Search results for: hip fracture risk

Authors: Yashved Serhun, Kim A. Timm

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Barclays Bank has identified the need for a head office building in Lusaka, Zambia, and construction of a 7200 m2 three-storey reinforced concrete office building with a structural steel roof is currently underway. A unique characteristic of the development is that the building footprint is positioned on dolomitic land. Dolomite rock has the tendency to react with and breakdown in the presence of slightly acidic water, including rainwater. This leads to a potential for subsidence and sinkhole formation. Subsidence and the formation of sinkholes beneath a building can be detrimental during both the construction and operational phases. This paper outlines engineering principles which were considered during the structural design of the raft foundation for the Barclays head office building. In addition, this paper includes multidisciplinary considerations and the impact of these on the structural engineering design of the raft foundation. By ensuring that the design of raft foundations on dolomitic land incorporates the requirements of all disciplines and relevant design codes during the design process, the risk associated with subsidence and sinkhole formation can be effectively mitigated during the operational phase of the building.

Keywords: dolomite, dolomitic land, raft foundation, structural engineering design

Procedia PDF Downloads 126

Authors: Issa M. Hweidi, Saba W. Al-Ibraheem

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This study aimed to assess the increased hospital length of stay and healthcare costs associated with SSIs among ventriculoperitoneal shunting surgery patients in Jordan. This study adopted a retrospective and nested 1:1 matched case-control design. A non-probability convenient sample of 48 VP shunt patients was recruited for the purpose of the study. The targeted groups of the study basically used to cross-match the variables investigated to minimize the risk of confounding. Information was extracted from the text of patients' electronic health records. As compared to the non-SSI group, the SSI group had an extra mean healthcare cost of $13,696.53 (p=0.001) and longer hospital length of stay (22.64 mean additional days). Furthermore, Acinetobacter baumannii and Klebsiella pneumonia were identified as being the most predominant causative agents of SSIs. The results of this study may provide baseline data for national and regional benchmarking to evaluate the quality of care provided to likewise patients. Adherence to infection control strategies and protocols considering new surveillance methods of SSIs is encouraged.

Keywords: ventriculoperitoneal shunt, health care cost, length of stay, neurosurgery, surgical site infections

Procedia PDF Downloads 79

Authors: M. Kosandi, V. Susanti, N. I. Subono, E. Kartini

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This paper discusses the risk of glorification trap in combating human trafficking, as it is shown in the case of Indonesia. Based on a research on Indonesian combat against trafficking in 2017-2018, this paper shows the tendency of misinterpretation and misapplication of the Indonesian anti-trafficking law into misusing the law for glorification, to create an image of certain extent of achievement in combating human trafficking. The objective of this paper is to explain the persistent occurrence of human trafficking crimes despite the significant progress of anti-trafficking efforts of Indonesian government. The research was conducted in 2017-2018 by qualitative approach through observation, depth interviews, discourse analysis, and document study, applying the three-dimensional model for analyzing human trafficking in the source country. This paper argues that the drive for glorification of achievement in the combat against trafficking has trapped Indonesian government in the loop of misinterpretation, misapplication, and misuse of the anti-trafficking law. In return, the so-called crime against humanity remains high and tends to increase in Indonesia.

Keywords: human trafficking, anti-trafficking policy, transnational crime, source country, glorification trap

Procedia PDF Downloads 170

Authors: Mulugeta Gurum Gerechal

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In this piece of study, food safety questions and potential health risks make this as one of the most serious environmental concerns. Then, the levels of essential and non-essential heavy metals concentration were studied in Onion, Carrot, Swiss chard and Lettuce vegetables and compared the permissible levels with international guidelines for safe food. The concentration of Fe was found in the higher concentrations compared to other metals analyzed or significantly different at 95% confidence level than the rest metals studied in this study. However, the levels of the concentration of Cd and Pb exceeded the permissible level set by WHO specifications in water samples, Cd and Pb exceeded the permissible level set by FAO/WHO specifications in all vegetable samples collected from Adiahferom River Fe and Cu were also found below the recommended levels. The higher concentration of Pb and Cd above the permissible level in vegetables used for human food may pose health risk to consumer. However, the Fe hasn’t any health effect they take on from the Adiahferom body River. Mostly, the levels of metals in similar vegetable samples differed between the three sampling site, that may be due to variation in sources and processes of contaminations.

Keywords: Adiahferom, turbidity, temperature, physico-chemical, assessment

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Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

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Kawasaki disease (KD) is the primary cause of acquired pediatric heart disease as an acute vasculitis. In children with prolonged fever, rash, and inflammation of the mucosa KD must be considered as a clinical diagnosis. There is a persuasive suggestion of immune-mediated damage as the pathophysiologic cascade of KD. For example, the invasion of cytotoxic T-cells supports a viral etiology and the inflammasome of the innate immune system is a critical component in the vasculitis formation in KD. Animal models of KD propose the cytokine profiles, such as increased IL-1 and GM-CSF, which cause vascular damage. CRP and IFN-γ elevated expression and the upregulation of IL-6, and IL-10 production are also described in previous studies. Untreated KD is a critical risk factor for coronary artery diseases and myocardial infarction. Vascular damage may encompass amplified T-cell activity. SMAD3 is an essential molecule in down-regulating T-cells and increasing expression of FoxP3. It has a critical effect in the differentiation of regulatory T-cells. The discrepancy of regulatory T-cells and pro-inflammatory Th17 has been studied in acute coronary syndrome during KD. However in the coronary artery damaged lymphocytes and IgA plasma cells are seen at the lesion locations, the major immune cells in the coronary lesions are monocytes/macrophages and neutrophils. These cells secrete TNF-α, and activates matrix metalloprotease (MMP)-9, reducing the integrity of vessels and prompting patients to arise aneurysm. MMPs can break down the components of the extracellular matrix and assist immune cell movement. IVIG as an effective form of treatment clarified the role of the immune system, which may target pathogenic antigens and regulate cytokine production. Several reports have revealed that in the coronary arteries, high expression of MMP-9 in monocyte/macrophage results in pathologic cascades. Curcumin is a potent antioxidant and anti-inflammatory molecule. Curcumin decreases the production of reactive oxygen and nitrogen species and inhibits transcription factors like AP-1 and NF-κB. Curcumin also contains the characteristics of inhibitory effects on MMPs, especially MMP-9. The upregulation of MMP-9 is an important cellular response. Curcumin treatment caused a reverse effect and down-regulates MMP-9 gene expression which may fund the anti-inflammatory effect. Curcumin inhibits MMP-9 expression via PKC and AMPK-dependent pathways in Human monocytes cells. Elevated expression and activity of MMP-9 are correlated with advanced vascular lesions. AMPK controls lipid metabolism and oxidation, and protein synthesis. AMPK is also necessary for the MMP-9 activity and THP-1 cell adhesion to endothelial cells. Curcumin was shown to inhibit the activation of AMPKα. Compound C (AMPK inhibitor) inhibits MMP-9 expression level. Therefore, through inactivating AMPKs and PKC, curcumin decreases the MMP-9 level, which results in inhibiting monocyte/macrophage differentiation. Compound C also suppress the phosphorylation of three major classes of MAP kinase signaling, suggesting that curcumin may suppress MMP-9 level by inactivation of MAPK pathways. MAPK cascades are activated to induce the expression of MMP-9. Curcumin inhibits MAPKs phosphorylation, which contributes to the down-regulation of MMP-9. This study demonstrated that the potential inhibitory properties of curcumin over MMP-9 lead to a therapeutic strategy to reduce the risk of coronary artery involvement during KD.

Keywords: MMP-9, coronary artery aneurysm, Kawasaki’s disease, curcumin, AMPK, immune system, NF-κB, MAPK

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

Procedia PDF Downloads 148

Authors: Haruna Abdu Usman, J. Mohammed Umar, U. M. Bashir

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Solid waste management continued to be the biggest threat to the sustainability of urban centers of developing countries. Most streets corners of these urban centers are characterized by heaps of uncollected wastes at drains, public spaces and road sides destroying the aesthetic qualities and environmental ecosystems of these cities. Also, harboring disease vectors and rodents putting the health of the populace at risk, thus posing a serious challenge to the municipalities who are in most cases responsible for the solid waste management in these cities. The typical or commonest method adapted by these agencies in dealing with the solid waste management is the conventional approach; focusing mainly on waste collection ,treatment(composting and incineration)and disposal giving little consideration to the 3RS, of waste reduce, re-used and recycled. The resultant consequence being huge budget spending in solid waste management as high as 80% but little collection rate as low as 50%. This paper attempt to analyze the impacts and effects of the conventional solid waste management practices on the stakeholders in solid waste management; the municipal authorities, the communities, formal and informal waste managers, the NGOs and CBOs and suggests appropriate measures that would lessen the effects.

Keywords: conventional waste management, solid waste, waste stakeholders, developing countries

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Authors: R. M. Chandler, A. J. Stringer

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In adults, short bursts of high-intensity exercise (intensities between 80-95% of maximum heart rates) increase cardiovascular and metabolic function without the time investment of traditional aerobic training. Similar improvements in various health indices are also becoming increasingly evident in children in countries other than the United States. In the United States, physical education programs have become shorter in length and fewer in frequency. With this in the background, it is imperative that health and physical educators delivered well-organized and focused fitness programs that can be tolerated across many different somatotypes. Perhaps the least effective lag-time in a US physical education (PE) class is the first 10 minutes, a time during which children warm up. Replacing a traditional PE warmup with a 10 min high-intensity excise protocol is a time-efficient method to impact health, leaving as much time for other PE material such as skill development, motor behavior development as possible. This supplemented 10 min high-intensity exercise increases cardiovascular function as well as induces favorable body composition changes in as little as six weeks with further enhancement throughout a semester of activity. The supplemental high-intensity exercise did not detract from the PE lesson outcomes.

Keywords: cardiovascular fitness, high intensity interval training, high intensity exercise, pediatric

Procedia PDF Downloads 138

Authors: Samera Salimpour Abkenar

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In traditional dyeing of natural fibers with natural dyes, metal salts are commonly used to increase color stability. This method always carries the risk of environmental pollution (contamination of arable soils and fresh groundwater) due to the release of dyeing effluents containing large amounts of metal. Therefore, researchers are always looking for new methods to obtain a green dyeing system. In this research, the use of the enzymatic dyeing method to prevent environmental pollution with metals and reduce production costs has been proposed. After degumming and bleaching, raw silk fabrics were dyed with natural dyes (Madder and Sumac) by three methods (pre-mordanting with a metal salt, one-step enzymatic dyeing, and two-step enzymatic dyeing). Results show that silk dyed with natural dyes by the enzymatic method has higher color strength and colorfastness than the pretreated with a metal salt. Also, the amount of remained dyes in the dyeing wastewater is significantly reduced by the enzymatic method. It is found that the enzymatic dyeing method leads to improvement of dye absorption, color strength, soft hand, no change in color shade, low production costs (due to low dyeing temperature), and a significant reduction in environmental pollution.

Keywords: eco-friendly, natural dyes, silk, traditional dyeing

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Authors: D. Subedi, S. Pradhan

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Current transformers are an integral part of power system because it provides a proportional safe amount of current for protection and measurement applications. However when the power system experiences an abnormal situation leading to huge current flow, then this huge current is proportionally injected to the protection and metering circuit. Since the protection and metering equipment’s are designed to withstand only certain amount of current with respect to time, these high currents pose a risk to man and equipment. Therefore during such instances, the CT saturation characteristics have a huge influence on the safety of both man and equipment and also on the reliability of the protection and metering system. This paper shows the effect of burden on the Accuracy Limiting factor/ Instrument security factor of current transformers and also the change in saturation characteristics of the CT’s. The response of the CT to varying levels of overcurrent at different connected burden will be captured using the data acquisition software LabVIEW. Analysis is done on the real time data gathered using LabVIEW. Variation of current transformer saturation characteristics with changes in burden will be discussed.

Keywords: accuracy limiting factor, burden, current transformer, instrument security factor, saturation characteristics

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Authors: Ewa Siedlecka

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Emotional stress is an important risk factor in the rate and severity of traffic accidents. Moreover, incorrect time perception is implicated in the increase of traffic violations, such as running red lights or collisions. While the role of emotional arousal on perceived time is well-established, the role of physiological arousal in time perception remains unexamined. Specific emotions can be, however, associated with distinct physiological responses. In the current research, two studies examined the role of physiological arousal in time perception. In the first experiment, 41 participants engaged in a cold pressor task and had their time perception measured throughout the experiment. In the second study, 138 participants engaged in either isometric or deep breathing exercises. These activities were designed to simulate the sympathetic and parasympathetic nervous systems, respectively. Participants completed a bisection task to measure time perception in both studies, as well as a physiological response via an Electrocardiography (ECG). Results found that activation of the parasympathetic nervous system is associated with greater time perception. These findings are discussed with reference to models of time perception, as well as implications for emotional driving and misperceptions of speed. It is important to consider the role of physiology in the misperception of time, as these factors can lead to increases in driving accidents.

Keywords: emotions, nervous system, physiology, time perception

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Authors: Dimitrios Akrivos, Alexandros K. Antoniou

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This paper looks at the crucial role of the British news media in the construction of extreme pornography as a social problem, suggesting that this paved the way for the subsequent criminalization of such material through the introduction of the Criminal Justice and Immigration Act 2008. Focusing on the high-profile case of Graham Coutts, it examines the British national press’ reaction to Jane Longhurst’s murder through a qualitative content analysis of 251 relevant news articles. Specifically, the paper documents the key arguments expressed in the corresponding claims-making process. It considers the different ways in which the consequent ‘trial by media’ presented this exceptional case as the ‘tip of the iceberg’ and eventually translated into policy. The analysis sheds light on the attempts to ‘piggyback’ the issue of extreme pornography on child sexual abuse images as well as the textual and visual mechanisms used to establish an ‘us versus them’ dichotomy in the pertinent media discourse. Finally, the paper assesses the severity of the actual risk posed by extreme pornography, concluding that its criminalization should not merely be dismissed as the outcome of an institutionalized media panic.

Keywords: criminalization, extreme pornography, social problem, trial by media

Procedia PDF Downloads 241

Authors: Humaira Saeed Malik, Salma Saad

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Introduction: Fowler's syndrome, first described by Clare Fowler in 1985, is a rare urological condition characterized by difficulty in urination due to the abnormal function of the urethral sphincter. It predominantly affects young women and leads to chronic urinary retention. The main concern in managing this condition is ensuring regular bladder emptying. Clam cystoplasty is a bladder augmentation surgery in which the bladder is clam-shelled open, and a segment of the intestine is used to increase the bladder's capacity and reduce bladder pressure. The Mitrofanoff procedure, a surgical creation of a continent urinary diversion, is often performed in patients with Fowler's syndrome who require long-term catheterization. This procedure involves creating a conduit (from the appendix or a segment of the small intestine) between the bladder and the skin, allowing for intermittent self-catheterization to manage urinary retention. Study: This case study examines a 39-year-old gravida 3, para 0+2 woman with a BMI of 40, Fowler's syndrome, type I diabetes, and post-traumatic stress disorder (PTSD), presenting at Dumfries and Galloway Royal Infirmary at 8 weeks of gestation. Diagnosed with Fowler's syndrome at 23, . A sacral nerve stimulator (SNS) device was initially placed but was subsequently removed after one year due to malfunction caused by trauma, subsequently she had undergone clam cystoplasty and the Mitrofanoff procedure for bladder management. Her pregnancy was complicated by vaginal bleeding at 10 weeks, treated with progesterone pessaries, and a urinary tract infection at 14 weeks, managed with antibiotics. Despite these challenges, she continued self-catheterization through the Mitrofanoff stoma and was placed on prophylactic antibiotics. Her diabetes was well-controlled on insulin, and a 20-week fetal anomaly scan was normal. The multidisciplinary team, including an obstetrician and a urologist, planned for serial growth scans and the initiation of low molecular weight heparin (LMWH) from 28 weeks due to the intermediate risk of venous thromboembolism (VTE) and to continue six weeks after delivery. A planned cesarean delivery at 37 weeks was arranged, with an MRI scan scheduled later in the pregnancy to assist in surgical planning, ensuring the preservation of the Mitrofanoff stoma's function. The surgery will occur in an elective setting and include a consultant urologist. Conclusion: Pregnancy in women with Fowler's syndrome who have undergone Clam cystoplasty and the Mitrofanoff procedure is rare, and management requires careful planning and a multidisciplinary approach. This case highlights the importance of individualized care plans and close monitoring of both mother and fetus. The patient's risk of recurrent UTIs, coupled with her diabetes and high BMI, necessitated coordinated care across specialties to ensure the best possible outcomes. The Mitrofanoff procedure proved effective in managing her urinary retention, allowing her to maintain self-catheterization during pregnancy. The multidisciplinary team approach was crucial in addressing her complex medical needs, involving obstetrics, urology, and endocrinology. This case adds valuable information to the limited literature on pregnancy management in patients with Fowler's syndrome who have undergone the Mitrofanoff procedure, highlighting the need for comprehensive, individualized care and the involvement of a multidisciplinary team to achieve the best results.

Keywords: fowler's syndrome, clam cystoplasty, mitrofanoff procedure, pregnancy

Procedia PDF Downloads 35

Authors: Aarti Singh, Anees Ahmad

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Carotenoids comprise a group of isoprenoid pigments. Carotenes, xanthophylls and their derivatives have been found to play an important role in all living beings through foods, neutraceuticals and pharmaceuticals. α-carotene, β-carotene and β-cryptoxanthin play a vital role in humans to provide vitamin A source for the growth, development and proper functioning of immune system and vision. They are very crucial for plants and humans as they protect from photooxidative damage and are excellent antioxidants quenching singlet molecular oxygen and peroxyl radicals. Diet including more intake of carotenoids results in reduced threat of various chronic diseases such as cancer (lung, breast, prostate, colorectal and ovarian cancers) and coronary heart diseases. The blue light filtering efficiency of the carotenoids in liposomes have been reported to be maximum in lutein followed by zeaxanthin, β-carotene and lycopene. Lycopene play a vital role for the protection from CVD. Lycopene in serum is directly related to reduced risk of osteoporosis in postmenopausal women. Carotenoids have the major role in the treatment of skin disorders. There is a need to identify and isolate novel carotenoids from diverse natural sources for human health benefits.

Keywords: antioxidants, carotenoids, neutraceuticals, osteoporosis, pharmaceuticals

Procedia PDF Downloads 363

Authors: Marcel Chevalier, Léo Dupont, Sylvain Marié, Frédérique Roffet, Elena Stolyarova, William Templier, Costin Vasile

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Industrial end-users are currently facing an increasing need to reduce the risk of unexpected failures and optimize their maintenance. This calls for both short-term analysis and long-term ageing anticipation. At Schneider Electric, we tackle those two issues using both machine learning and first principles models. Machine learning models are incrementally trained from normal data to predict expected values and detect statistically significant short-term deviations. Ageing models are constructed by breaking down physical systems into sub-assemblies, then determining relevant degradation modes and associating each one to the right kinetic law. Validating such anomaly detection and maintenance models is challenging, both because actual incident and ageing data are rare and distorted by human interventions, and incremental learning depends on human feedback. To overcome these difficulties, we propose to simulate physics, systems, and humans -including asset maintenance operations- in order to validate the overall approaches in accelerated time and possibly choose between algorithmic alternatives.

Keywords: degradation models, ageing, anomaly detection, soft sensor, incremental learning

Procedia PDF Downloads 128

Authors: Mojahid F. Saeed Osman

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Repairable items inventory system is a management tool used to incorporate all information concerning inventory levels and movements for repaired and new items. This paper presents development of an effective simulation model for managing the inventory of repairable items for a production system where production lines send their faulty items to a repair shop considering the stochastic failure behavior and repair times. The developed model imitates the process of handling the on-hand inventory of repaired items and the replenishment of the inventory of new items using Economic Order Quantity and Reorder Point ordering policy in a flexible and risk-free environment. We demonstrate the appropriateness and effectiveness of the proposed simulation model using an illustrative case problem. The developed simulation model can be used as a reliable tool for estimating a healthy on-hand inventory of new and repaired items, backordered items, and downtime due to unavailability of repaired items, and validating and examining Economic Order Quantity and Reorder Point ordering policy, which would further be compared with other ordering strategies as future work.

Keywords: inventory system, repairable items, simulation, maintenance, economic order quantity, reorder point

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Authors: Peter Shi

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Algorithmic trading is a rapidly expanding domain within quantitative finance, constituting a substantial portion of trading volumes in the US financial market. The demand for rigorous and robust mathematical theories underpinning these trading algorithms is ever-growing. In this study, the author establishes a new stock market model that integrates the Efficient Market Hypothesis and the statistical arbitrage. The model, for the first time, finds probabilistic relations between the rational price and the market price in terms of the conditional expectation. The theory consequently leads to a mathematical justification of the old market adage: buy-low and sell-high. The thresholds for “low” and “high” are precisely derived using a max-min operation on Bayes’s error. This explicit connection harmonizes the Efficient Market Hypothesis and Statistical Arbitrage, demonstrating their compatibility in explaining market dynamics. The amalgamation represents a pioneering contribution to quantitative finance. The study culminates in comprehensive numerical tests using historical market data, affirming that the “buy-low” and “sell-high” algorithm derived from this theory significantly outperforms the general market over the long term in four out of six distinct market environments.

Keywords: efficient market hypothesis, behavioral finance, Bayes' decision, algorithmic trading, risk control, stock market

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Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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Authors: Byeal-I Han, Michael Lee

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Ageing is associated with an increased risk of diseases such as cancer, and neurodegenerative disorders. Increased autophagy delays ageing and extends longevity. In this study, we investigated the role of autophagy in longevity using human foreskin fibroblast HS68 cells, in which a senescence-like growth arrest can be induced. In particular, cellular senescence is manifested by the irreversible cell cycle arrest, and may contribute to the ageing of organisms. The senescence state was measured with staining for senescence-associated β-galactosidase (SA-β-gal) activity that represents a sensitive and reliable marker to quantify senescent cells. We detected a significantly increased percentage (%) of SA-β-gal positive cells in HS68 cultures at passage 40 (63%) when compared with younger ones at passage 15 (0.5%). As expected, HS68 cells at passage 40 exhibited much lower proliferation rate than cells at passage 15. The basal levels of LC3 were measured by immunoblotting showing a comparison of LC3-I and LC3-II levels at 3 age-points in serially passaged HS68 cells. LC3-II/LC3-I ratio at different passage levels relative to β-actin levels of each band confirmed that cells at passage 34 showed lower conversion of non-autophagic LC3-I to autophagic LC3-II than the cells at passage 16. Furthermore, Cyto-ID autophagy assay also revealed that late passage cells showed lower autophagy than the early passage cells. Together, our findings suggest that senescence induction might be associated with decreased autophagy.

Keywords: ageing, autophagy, senescence, HS68

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Authors: Zainal Abu Zarim, Hafizah Omar Zaki

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The objective of this study is to analyse the success factors of entrepreneurs in the Malaysian SMEs in the urge to discover their entrepreneurial leadership characteristics. Data has been collected from top 50 SME award winning companies. The study has used the qualitative approach to data collection, where interviews are dispersed on these selected companies. From these 50 SMEs, only 25 accepted the interview request where one entrepreneur from each SME answered the questions. To successfully run this study, we administered some questions based on Hornaday 42 characteristics of an entrepreneurs, as well some structured questions to determine a successful of a company. The result shows that, entrepreneurs are confident, determine, diligent, flexible, responsive to challenges, responsible, foresight, courageous, aggressive, and committed. Consistent to this, several elements that makes the company successful includes (1) strong financial control, (2) continuous improvement, (3) product quality and product safety as top priority, (4) hard work and team work, and (5) eagerness in taking challenges. These results has deemed that entrepreneurs in many aspects are also leaders that are risk averse and determine, and are eager to work on continuous improvement in a financially strong company.

Keywords: characteristics of entrepreneurs, success of a company, key success factors, Malaysian SMEs

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Authors: Anton Bahtiar, Lukas Tjandra Leksana, Fransiscus D. Suyatna

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Hypercholesterolemia is one of the major risk factors that can trigger the development of cardiovascular disease, especially coronary heart disease. One of the traditional drugs used for hypercholesterolemia is a combination of herbs celery (Apium graveolens) and garlic (Allium sativum). This study aimed to investigate the effects of the extract on lipid profile in hypercholesterolemic subjects. Subjects consisted of patients with traditional medicine clinic in Jakarta. Each subject received treatment capsules containing herbal extract and placebo capsules. On the 44 subjects, the lipid profile was examined blood levels of total cholesterol, HDL, LDL, and triglycerides. Paired two-tailed t-test was used for the difference between lipid profile of the therapy group and the placebo group. The changes in the lipid profile between the treatment groups and the placebo group for total cholesterol, HDL, LDL, and triglycerides was 14,82 ± 6,946;1.45 ± 2,945;6,98 ± 8,105;2,48 ± 6,504 mg/dL. The herbal extract decrease blood cholesterol and LDL levels significantly (P <0.05).

Keywords: Allium sativum, Apium graveolens, hypercholesterolemia, cholesterol, HDL, LDL

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Authors: Abu Umar Faruq Ahmad, Muhammad Ayub

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Tabarru` (unilateral gratuitous contribution) is thought to be the basic concept that distinguishes Takaful from conventional non-Sharīʿah compliant insurance. The Sharīʿah compliance of its current practice has been questioned in the premise that, a) it is a form of commutative contract; b) it is akin to the commercial corporate structure of insurance companies due to following the same marketing strategies, allocation to reserves, sharing of underwriting surplus by the companies one way or the other, providing loans to the Takaful funds, and resultantly absorbing the underwriting losses. The Sharīʿah scholars are of the view that the relationship between participants in Takaful should be in the form of commitment to donate, under which a contributor makes commitments himself to donate a sum of money for mutual help and cooperation on the condition that the balance, if any, should be returned to him. With the aim of finding solutions to the above mentioned concerns and other Sharīʿah related issues the study seeks to investigate whether the Takaful companies are functioning in accordance with the Islamic principles of brotherhood, solidarity, and cooperative risk sharing. Given that it discusses the cooperative model of Takaful to address the current and future Sharīʿah related and legal concerns. The study proposed an alternative model and considers it to best serve the objectives of Takaful which operates on the basis of ta`awun or mutual co-operation.

Keywords: hibah, musharakah ta`awuniyyah, Tabarru`, Takaful

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Authors: Sweta Kandari

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Predominantly, the conventional role of an architect is to design and construct. However, in a post-disaster scenario, the prevalent role expands and includes many other responsibilities. Agencies collaborating in post-disaster reconstruction face the challenge of building back quickly while requiring them to listen, reflect, develop and deliver as per the needs and requirements of the people. The question of the role of an architect has been extensively discussed in the reconstruction field. Discourses about the role of an architect in post-disaster scenario revolve around the ignorance by the profession, their professional abilities and inabilities. Within this domain, this paper aims at analyzing and recognizing the roles, responsibilities, scope, limitations, skillsets applied and required by an architect while working in a post-disaster situation. Four projects rebuilt after the 2001 Bhuj earthquake in Gujarat, India were examined for this research. Based on the analysis of the case study, areas of intervention of an architect in the various stages of rebuilding were identified. It was reinforced that within the areas of intervention identified, there is a vast gap between the prescribed, the prevalent notion and the performed responsibilities of an architect. This paper brings forth the specific gaps in the rebuilding process while exploring and understanding the relationship between various stakeholders that influence the role of an architect.

Keywords: rebuilding, role of an architect, Bhuj, post-disaster

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Authors: S. Rostampour Yasouri, M. Ghane

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Leptospirosis is one the most important common diseases between human and live stock occurred by different species of Leptospira. This disease has been construed as the native in the northern provinces of Iran and risk of the infection with pathogenic is high. One hundred fifteen samples of water (67), soil (36) and feces of rodents (12) were collected from the rice fields of the suburbs of Tonekabon Township situated in northern part of Iran in 2012. The samples, after passage from membranous filters, were cultured in the liquid and solid EMJH medium and incubated at 30°C for 1 month. Leptospira spp. were isolated using culture technique, and the plates were studied from viewpoint of colony formation, microscopic observations and then identified by phenotyping tests. Finally, the identification of Leptospira genus was verified by PCR technique and 16S rRNA gene sequencing. Of 115 samples totally, 55 samples (47.82%) became positive by use of the culture technique which the positive cases included 47 water samples (70.14%) and 8 soil samples (22.22%), while the isolation was not accomplished from the sample of the rodents feces. Overall, according to these data, Leptospira spp. exists with high frequency in North Iran. Hence, based on foregoing evidence environments in the north of Iran are vehicles of Leptospira spp.

Keywords: EMJH Medium, Leptospira, Northern of Iran, rice fields

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Authors: Remi Safi, Aline Hamade, Najat Bteich, Jamal El Saghir, Mona Diab Assaf, Marwan El-Sabban, Fadia Najjar

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Estrogen is considered a risk factor for breast cancer since it promotes breast-cell proliferation. The jaesckeanadiol-3-p-hydroxyphenylpropanoate, a hemi-synthetic analogue of the natural phytoestrogen ferutinin (jaesckeanadiol-p-hydroxybenzoate), is designed to be devoid of estrogenic activity. This analogue induces a cytotoxic effect 30 times higher than that of ferutinin towards MCF-7 breast cancer cell line. We compared these two compounds with respect to their effect on proliferation, cell cycle distribution and cancer stem-like cells in the MCF-7 cell line. Treatment with ferutinin (30 μM) and its analogue (1 μM) produced a significant accumulation of cells at the pre G0/G1 cell cycle phase and triggered apoptosis. Importantly, this compound retains its anti-proliferative activity against breast cancer stem/progenitor cells that are naturally insensitive to ferutinin at the same dose. These results position ferutinin analogue as an effective compound inhibiting the proliferation of estrogen-dependent breast cancer cells and consistently targeting their stem-like cells.

Keywords: ferutinin, hemi-synthetic analogue, breast cancer, estrogen, stem/progenitor cells

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Authors: Claire Maillet

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Insider fraud, including its various forms such as employee fraud or internal fraud, is a major financial crime threat whereby an employee defrauds (or attempts to defraud) their current, prospective or past employer. ‘Employee’ covers anyone employed by the company, including contractors, agency workers, directors and part time staff. Insider fraud is even more of a concern given the impacts of the Coronavirus pandemic and the cost-of-living crisis, which have generated multiple opportunities to commit insider fraud. Insider fraud is something that is not necessarily thought of as a significant financial crime; Without the face-to-face, ‘over the shoulder’ capabilities of staff being able to keep an eye on their employees, there is a heightened reliance on trust and transparency. With this, naturally, comes an increased risk of insider fraud. Given that the number of FinTechs is on the rise and there is a significant lack of empirically based solutions for reducing insider fraud, these are gaps in the research space that this thesis aims to fill. Finally, Kassem (2022) notes that “academic research plays a crucial role in raising awareness about fraud and researching effective methods for countering it”. Thus, this thesis may be used as an opportune tool to provide an extensive list of controls spanning detection, deterrence and prevention, that are recommended to be implemented to help combat the insider threat.

Keywords: insider fraud, internal fraud, pandemic, Covid-19

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Authors: Prabin Raj Gautam

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Entrepreneurship in tourism sectors, particularly hotel entrepreneurship has contributed to Nepalese Gross Domestic Production (GDP). The tourist standard and star hotels in developing countries have not only been generating revenues but also providing international hospitality to the guest in the local areas. For doing so, these hotel enterprises must need to implement different business strategies to enhance and maintain their international business benchmark. The Entrepreneurial Orientation (EO) is core for making business strategies. Meanwhile, the corruption is labeled as negative factor for economic development. This paper presents the relationship between EO of Nepalese star hotels and organizational corruption. The study employed questionnaire survey as data collection tool under the quantitative methodology. Five hypotheses are developed and tested. After gathering the data form 216 questionnaire distributed to CEOs/Managers of the sample hotels, the findings show that out of five dimensions of EO, only autonomy, pro-activeness, and innovativeness are not significant to organizational corruption; however, risk-taking and competitive aggressiveness are found significant contributor. The descriptive statistics and structural equation modeling are employed to describe the data and fit the model.

Keywords: entrepreneurship, entrepreneurial orientation, organizational corruption, dimensions

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Authors: Bambang Wispriyono, Satria Pratama, Haryoto Kusnoputranto, Faisal Yunus, Meliana Sari

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Introduction/objective: The impact of the development of motor vehicles is increasing the number of pollutants in the air. One of the substances that cause serious health problems is NO2. The health impacts arising from exposure to NO2 include pulmonary function impairment. The purpose of this study was to determine the relationship of NO2 exposure on the incidence of pulmonary function impairment. Methods: We are using a cross-sectional study design with 110 traffic police who were divided into two groups: exposed (police officers working on the highway) and the unexposed group (police officers working in the office). Election subject convenient sampling carried out in each group to the minimum number of samples met. Results: The results showed that the average NO2 in the exposed group was 18.72 ppb and unexposed group is 4.14 ppb. Pulmonary dysfunction on exposed and unexposed groups showed that FVC (Forced Vital Capacity) value are 88.68 and 90.27. And FEV1 (Forced Expiratory Volume in One) value are 94.9 and 95.16. Some variables like waist circumference, Body Mass Index, Visceral Fat, and Fat has associated with the incidence of Pulmonary Dysfunction (p < 0.05). Conclusion: Health monitoring is needed to decreasing health risk in Policeman.

Keywords: NO2, pulmonary dysfunction, police traffic, Jakarta

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

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Authors: Jin-Ming Wu, Te-Wei Ho, Yu-Wen Tien

Abstract:

Background: The aim of this population-based study was to determine the occurrence of diabetes and exocrine pancreatic insufficiencies (EPI) on non-diabetes subjects receiving distal pancreatectomy (DP). Method: A nationwide cohort study between 2000 and 2010 was collected from the Taiwan National Health Insurance Research Database. Among 3264 DP patients, we identified 1410 non-diabetes and 966 non-diabetes non-EPI. Results. Of 1410 non-diabetes DP subjects, 312 patients (22.1%) developed newly-diagnosed diabetes after PD. On a multiple logistic regression model, co-morbid hyperlipidemia (odds ratio, 1.640; 95% CI, 1.362–2.763; P < 0.001) and pancreatitis (odds ratio, 2.428; 95% CI, 1.889–3.121; P < 0.001) significantly contributed to higher incidences of diabetes after DP. Moreover, 380 subjects (39.3%) developed EPI, and pancreatic cancer is the statistically significant risk factor (odds ratio, 4.663; 95% CI, 2.108–6.085; P < 0.001). Conclusion: The patients with co-morbid hyperlipidemia and chronic pancreatitis had higher rates of newly-diagnosed diabetes after DP, moreover, pancreatic cancer subjects had higher rates of pancreatic exocrine insufficiency after DP. The clinicians should be alert to follow up glucose metabolism and clinical symptoms of fat intolerance for DP patients.

Keywords: distal pancreatectomy, National database, diabetes, exocrine insufficiency

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