of resources is a normal condition for the Orphanages.AIM- The present study was intended to study the level of Happiness among the orphans of Patna District, also it was attempted to find the role of happiness in their lives as an individual.Method- The sample of 70 Orphans in the age group of 12 to 18 years were taken from the orphanages of Patna district-Apnaghar, Rainbow homes, etc. Purposive sampling was used in the study, There has been one research tool used in the study, which is Happiness scale by Dr.R.L Bhardwaj and Dr.Poonam R Das. Results- Results have revealed that Orphans have possessed a very low level of happiness and unhappiness was related due to their living conditions in the orphanage.Conclusion-It can be stated that the Level of happiness is an important missing determinant in the lives of orphans.

Keywords: happiness, orphans, patna, orphanage

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Authors: Preethi Sudarshanie Dassanayake, R. A. Sudath Weerasiri

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Objective: The objective of this study were to find out highest expectation and perception,highest gap between perception and expectation of service quality, and to find out such gaps between perception and expectation with regard to service quality dimensions were whether statistically significant. Methodology: This study carried out at the Out Patient Department (OPD) of the Veterinary Teaching Hospital (VTH), University of Peradeniya. Modified version of SERVQUAL with 22-pairs of items regarding expectation and perception of service quality in dimensions of tangible, reliability, responsiveness, assurance and empathy were included in Part 1 and the Part 2 of the questionnaire consisted of questions regarding socio-demographic factors. Sample size was 200 and sampling procedure was Systematic Random Sampling. Customers above 18 years of age, able to read, write and understand Sinhala or English language, visits more than twice in last six months and who willing to respond were selected. Findings: The analysis revealed customers expectations of service higher than the perceived for all 22- items of the SERVQUAL. This high expectation suggests that there is sufficient room for further improvement of service quality in all five dimensions. Originality/Value of the Paper: This study gave a new insight for poorly researched area of veterinary health service quality in Sri Lankan context. It provides hospital administrators and policy makers to develop strategies for further improvement of service quality according to customers' view.

Keywords: expectation, perception, service quality, SERVQUAL, veterinary health care

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Authors: Muhammad Aasim, Mehmet Karataş, Fatih Erci, Şeyma Bakırcı, Ecenur Korkmaz, Burak Kahveci

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Water hyssop (Bacopa monnieri L. Wettst.) is an important medicinal aquatic/semi aquatic plant native to India where it is used in traditional medicinal system. The plant contains bioactive compounds mainly Bacosides which are the main ingridient of commercial drug available as memory enhancer tonic. The local name of water hyssop is Brahmi and brahmi based drugs are available against for curing chronic diseases and disorders Alzheimer’s disease, anxiety, asthma, cancer, mental illness, respiratory ailments, and stomach ulcers. The plant is not a cultivated plant and collection of plant from nature make palnt threatened to endangered. On the other hand, low seed viability and availability make it difficult to propagate plant through traditional techniques. In recent years, plant tissue culture techniques have been employed to propagate plant for its conservation and production for continuous availability of secondary metabolites. On the other hand, application of nanoparticles has been reported for increasing biomass, in vitro regeneration and secondary metabolites production. In this study, silver nanoparticles (AgNPs) were applied at the rate of 2, 4, 6, 8 and 10 ppm to Murashihe and Skoog (MS) medium supplemented with 1.0 mg/l Benzylaminopurine (BAP), 3.0% sucrose and 0.7% agar. Leaf explants of water hyssop were cultured on AgNPs containing medium. Shoot induction from leaf explants were relatively slow compared to medium without AgNPs. Multiple shoot induction was recorded after 3-4 weeks of culture comapred to control that occured within 10 days. Regenerated shoots were rooted successfully on MS medium supplemented with 1.0 mg/l IBA and acclimatized in the aquariums for further studies.

Keywords: Water hyssop, Silver nanoparticles, In vitro, Regeneration, Secondary metabolites

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Authors: M. Ridwanul Hassan, Samuel George

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Aims: Steroid injections are commonly used as a diagnostic tool or an alternative to surgical management of carpal tunnel syndrome (CTS) and are generally safe. Ischaemia is a rare complication with very few cases reported in the literature. Methods: We report a case of a 50-year-old female that presented with a necrotic wound to her left palm one month after a steroid injection into the carpal tunnel. She had a 2-year history of CTS in her left hand that was treated with six previous steroid injections in primary care during this period. The wound evolved from a blister to a necrotic ulcer which led to a painful, hollow defect in the centre of her palm. She did not report any history of trauma, nor did she have any co-morbidities. Clinical photographs were taken. Results: On examination, she had a 0.5 cmx1 cm defect in the palm of her left hand down to aponeurosis. There was purulent discharge in the wound with surrounding erythema but no spreading cellulitis. She had full function of her fingers but was very tender on movements and at rest. She was admitted for intravenous antibiotics and underwent a debridement, washout, and carpal tunnel release the next day. The defect was packed to heal by secondary intention and has now fully healed one month following her operation. Conclusions: This is an extremely rare complication of steroid injections to the carpal tunnel and may have been avoided by earlier referral for surgery rather than treatment using multiple steroid injections.

Keywords: hand surgery, complication, rare, carpal tunnel syndrome

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Authors: Serzhan Ashirov, Dana Nour, Rafat Rob, Khaled Alotaibi

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There has been a fast growth in the introduction and use of communications, information, monitoring, and sensing technologies. The new technologies are making their way to the Industrial Control Systems as embedded in products, software applications, IT services, or commissioned to enable integration and automation of increasingly global supply chains. As a result, the lines that separated the physical, digital, and cyber world have diminished due to the vast implementation of the new, disruptive digital technologies. The variety and increased use of these technologies introduce many cybersecurity risks affecting cyber-resilience of the supply chain, both in terms of the product or service delivered to a customer and members of the supply chain operation. US department of energy considers supply chain in the IR4 space to be the weakest link in cybersecurity. The IR4 identified the digitization of the field devices, followed by digitalization that eventually moved through the digital transformation space with little care for the new introduced cybersecurity risks. This paper will examine the best methodologies for securing the electrical substations from cybersecurity attacks due to supply chain risks, and due to digitization effort. SCADA systems are the most vulnerable part of the power system infrastructure due to digitization and due to the weakness and vulnerabilities in the supply chain security. The paper will discuss in details how create a secure supply chain methodology, secure substations, and mitigate the risks due to digitization

Keywords: cybersecurity, supply chain methodology, secure substation, digitization

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Authors: B. Sanchez, D. Zambrana-Vasquez, J. Fresner, C. Krenn, F. Morea, L. Mercatelli

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Local administrations are facing established targets on sustainable development from different disciplines at the heart of different city departments. Nevertheless, some of these targets, such as CO₂ reduction, relate to two or more disciplines, as it is the case of sustainable mobility and energy plans (SUMP & SECAP/SEAP). This opens up the possibility to efficiently cooperate among different city departments and to create and develop harmonized spatial plans by using available resources and together achieving more ambitious goals in cities. The steps of the harmonization processes developed result in the identification of areas to achieve common strategic objectives. Harmonization, in other words, helps different departments in local authorities to work together and optimize the use or resources by sharing the same vision, involving key stakeholders, and promoting common data assessment to better optimize the resources. A methodology to promote resilient city planning via the harmonization of sustainable mobility and energy plans is presented in this paper. In order to validate the proposed methodology, a representative city engaged in an innovation process in efficient spatial planning is used as a case study. The harmonization process of sustainable mobility and energy plans covers identifying matching targets between different fields, developing different spatial plans with dual benefit and common indicators guaranteeing the continuous improvement of the harmonized plans. The proposed methodology supports local administrations in consistent spatial planning, considering both energy efficiency and sustainable mobility. Thus, municipalities can use their human and economic resources efficiently. This guarantees an efficient upgrade of land use plans integrating energy and mobility aspects in order to achieve sustainability targets, as well as to improve the wellbeing of its citizens.

Keywords: integrated multi-sector planning, spatial plans harmonization, sustainable energy and climate action plan, sustainable urban mobility plan

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Authors: Ricardo Paiva, Rui Soares, Felix Harnau, Bruno Fragoso

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Nickel-based alloys are materials well suited for service in extreme environments subjected to pressure and heat. Some industrial applications for Nickel-based alloys are aerospace and jet engines, oil and gas extraction, pollution control and waste processing, automotive and marine industry. It is generally recognized that grain refinement is an effective methodology to improve the quality of casted parts. Conventional grain refinement techniques involve the addition of inoculation substances, the control of solidification conditions, or thermomechanical treatment with recrystallization. However, such methods often lead to non-uniform grain size distribution and the formation of hard phases, which are detrimental to both wear performance and biocompatibility. Stirring of the melt by electromagnetic fields has been widely used in continuous castings with success for grain refinement, solute redistribution, and surface quality improvement. Despite the advantages, much attention has not been paid yet to the use of this approach on functional castings such as investment casting. Furthermore, the effect of electromagnetic stirring (EMS) fields on Nickel-based alloys is not known. In line with the gaps/needs of the state-of-art, the present research work targets to promote new advances in controlling grain size and morphology of investment cast Nickel based alloys. For such a purpose, a set of experimental tests was conducted. A high-frequency induction furnace with vacuum and controlled atmosphere was used to cast the Inconel 718 alloy in ceramic shells. A coil surrounded the casting chamber in order to induce electromagnetic stirring during solidification. Aiming to assess the effect of the electromagnetic stirring on Ni alloys, the samples were subjected to microstructural analysis and mechanical tests. The results show that electromagnetic stirring can be an effective methodology to modify the grain size and mechanical properties of investment-cast parts.

Keywords: investment casting, grain refinement, electromagnetic stirring, nickel alloys

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Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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Authors: Velasco-Rendón María Del Carmen, Cuéllar-Bermúdez Sara Paulina, Parra-Saldívar Roberto

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Phycocyanin is a blue pigment protein with fluorescent activity produced by cyanobacteria. It has been recently studied to determine its anticancer, antioxidant and antiinflamatory potential. Since 2014 it was approved as a Generally Recognized As Safe (GRAS) proteic pigment for the food industry. Therefore, phycocyanin shows potential for the food, nutraceutical, pharmaceutical and diagnostics industry. Conventional phycocyanin extraction includes buffer solutions and ammonium sulphate followed by chromatography or ATPS for protein separation. Therefore, further purification steps are time-requiring, energy intensive and not suitable for scale-up processing. This work presents an alternative to conventional methods that also allows large scale application with commercially available equipment. The extraction was performed by exposing the dry biomass to mechanical cavitation and salting out with NaCl to use an edible reagent. Also, isoelectric point precipitation was used by addition of HCl and neutralization with NaOH. The results were measured and compared in phycocyanin concentration, purity and extraction yield. Results showed that the best extraction condition was the extraction by salting out with 0.20 M NaCl after 30 minutes cavitation, with a concentration in the supernatant of 2.22 mg/ml, a purity of 3.28 and recovery from crude extract of 81.27%. Mechanical cavitation presumably increased the solvent-biomass contact, making the crude extract visibly dark blue after centrifugation. Compared to other systems, our process has less purification steps, similar concentrations in the phycocyanin-rich fraction and higher purity. The contaminants present in our process edible NaCl or low pHs that can be neutralized. It also can be adapted to a semi-continuous process with commercially available equipment. This characteristics make this process an appealing alternative for phycocyanin extraction as a pigment for the food industry.

Keywords: extraction, phycocyanin, precipitation, scale-up

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Authors: M. F. Wu, F. T. Cheng, C. S. Wu, M. C. Tan

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It is a critical time to upgrade technology and increase value added with manufacturing skills developing and management strategies that will highly satisfy the customers need in the precision machinery global market. In recent years, the supply side, each precision machinery manufacturers in each country are facing the pressures of price reducing from the demand side voices that pushes the high-end precision machinery manufacturers adopts low-cost and high-quality strategy to retrieve the market. Because of the trend of the global market, the manufacturers must take price reducing strategies and upgrade technology of low-end machinery for differentiations to consolidate the market. By using six key success factors (KSFs), customer perceived value, customer satisfaction, customer service, product design, product effectiveness and machine structure quality are causal conditions to explore the impact of competitive advantage of the enterprise, such as overall profitability and product pricing power. This research uses key success paths (KSPs) approach and f/s QCA software to explore various combinations of causal relationships, so as to fully understand the performance level of KSFs and business objectives in order to achieve competitive advantage. In this study, the combination of a causal relationships, are called Key Success Paths (KSPs). The key success paths guide the enterprise to achieve the specific outcomes of business. The findings of this study indicate that there are thirteen KSPs to achieve the overall profitability, sixteen KSPs to achieve the product pricing power and seventeen KSPs to achieve both overall profitability and pricing power of the enterprise. The KSPs provide the directions of resources integration and allocation, improve utilization efficiency of limited resources to realize the continuous vision of the enterprise.

Keywords: precision machinery industry, key success factors (KSFs), key success paths (KSPs), overall profitability, product pricing power, competitive advantages

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Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

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Authors: Sally Shepherd, Jessica Wong, David Read

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Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.

Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma

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Authors: Yang Ye, Hongfei Qiu, Yaqi Li

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The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.

Keywords: driverless, urban public space, construction strategy, urban design

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Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry

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The continuous increase in the world population, resource shortage and the warning of climate change cause various environmental and social issues to the world. Thus, sustainability concept is much needed nowadays. Organizations are progressively falling under strong worldwide pressure to integrate sustainability practices into their project decision-making development. Construction projects in the industry are amongst the most significant, since it is one of the biggest divisions and of main significance for the national economy and hence has a massive effect on the environment and society. So, it is important to discover approaches to incorporate sustainability into the management of those projects. This study presents a combined sustainability index of projects with sustainable transportation which has been formed as per a comprehensive literature review and survey study. Transportation systems enable the movement of goods and services worldwide, and it is leading to economic growth and creating jobs while creating negative impacts on the environment and society. This research is study to quantify the sustainability indicators, through 1) identifying the importance of sustainable transportation indicators that are based on the sustainable practices used for the construction projects and 2) measure the effectiveness of practices through these indicators on the three sustainable pillars. A total 26 sustainability indicators have been selected and grouped under each related sustainability pillars. A survey was used to collect the opinion about the sustainability indicators by a scoring system. A combined sustainability index considering three sustainable pillars can be helpful in evaluating the transportation sustainable practices of a project and making decisions regarding project selection. In addition to focus on the issue of financial resource allocation in a project selection, the decision-maker could take into account the sustainability as an important key in addition to the project’s return and risk. The purpose of this study is to measure the performance of transportation sustainability which allow companies to assess multiple projects selection. This is useful to decision makers to rank and focus more on future sustainable projects.

Keywords: sustainable transportation, transportation performances, sustainable indicators, sustainable construction practice, sustainability

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Authors: Hepinda Fajari Nuharini, Sugiarti A. Musabiq

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Background: Various and continuous pressures that exceed individual resources can cause first-year undergraduate college students to experience psychological distress. Psychological distress can occur when individuals use rumination as cognitive coping strategies. Rumination is one of the cognitive coping strategies that can be used by individuals to respond to psychological distress that causes individuals to think about the causes and consequences of events that have occurred. Rumination had two subtypes, such as brooding and reflective. Therefore, the purpose of this study was determining the role of brooding and reflective as subtypes of rumination toward psychological distress in University of Indonesia first-year undergraduate students. Methods: Participants of this study were 403 University of Indonesia first-year undergraduate students aged between 18 and 21 years old. Psychological distress measured using self reporting questionnaire (SRQ-20) and brooding and reflective as subtypes of rumination measured using Ruminative Response Scale - Short Version (RRS - Short Version). Results: Binary logistic regression analyses showed that 22.8% of the variation in psychological distress could be explained by the brooding and reflective as subtypes of rumination, while 77.2% of the variation in psychological distress could be explained by other factors (Nagelkerke R² = 0,228). The results of the binary logistic regression analysis also showed rumination subtype brooding is a significant predictor of psychological distress (b = 0,306; p < 0.05), whereas rumination subtype reflective is not a significant predictor of psychological distress (b = 0,073; p > 0.05). Conclusion: The findings of this study showed a positive relationship between brooding and psychological distress indicates that a higher level of brooding will predict higher psychological distress. Meanwhile, a negative relationship between reflective and psychological distress indicates a higher level of reflective will predict lower psychological distress in University of Indonesia first-year undergraduate students. Added Values: The psychological distress among first-year undergraduate students would then have an impact on student academic performance. Therefore, the results of this study can be used as a reference for making preventive action to reduce the percentage and impact of psychological distress among first-year undergraduate students.

Keywords: brooding as subtypes of rumination, first-year undergraduate students, psychological distress, reflective as subtypes of rumination

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Authors: Felipa de Mello-Sampayo

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The aim of this study is to undertake, from patient’s perspective, the timing and probability of using teledermatology, comparing it with a conventional referral system. The dynamic stochastic model’s main value-added consists of the concrete application to patients waiting for dermatology surgical intervention. Patients with low health level uncertainty must use teledermatology treatment as soon as possible, which is precisely when the teledermatology is least valuable. The results of the model were then tested empirically with the teledermatology network covering the area served by the Hospital Garcia da Horta, Portugal, links the primary care centers of 24 health districts with the hospital’s dermatology department via the corporate intranet of the Portuguese healthcare system. Health level volatility can be understood as the hazard of developing skin cancer and the trend of health level as the bias of developing skin lesions. The results of the survival analysis suggest that the theoretical model can explain the use of teledermatology. It depends negatively on the volatility of patients' health, and positively on the trend of health, i.e., the lower the risk of developing skin cancer and the younger the patients, the more presurgical teledermatology one expects to occur. Presurgical teledermatology also depends positively on out-of-pocket expenses and negatively on the opportunity costs of teledermatology, i.e., the lower the benefit missed by using teledermatology, the more presurgical teledermatology one expects to occur.

Keywords: teledermatology, wait time, uncertainty, opportunity cost, survival analysis

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Authors: Dominika Pihikova, Stefan Belicky, Tomas Bertok, Roman Sokol, Petra Kubanikova, Jan Tkac

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Since aberrant glycosylation is frequently accompanied by both physiological and pathological processes in a human body (cancer, AIDS, inflammatory diseases, etc.), the analysis of tumor-associated glycan patterns have a great potential for the development of novel diagnostic approaches. Moreover, altered glycoforms may assist as a suitable tool for the specificity and sensitivity enhancement in early-stage prostate cancer diagnosis. In this paper we discuss the construction and optimization of ultrasensitive sandwich biosensor platform employing lectin as glycan-binding protein. We focus on the immunoassay development, reduction of non-specific interactions and final glycoprofiling of human serum samples including both prostate cancer (PCa) patients and healthy controls. The fabricated biosensor was measured by label-free electrochemical impedance spectroscopy (EIS) with further lectin microarray verification. Furthermore, we analyzed different biosensor interfaces with atomic force microscopy (AFM) in nanomechanical mapping mode showing a significant differences in the altitude. These preliminary results revealing an elevated content of α-2,3 linked sialic acid in PCa patients comparing with healthy controls. All these experiments are important step towards development of point-of-care devices and discovery of novel glyco-biomarkers applicable in cancer diagnosis.

Keywords: biosensor, glycan, lectin, prostate cancer

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Authors: Jack Santiago Monell

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In America, misrepresentations of black males have been perpetuated throughout the history of popular culture. Because of these narratives, varying communities have developed biases and stereotypes about what black male masculinity represents and more importantly, how they respond to them. The researcher explored the perspectives of police officers in the following states, Maryland, Pennsylvania, and North Carolina. Because of the nature of police and community relations, and national attention to high profile cases, having officers provide context into how black males are viewed from their lens, was critical while expanding on the theoretical explanations to describe attitudes towards police confrontations. As one of the objectives was to identify specific themes relevant to why police officers may view African American males differently, hence, responding more aggressively, this proved to be the most beneficial method of initial analysis to identify themes. The following nodes (appearance, acting suspicious/ troublesome behavior, upbringing about black males, excessive force) were identified to analyze the transcripts to discern associations. The data was analyzed through NVivo 11, and several themes resulted to elaborate on the data received. In analyzing the data, four themes were identified: appearance, acting suspicious/ troublesome behavior, upbringing about black males, and excessive force. The data conveyed that continuous stereotypes about African American men will ultimately result in excessive use of force or pervasive shootings, albeit the men are armed or unarmed. African American males are consistently targeted because of their racial makeup and appearance over any other probable circumstances. As long as racial bias and stereotypical practices continue in policing, African American males will endlessly be unjustly targeted and at times, the victims of violent encounters with police officers in the United States.

Keywords: African American males, police perceptions, masculinity, popular culture

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Authors: Manish Madappa, Madhavi Gayathri Raman

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The primary vehicle of human communication is language. A breakdown occurring in any aspect of communication may lead to frustration and isolation among the learners and the teachers. Over seven percent of the population in the world currently experience limitations and those children who exhibit a deviant/deficient language acquisition curve even when being in a language rich environment as their peers may be at risk of having a language disorder or language impairment. The difficulty may be in the word level [vocabulary/word knowledge] and/or the sentence level [syntax/morphology) Children with SLI appear to be developing normally in all aspects except for their receptive and/or expressive language skills. Thus, it is utmost importance to identify children with or at risk of SLI so that an early intervention can foster language and social growth, provide the best possible learning environment with special support for language to be explicitly taught and a step in providing continuous and ongoing support. The present study looks at Kannada English bilingual children and works towards identifying children at risk of “specific language impairment”. The study was conducted through an exploratory study which systematically enquired into the narratives of young Kannada-English bilinguals and to investigate the data for story structure in their narrative formulations. Oral narrative offers a rich source of data about a child’s language use in a relatively natural context. The fundamental objective is to ensure comparability and to be more universal and thus allows for the evaluation narrative text competence. The data was collected from 10 class three students at a primary school in Mysore, Karnataka and analyzed for macrostructure component reflecting the goal directed behavior of a protagonist who is motivated to carry out some kind of action with the intention of attaining a goal. The results show that the children exhibiting a deviation of -1.25 SD are at risk of SLI. Two learners were identified to be at risk of Specific Language Impairment with a standard deviation of more the 1.25 below the mean score.

Keywords: bilingual, oral narratives, SLI, macrostructure

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Authors: Mai Ali

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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they'll encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in pediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing diabetic ketoacidosis (DKA) emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: junior pediatrician, DKA, standardized protocols, level of competence

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Authors: Ismail Okur, Betul Taspinar, Turkan Pasali Kilit, Eda O. Okur, Ferruh Taspinar

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Type 2 Diabetes Mellitus (T2DM) is one of the most important global health emergencies and every year more and more people are affected by T2DM. T2DM causes life-changing complications by affecting organ and systems. Although diet and exercise are the best way to treat patients with T2DM, those patients generally have a sedentary life style. This study was planned to determine whether patients with T2DM have kinesiophobia (fear of movement). A controlled trial was conducted on 87 adults. Forty-one individuals with T2DM (study group, 34 female and 7 male) and 46 nondiabetic individuals (control group, 39 female and 7 male) were included in the study. Patients were screened for fear of movement using the Tampa Scale for Kinesiophobia (TSK). The data including age, sex, weight, height, and TSK scores were obtained. Mann Whitney U test were used to analyse the data. The mean ages and BMI of study and control groups were 51.98 ± 6.03 year and 49.52 ± 5.61 year and 31.82 ± 2.88 kg/m2 and 30.22 ± 2.91 kg/m2, respectively. The groups have similar demographic properties. The kinesiophobia scores of study and control groups were 42.78 ± 5.50 and 39.48 ± 5.05, respectively and the difference was statistically significant (p=0.05). This study showed that patients with T2DM had high kinesiophobia scores rather than nondiabetics. Those patients might avoid to do exercise. In other words, patients with T2DM might have lower physical activity level. Therefore the authors suggest that to evaluate and interfere with kinesiophobia before conducting exercise therapy will be useful for diabetes care.

Keywords: diabetes, fear of movement, kinesiophobia, type 2 diabetes mellitus

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Authors: G. La Scalia, M. Enea, R. Micale, O. Corona, L. Settanni

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The quality and condition of perishable products delivered to the market and their subsequent selling prices are directly affected by the care taken during harvesting and handling. Mechanical injury, in fact, occurs at all stages, from pre-harvest operations through post-harvest handling, packing and transport to the market. The main implications of this damage are the reduction of the product’s quality and economical losses related to the shelf life diminution. For most perishable products, the shelf life is relatively short and it is typically dictated by microbial growth related to the application of dynamic and static loads during transportation. This paper presents the correlation between vibration levels and microbiological growth on strawberries and woodland strawberries and detects the presence of volatile organic compounds (VOC) in order to develop an intelligent logistic unit capable of monitoring VOCs using a specific sensor system. Fresh fruits were exposed to vibrations by means of a vibrating table in a temperature-controlled environment. Microbiological analyses were conducted on samples, taken at different positions along the column of the crates. The values obtained were compared with control samples not exposed to vibrations and the results show that different positions along the column influence the development of bacteria, yeasts and filamentous fungi.

Keywords: microbiological analysis, shelf life, transport damage, volatile organic compounds

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Authors: Yen-An Tsai, Ching-Ling Lin, Jia-Woei Hou, Mei-Lien Chen

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Endocrine-disrupting chemicals (EDCs) adversely affect the endocrine system. Phthalates, also called phthalic acid esters (PAEs), are manmade chemicals that are used as stabilizing agents in personal care products such as perfumes, lotions, and cosmetics. The aim was to explore whether PAEs exposure was associated with central precocious puberty (CPP) or constitutional delays in growth (CDGP). This case-control study included 48 female with CPP, 37 male with constitutional delays in growth, and 127 normal children and was conducted from December 2011 to August 2014. All participants completed a structured questionnaire regarding socio-demographic characteristics, lifestyle, and secondary sexual characteristics. The analytical method was based on ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) with isotope dilution for the quantitative detection of several phthalate metabolites in human urine. The risk of CPP with mep, mnbp, LMW >50th percentile were higher than those with 50th percentile were higher than those with <50 percentile in model 2. In model 1, we only found higher CDGP risk in mep, mnbp, and ΣPAEs. It shows that high phthalate exposure may associate with CDGP. In this case-control study, we found PAEs exposure was associated with central precocious puberty (CPP) or constitutional delays in growth.

Keywords: phthalates, puberty, delays, growth

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Authors: Fatema Salman, Ridha Hammam, Fatima Khairallah, Fatima Aradi, Nafeesa Abdulla, Mohammed Alsafar

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Purpose: This study aims at measuring the extent of nurses’ knowledge and attitudes toward the use of physical restraints in different hospital wards at Salmaniya Medical Complex (SMC). Background: The habitual use of physical restraint is a widespread practice among nurses working in the clinical settings. Restraints inflict many deleterious consequences on patients physically and psychologically which in turn increases their morbidity and mortality risk and jeopardizes care quality. Nurses’ knowledge and attitudes toward physical restraints are crucial determinants of the persistence of this practice. Literature review: the evidence of lack of knowledge among nurses regarding the use of physical restraints is overwhelming in various clinical settings, especially in two main areas which are the negative consequences and the available alternatives to physical restraints. Studies explored nurses’ attitudes toward physical restraints yielded inconsistent findings. Equally comparable, some studies found that nurses hold positive attitudes toward the use of physical restraints while some others reported just the opposite. Methods: Self-administered knowledge and attitudes scales to 106 nurses working in the SMC. Findings: nurses hold the moderate level of knowledge about restraints (M=58%) with weak negative attitudes (M = -20%) toward using it. Significant moderately-strong negative correlation (r= -0.57, r2= 0.32, p= 0.000) was uncovered between nurses knowledge and their attitudes which provided an empirical explanation of this phenomenon (use of physical restraints). Recommendations: Induction of awareness program that especially focuses on the negative consequences and encourages the use of alternatives is an evident need. This effort necessarily should be adjoined with policy and procedure adjustments.

Keywords: attitudes, knowledge, nurses, restraints

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

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Authors: Ganesh Nivrutti Akhade

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This paper attempts to develop a reliable and valid instrument of measuring Healthcare service quality in India, and also analyses the impact of demographic factor of respondent on healthcare service quality. In this research paper , extant literature survey, discussion with stakeholder of healthcare system such as patients, patients relative, administrators of hospitals, clinics, professionals and expert interviews were used to develop a attributes of healthcare service quality dimensions. A pilot study was conducted with a sample of 31 healthcare patients of private sector, public sector ,trust hospital ,primary health care centers and clinics was surveyed in the Nagpur Metropolitan Area. At the end fifteen dimensions—reliability, assurance, responsiveness, tangibility, empathy, affordability, respect, and caring, Attitude of staff, Technical competence, Appropriateness, Safety, continuity, Effectiveness, Availability, Financial support. This fifteen-dimensional model was validated through a content validity and construct validity. The proposed research model shows acceptable fit indices. Impact of these dimensions on the Overall Healthcare Service Quality and customer satisfaction are analyzed using multiple regression technique. Findings indicate that all dimensions carry significant impact on the Overall Healthcare Service Quality perceptions and customer satisfaction. However, availability and effectiveness dimensions carry the maximum impact on the Overall healthcare Service Quality .

Keywords: healthcare, service quality, factor analysis (CFA), india, service quality dimensions

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Authors: Emile Niringiyimana, LI Ji Qing, Giovanni Dushimimana, Virginie Umwere

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The development and utilization of renewable energy (RE) can not only effectively reduce carbon dioxide (CO2) emissions, but also became a solution to electricity shortage mitigation in rural areas. Hybrid RE systems are promising ways to provide consistent and continuous power for isolated areas. This work investigated the prospect and cost effectiveness of hybrid system complementarity between a 100kW solar PV system and a small-scale 200kW hydropower station in the South of Rwanda. In order to establish the optimal size of a RE system with adequate sizing of system components, electricity demand, solar radiation, hydrology, climate data are utilized as system input. The average daily solar radiation in Rukarara is 5.6 kWh/m2 and average wind speed is 3.5 m/s. The ideal integrated RE system, according to Homer optimization, consists of 91.21kW PV, 146kW hydropower, 12 x 24V li-ion batteries with a 20kW converter. The method of enhancing such hybrid systems control, sizing and choice of components is to reduce the Net present cost (NPC) of the system, unmet load, the cost of energy and reduction of CO2. The power consumption varies according to dominant source of energy in the system by controlling the energy compensation depending on the generation capacity of each power source. The initial investment of the RE system is $977,689.25, and its operation and maintenance expenses is $142,769.39 over a 25-year period. Although the investment is very high, the targeted profits in future are huge, taking into consideration of high investment in rural electrification structure implementations, tied with an increase of electricity cost and the 5 years payback period. The study outcomes suggest that the standalone hybrid PV-Hydropower system is feasible with zero pollution in Rukara community.

Keywords: HOMER optimization, hybrid power system, renewable energy, NPC and solar pv systems

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Authors: Himer Khalid, Alami Ilyass, Kharchoufa Loubna, Elachouri Mostafa

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It has been estimated by the World Health Organization that 80% of the world's population relies on traditional medicine to meet their daily health requirements. In Morocco reliance on such medicine is partly owing to the high cost of conventional medicine and the inaccessibility of modern health care facilities. There was high agreement in the use of plants as medicine in Oriental Morocco. Our objective is to evaluate the informant’s knowledge on medicinal plants by the local population and to document the uses of medicinal plants by this community, for the treatment of different illnesses. Using an ethnopharmacological approach, we collected information concerning the traditional medicinal knowledge and the medicinal plants used, by interviewing successfully 458 informants living in oriental Morocco (from Debdou, Taourirt, Guersif a,d Laayoune districts). The data were analyzed by statistical methods (Component Analysis “CA”, Factorial Analysis “FA”) and other methods such as through Informant’s Consensus Factor (ICF) and Use Value (UV). Our results indicate that, more than 60% of the population in these regions relies on medicinal plants for the treatment of different ailments with predominance of women consumers. 135 plant species belonging to 61 families were documented. These plants were used by the population for the treatment of a group of illness (about 14 principal ailments). We conclude that, in oriental Morocco, till now, the population has some traditional knowledge commonly used as medical tradition. These wealthy heritage needs conservation and evaluation.

Keywords: Morocco, medicinal plants, traditional knowledge, wealthy heritage

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Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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Authors: Shivalal Sharma, Sanjib K. Sharma, Madhab Lamsal

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Background: The aim of this study was to evaluate the clinical and laboratory changes three months after full-mouth scaling and root planing (SRP) in periodontitis patients with type 2 diabetes mellitus (DM). Methods: Forty-seven type 2 DM subjects with moderate to severe periodontitis were randomly divided into two groups. Treatment group (TG), 25 subjects, received full-mouth scaling and root planning; control group (CG), 22 subjects, received no treatment. At baseline and at the end of three months, glycated hemoglobin (HbA1c) values, fasting glucose, and clinical parameters like plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded in all the patients. Following SRP, the patients were enrolled in a monthly interval maintenance program for 3 months. Results: A statistically significant effect could be demonstrated for PI, GI, PPD, and CAL for the treatment group. HbA1c levels in the treatment group decreased significantly whereas the control group showed a slight but insignificant increase for these parameters. Conclusions: The results of this study showed that non-surgical periodontal treatment (SRP) is associated with improved glycemic control in type 2 DM patients and could be undertaken along with the standard measures for the diabetic patient care.

Keywords: periodontitis, type 2 diabetes mellitus, non-surgical periodontal therapy, SRP

Procedia PDF Downloads 284