Search results for: automated early warning score

Authors: T. Schilirò, S. Bonetta, S. Bonetta, E. Ceretti, D. Feretti, I. Zerbini, V. Romanazzi, S. Levorato, T. Salvatori, S. Vannini, M. Verani, C. Pignata, F. Bagordo, G. Gilli, S. Bonizzoni, A. Bonetti, E. Carraro, U. Gelatti

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Air pollution is one of the most important worldwide health concern. In the last years, in both the US and Europe, new directives and regulations supporting more restrictive pollution limits were published. However, the early effects of air pollution occur, especially for the urban population. Several epidemiological and toxicological studies have documented the remarkable effect of particulate matter (PM) in increasing morbidity and mortality for cardiovascular disease, lung cancer and natural cause mortality. The finest fractions of PM (PM with aerodynamic diameter <2.5 µm and less) play a major role in causing chronic diseases. The International Agency for Research on Cancer (IARC) has recently classified air pollution and fine PM as carcinogenic to human (1 Group). The structure and composition of PM influence the biological properties of particles. The chemical composition varies with season and region of sampling, photochemical-meteorological conditions and sources of emissions. The aim of the MAPEC (Monitoring Air Pollution Effects on Children for supporting public health policy) study is to evaluate the associations between air pollution and biomarkers of early biological effects in oral mucosa cells of 6-8 year old children recruited from first grade schools. The study was performed in five Italian towns (Brescia, Torino, Lecce, Perugia and Pisa) characterized by different levels of airborne PM (PM10 annual average from 44 µg/m3 measured in Torino to 20 µg/m3 measured in Lecce). Two to five schools for each town were chosen to evaluate the variability of pollution within the same town. Child exposure to urban air pollution was evaluated by collecting ultrafine PM (PM0.5) in the school area, on the same day of biological sampling. PM samples were collected for 72h using a high-volume gravimetric air sampler and glass fiber filters in two different seasons (winter and spring). Gravimetric analysis of the collected filters was performed; PM0.5 organic extracts were chemically analyzed (PAH, Nitro-PAH) and tested on A549 by the Comet assay and Micronucleus test and on Salmonella strains (TA100, TA98, TA98NR and YG1021) by Ames test. Results showed that PM0.5 represents a high variable PM10 percentage (range 19.6-63%). PM10 concentration were generally lower than 50µg/m3 (EU daily limit). All PM0.5 extracts showed a mutagenic effect with TA98 strain (net revertant/m3 range 0.3-1.5) and suggested the presence of indirect mutagens, while lower effect was observed with TA100 strain. The results with the TA98NR and YG1021 strains showed the presence of nitroaromatic compounds as confirmed by the chemical analysis. No genotoxic or oxidative effect of PM0.5 extracts was observed using the comet assay (with/without Fpg enzyme) and micronucleus test except for some sporadic samples. The low biological effect observed could be related to the low level of air pollution observed in this winter sampling associated to a high atmospheric instability. For a greater understanding of the relationship between PM size, composition and biological effects the results obtained in this study suggest to investigate the biological effect of the other PM fractions and in particular of the PM0.5-1 fraction.

Keywords: airborne PM, ames test, comet assay, micronucleus test

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Authors: Marji Umil, Miane Karyle Urolaza, Ian Winston Dale Uy, John Charle Magne Valdez, Karen Elizabeth Valdez, Ervin Charles Valencia, Cheryleen Tan-Chua

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Objective: Distraction techniques can be successful in reducing the anxiety of children during medical procedures. Dental procedures, in particular, are associated with dental anxiety which has been identified as a significant and common problem in children, however, only limited studies were conducted to address such problem. Thus, this study determined the effectiveness of computer video games on the levels of anxiety of children between 5-12 years old scheduled for tooth extraction. Methods: A pre-test post-test quasi-experimental study was conducted involving 30 randomly-assigned subjects, 15 in the experimental and 15 in the control. Subjects in the experimental group played computer video games for a maximum of 15 minutes, however, no intervention was done on the control. The modified Yale Pre-operative Anxiety Scale (m-YPAS) with a Cronbach’s alpha of 0.9 was used to assess anxiety at two different points: upon arrival in the clinic (pre-test anxiety) and 15 minutes after the first measurement (post-test anxiety). Paired t-test and ANCOVA were used to analyze the gathered data. Results: Results showed that there is a significant difference between the pre-test and post-test anxiety scores of the control group (p=0.0002) which indicates an increased anxiety. A significant difference was also noted between the pre-test and post-test anxiety scores of the experimental group (p=0.0002) which indicates decreased anxiety. Comparatively, the experimental group showed lower anxiety score (p=<0.0001) than the control. Conclusion: The use of computer video games is effective in reducing the pre-operative anxiety among children and can be an alternative non-pharmacological management in giving pre-operative care.

Keywords: play therapy, preoperative anxiety, tooth extraction, video games

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Choki, Supatchai Boonpratham, Suwannee Luppanapornlarp

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The objective of this study was to find a correlation between cephalometric measurements and visual perception of facial profile in skeletal type II patients. In this study, 250 lateral cephalograms of female patients from age, 20 to 22 years were analyzed. The profile outlines of all the samples were hand traced and transformed into silhouettes by the principal investigator. Profile ratings were done by 9 orthodontists on Visual Analogue Scale from score one to ten (increasing level of convexity). 37 hard issue and soft tissue cephalometric measurements were analyzed by the principal investigator. All the measurements were repeated after 2 weeks interval for error assessment. At last, the rankings of visual perceptions were correlated with cephalometric measurements using Spearman correlation coefficient (P < 0.05). The results show that the increase in facial convexity was correlated with higher values of ANB (A point, nasion and B point), AF-BF (distance from A point to B point in mm), L1-NB (distance from lower incisor to NB line in mm), anterior maxillary alveolar height, posterior maxillary alveolar height, overjet, H angle hard tissue, H angle soft tissue and lower lip to E plane (absolute correlation values from 0.277 to 0.711). In contrast, the increase in facial convexity was correlated with lower values of Pg. to N perpendicular and Pg. to NB (mm) (absolute correlation value -0.302 and -0.294 respectively). From the soft tissue measurements, H angles had a higher correlation with visual perception than facial contour angle, nasolabial angle, and lower lip to E plane. In conclusion, the findings of this study indicated that the correlation of cephalometric measurements with visual perception was less than expected. Only 29% of cephalometric measurements had a significant correlation with visual perception. Therefore, diagnosis based solely on cephalometric analysis can result in failure to meet the patient’s esthetic expectation.

Keywords: cephalometric measurements, facial profile, skeletal type II, visual perception

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Authors: Timur Zhukov, Yuko Yamashita

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Music as a product of hedonic consumption has been researched at least since the early 20th century, but little light has been shed on how language affects its consumption process. At the intersection of music consumption, language impact, and consumer behavior, this research explores the influence of language on music consumption in Japan. Its aim is to clarify how listening to music in different languages affects the listener’s purchase intention and sharing intention by conducting a survey where respondents listen to three versions of the same song in different languages in random order. It uses an existing framework that views the flow of music consumption as a combination of responses (emotional response, sensory response, imaginal response, analytical responses) affecting the experiential response, which then affects the overall affective response, followed by the need to reexperience and lastly the purchase intention. In this research, the sharing intention has been added to the model to better fit the modern consumption model (e.g., AISAS). This research shows how positive and negative emotions and imaginal and analytical responses change depending on the language and what impact it has on consumer behavior. It concludes by proposing how modern music businesses can learn from the language differences and cater to the needs of the audiences who speak different languages.

Keywords: AISAS, consumer behavior, first language, music consumption, second language

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Authors: Babak Nemat Shahrbabaki, Arezo Fallahi, Masoomeh Hashemian

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Introduction: Health and safety are basic components of civil right. Health care systems in different countries were influenced by political, economic and cultural circumstances. In order to health services to people, these systems are organized with different forms, methods such as: prevention, treatment and rehabilitation and in this among, public satisfaction with the services provided is important. This study aimed to determine client satisfaction with family physician and relationship with physician’ demographic variables in health care centers of Jiroft county, Iran. Methods: This is a descriptive-analytical study. The collective data tool was a self-made questionnaire with two parts. The first part comprised demographic characteristics, and the second part contained 11 items for the assessment of satisfaction with family physician from different aspects. In addition, questionnaire, reliability and validity were confirmed. Random simple sampling method was used to determine samples. 234 people referred to the health centers filled questionnaire. The data were analyzed using SPSS software, and inferential statistical analysis was performed. Findings: The majority of the study population were women, married, and aged between 18 and 62 years (mean= 30.09±10.71). Total average satisfaction score was 42.63±3.68. Overall satisfaction averages were 9.47% very high, 30.04% high, 33.09% moderate, 15.12% low, and 12.28% very low. Except lodge on of family physician none of physician’ demographic variables did not effect on satisfaction index. Discussion & Conclusion: The Results showed that mean of satisfaction indexes of family physicians was high and lodge on of family physician effected on this index. Informing people about the main goals of family-doctor program will help to promote the quality of program and increase people satisfaction.

Keywords: family physician program, satisfaction, health-care centers, client

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Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

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Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

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Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

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The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

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Authors: Anmar Dulaimi, Hassan Al Nageim, Felicite Ruddock, Linda Seton

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Fast-curing cold bituminous emulsion mixture (CBEM) including active filler from high calcium fly ash (HCFA) and waste material (LJMU-A2) has been developed in this study. This will overcome the difficulties related with the use of hot mix asphalt such as greenhouse gases emissions and problems in keeping the temperature when transporting long distance. The aim of this study is to employ petrographic examinations using scanning electron microscopy (SEM) for characterizing the hydrates microstructure, in a new binary blended cement filler (BBCF) system. The new BBCF has been used as a replacement to traditional mineral filler in cold bituminous emulsion mixtures (CBEMs), comprises supplementary cementitious materials containing high calcium fly ash (HCFA) and a waste material (LJMU-A2). SEM analysis demonstrated the formation of hydrates after varying curing ages within the BBCF. The accelerated activation of HCFA by LJMU-A2 within the BBCF was revealed and as a consequence early and later stiffness was developed in novel CBEM.

Keywords: cold bituminous emulsion mixtures, indirect tensile stiffness modulus, scanning electron microscopy (SEM), and high calcium fly ash

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Authors: Ugwu Blessing Nkiruka

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This paper seeks to examine Nigerian National Agency for the control of AIDS (NACA) and international response to the control of HIV/AIDS in Nigeria. The paper adopted the Functionalist theory alongside Liberalism and Idealism, but anchored extensively on functionalism. On the response of HIV/AIDS, Functionalist theory advocated for international corporation of both intergovernmental and non-governmental organisations as the basis for the reduction of the virus. the study adopted secondary source of data i.e journals, articles, newspapers and policy briefs to discuss the reduction of the pandemic (HIV/AIDS).This paper discovered that although HIV/AIDS is a global threat, especially to developing countries where the prevalence rate is still very high, yet international governmental and non-governmental organisation have been able to collaborate with National agencies like NACA in Nigeria and respond speedily through diverse initiatives and action plans to curb the spread of the virus. The study therefore recommends greater awareness on testing and early introduction of antiretroviral therapy, proper screening of blood before transfusion, absolute faithfulness among partners. Similarly, sharing of sharp objects like needles, knives and syringes should be avoided at all cost.

Keywords: HIV/AIDS, developing countries, Nigeria, international organizations, NACA

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Authors: Ali Akbar

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The importance of advancing women’s rights is closely intertwined with the development of civil society and the institutionalization of democracy in Middle Eastern countries. There is indeed an intimate relationship between the process of democratization and promoting gender equality, since democracy necessitates equality between men and women. In order to advance the issue of gender equality, what is required is a solid theoretical framework which has its roots in the reexamination of pre-modern interpretation of certain Qurʾānic passages that seem to have given men more rights than it gives women. This paper suggests that those Muslim scholars who adopt a contextualist approach to the Qurʾānic text and its interpretation provide a solid theoretical background for improving women’s rights. Indeed, the aim of the paper is to discuss how the contextualist approach to the Qurʾānic text and its interpretation given by a number of prominent scholars is capable of promoting the issue of gender equality. The paper concludes that since (1) much of the gender inequality found in the primary sources of Islam as well as pre-modern Muslim writings is rooted in the natural cultural norms and standards of early Islamic societies and (2) since the context of today’s world is so different from that of the pre-modern era, the proposed models provide a solid theoretical framework for promoting women’s rights and gender equality.

Keywords: contextualism, gender equality, Islam, the rights of women

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Authors: I. Schiller, D. Morsomme, A. Remacle

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Children’s ability to process spoken language develops until the late teenage years. At school, where efficient spoken language processing is key to academic achievement, listening conditions are often unfavorable. High background noise and poor teacher’s voice represent typical sources of interference. It can be assumed that these factors particularly affect primary school children, because their language and literacy skills are still low. While it is generally accepted that background noise and impaired voice impede spoken language processing, there is an increasing need for analyzing impacts within specific linguistic areas. Against this background, the aim of the study was to investigate the effect of speech-shaped noise and imitated dysphonic voice on first-grade primary school children’s speech perception and sentence comprehension. Via headphones, 5 to 6-year-old children, recruited within the French-speaking community of Belgium, listened to and performed a minimal-pair discrimination task and a sentence-picture matching task. Stimuli were randomly presented according to four experimental conditions: (1) normal voice / no noise, (2) normal voice / noise, (3) impaired voice / no noise, and (4) impaired voice / noise. The primary outcome measure was task score. How did performance vary with respect to listening condition? Preliminary results will be presented with respect to speech perception and sentence comprehension and carefully interpreted in the light of past findings. This study helps to support our understanding of children’s language processing skills under adverse conditions. Results shall serve as a starting point for probing new measures to optimize children’s learning environment.

Keywords: impaired voice, sentence comprehension, speech perception, speech-shaped noise, spoken language processing

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Authors: Oumaima Khlifati, Khadija Baba

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Pavement distress is the main factor responsible for the deterioration of road structure durability, damage vehicles, and driver comfort. Transportation agencies spend a high proportion of their funds on pavement monitoring and maintenance. The auscultation of pavement distress was based on the manual survey, which was extremely time consuming, labor intensive, and required domain expertise. Therefore, the automatic distress detection is needed to reduce the cost of manual inspection and avoid more serious damage by implementing the appropriate remediation actions at the right time. Inspired by recent deep learning applications, this paper proposes an algorithm for automatic road distress detection and classification using on the Deep Convolutional Neural Network (DCNN). In this study, the types of pavement distress are classified as transverse or longitudinal cracking, alligator, pothole, and intact pavement. The dataset used in this work is composed of public asphalt pavement images. In order to learn the structure of the different type of distress, the DCNN models are trained and tested as a multi-label classification task. In addition, to get the highest accuracy for our model, we adjust the structural optimization hyper parameters such as the number of convolutions and max pooling, filers, size of filters, loss functions, activation functions, and optimizer and fine-tuning hyper parameters that conclude batch size and learning rate. The optimization of the model is executed by checking all feasible combinations and selecting the best performing one. The model, after being optimized, performance metrics is calculated, which describe the training and validation accuracies, precision, recall, and F1 score.

Keywords: distress pavement, hyperparameters, automatic classification, deep learning

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Authors: İbrahi̇m Kara, Seher Arslankaya

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Frequently preferred in the field of engineering in particular, data mining has now begun to be used in the field of health as well since the data in the health sector have reached great dimensions. With data mining, it is aimed to reveal models from the great amounts of raw data in agreement with the purpose and to search for the rules and relationships which will enable one to make predictions about the future from the large amount of data set. It helps the decision-maker to find the relationships among the data which form at the stage of decision-making. In this study, it is aimed to determine the risk of heart attack at the first stage, to control it, and to make its resource planning with the method of data mining. Through the early and correct diagnosis of heart attacks, it is aimed to reveal the factors which affect the diseases, to protect health and choose the right treatment methods, to reduce the costs in health expenditures, and to shorten the durations of patients’ stay at hospitals. In this way, the diagnosis and treatment costs of a heart attack will be scrutinized, which will be useful to determine the risk of the disease at the first stage, to control it, and to make its resource planning.

Keywords: data mining, decision support systems, heart attack, health sector

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Authors: Nahush Modak, Meena Pangarkar, Anand Pathak, Ankita Tamhane

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Background: Breast cancer is the prominent cause of cancer and mortality among women. This study was done to show the statistical analysis of a cohort of over 250 patients detected with breast cancer diagnosed by oncologists using Immunohistochemistry (IHC). IHC was performed by using ER; PR; HER2; Ki-67 antibodies. Materials and methods: Formalin fixed Paraffin embedded tissue samples were obtained by surgical manner and standard protocol was followed for fixation, grossing, tissue processing, embedding, cutting and IHC. The Ventana Benchmark XT machine was used for automated IHC of the samples. Antibodies used were supplied by F. Hoffmann-La Roche Ltd. Statistical analysis was performed by using SPSS for windows. Statistical tests performed were chi-squared test and Correlation tests with p<.01. The raw data was collected and provided by National Cancer Insitute, Jamtha, India. Result: Luminal B was the most prevailing molecular subtype of Breast cancer at our institute. Chi squared test of homogeneity was performed to find equality in distribution and Luminal B was the most prevalent molecular subtype. The worse prognostic indicator for breast cancer depends upon expression of Ki-67 and her2 protein in cancerous cells. Our study was done at p <.01 and significant dependence was observed. There exists no dependence of age on molecular subtype of breast cancer. Similarly, age is an independent variable while considering Ki-67 expression. Chi square test performed on Human epidermal growth factor receptor 2 (HER2) statuses of patients and strong dependence was observed in percentage of Ki-67 expression and Her2 (+/-) character which shows that, value of Ki depends upon Her2 expression in cancerous cells (p<.01). Surprisingly, dependence was observed in case of Ki-67 and Pr, at p <.01. This shows that Progesterone receptor proteins (PR) are over-expressed when there is an elevation in expression of Ki-67 protein. Conclusion: We conclude from that Luminal B is the most prevalent molecular subtype at National Cancer Institute, Jamtha, India. There was found no significant correlation between age and Ki-67 expression in any molecular subtype. And no dependence or correlation exists between patients’ age and molecular subtype. We also found that, when the diagnosis is Luminal A, out of the cohort of 257 patients, no patient shows >14% Ki-67 value. Statistically, extremely significant values were observed for dependence of PR+Her2- and PR-Her2+ scores on Ki-67 expression. (p<.01). Her2 is an important prognostic factor in breast cancer. Chi squared test for Her2 and Ki-67 shows that the expression of Ki depends upon Her2 statuses. Moreover, Ki-67 cannot be used as a standalone prognostic factor for determining breast cancer.

Keywords: breast cancer molecular subtypes , correlation, immunohistochemistry, Ki-67 and HR, statistical analysis

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Authors: Ching Kin Keong, Koh Tieng Wei, Abdul Azim Abd. Ghani, Khaironi Yatim Sharif

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Maintaining factory default battery endurance rate over time in supporting huge amount of running applications on energy-restricted mobile devices has created a new challenge for mobile applications developer. While delivering customers’ unlimited expectations, developers are barely aware of efficient use of energy from the application itself. Thus developers need a set of valid energy consumption indicators in assisting them to develop energy saving applications. In this paper, we present a few software product metrics that can be used as an indicator to measure energy consumption of Android-based mobile applications in the early of design stage. In particular, Trepn Profiler (Power profiling tool for Qualcomm processor) has used to collect the data of mobile application power consumption, and then analyzed for the 23 software metrics in this preliminary study. The results show that McCabe cyclomatic complexity, number of parameters, nested block depth, number of methods, weighted methods per class, number of classes, total lines of code and method lines have direct relationship with power consumption of mobile application.

Keywords: battery endurance, software metrics, mobile application, power consumption

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Authors: Ricardo Torcato, Helder Morais

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The manufacture of crystal glass parts is based on obtaining the rough geometry by blowing and/or injection, generally followed by a set of manual finishing operations using cutting and grinding tools. The forming techniques used do not allow the obtainment, with repeatability, of parts with complex shapes and the finishing operations use intensive specialized labor resulting in high cycle times and production costs. This work aims to explore the digital manufacture of crystal glass parts by investigating new subtractive techniques for the automated, flexible finishing of these parts. Finishing operations are essential to respond to customer demands in terms of crystal feel and shine. It is intended to investigate the applicability of different computerized finishing technologies, namely milling and grinding in a CNC machining center with or without ultrasonic assistance, to crystal processing. Research in the field of grinding hard and brittle materials, despite not being extensive, has increased in recent years, and scientific knowledge about the machinability of crystal glass is still very limited. However, it can be said that the unique properties of glass, such as high hardness and very low toughness, make any glass machining technology a very challenging process. This work will measure the performance improvement brought about by the use of ultrasound compared to conventional crystal grinding. This presentation is focused on the mechanical characterization and analysis of the cutting forces in CNC machining of superior crystal glass (Pb ≥ 30%). For the mechanical characterization, the Vickers hardness test provides an estimate of the material hardness (Hv) and the fracture toughness based on cracks that appear in the indentation. Mechanical impulse excitation test estimates the Young’s Modulus, shear modulus and Poisson ratio of the material. For the cutting forces, it a dynamometer was used to measure the forces in the face grinding process. The tests were made based on the Taguchi method to correlate the input parameters (feed rate, tool rotation speed and depth of cut) with the output parameters (surface roughness and cutting forces) to optimize the process (better roughness using the cutting forces that do not compromise the material structure and the tool life) using ANOVA. This study was conducted for conventional grinding and for the ultrasonic grinding process with the same cutting tools. It was possible to determine the optimum cutting parameters for minimum cutting forces and for minimum surface roughness in both grinding processes. Ultrasonic-assisted grinding provides a better surface roughness than conventional grinding.

Keywords: CNC machining, crystal glass, cutting forces, hardness

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Authors: Ilyasu G., Ogoina D., Otu AA, Muhammed FD, Ebenso B., Otokpa D., Rotifa S., Tuduo-Wisdom O., Habib AG

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Background: The 2014 Ebola Virus Disease (EVD) outbreak was characterized by fear, misconceptions and irrational behaviors. We conducted a knowledge attitude and practice survey of EVD in Nigeria to inform the institution of effective control measures. Methods: Between July 30th and September 30th 2014, a cross-sectional study on knowledge, attitude and practice (KAP) of Ebola Virus Disease (EVD) was undertaken among adults of the general population and healthcare workers (HCW) in three states of Nigeria, including Kano, Cross River and Bayelsa states. Demographic information and data on KAP were obtained using a self-administered standardized questionnaire. The percentage KAP scores were categorized as good and poor. Independent predictors of good knowledge of EVD were ascertained using a binary logistic regression model. Results: Out of 1035 study participants with a median age of 32 years, 648 (62.6%) were males, 846 (81.7%) had tertiary education and 441 (42.6%) were HCW. There were 218, 239 and 578 respondents from Bayelsa, Cross Rivers, and Kano states, respectively. The overall median percentage KAP scores and interquartile ranges (IQR) were 79.46% (15.07%), 95.0% (33.33%), and 49.95% (37.50%), respectively. Out of the 1035 respondents, 470 (45.4%), 544(52.56%), and 252 (24.35%) had good KAP of EVD defined using 80%, 90%, and 70% score cut-offs, respectively. Independent predictors of good knowledge of EVD were a HCW (Odds Ratio-OR-2.89, 95% Confidence interval-CI of 1.41-5.90), reporting ‘moderate to high fear of EVD’ (OR-2.15, 95% CI-1.47-3.13) and ‘willingness to modify habit’ (OR-1.68, 95% CI-1.23-2.30). Conclusion: Our results reveal suboptimal EVD-related knowledge, attitude and practice among adults in Nigeria. To effectively control future outbreaks of EVD in Nigeria, there is a need to institute public sensitization programs that improve understanding of EVD and address EVD-related myths and misconceptions, especially among the general population.

Keywords: Ebola, health care worker, knowledge, attitude

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Authors: Sandeep Pandey, Nimra Habib, Ranjana Singh, Abbas Ali Mahdi

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Leukemia is a malignancy of blood that mainly affects children and young adults; while advancement in the early diagnosis will have the potential to improve the outcome of diseases. A wide range of disease including leukemia shows inflammatory signals in their pathogenesis. In a pilot study conducted in our laboratory, 52 people were screened, of which 26 had leukemia and 26 were free from any kind of malignancy. We performed the estimation of the inflammatory cytokine Interleukin-8 and it was found significantly raised in all the leukemia patients concerning healthy volunteers who participated in the study. Flow cytometry had been performed for the confirmation of leukemia and further genomic, and proteomic, analyses of the sample revealed that IL-8 levels showed a positive correlation in patients with leukemia. The results had shown constitutive secretion of interleukin-8 by leukemia cells. So, our finding demonstrated that IL-8 is considered to have a role in the pathogenesis of leukemia, and quantification of IL-8 levels in leukemia conditions might be more useful and feasible in the clinical setting for the prediction of drug responses where it may represent a putative target for innovative diagnostic toward effective therapeutic approaches. However, further research explorations in this area are needed that include a greater number of patients with all different forms of leukemia, and estimating their IL-8 levels may hold the key for the additional predictive values on the recurrence of leukemia and its prognosis.

Keywords: T-ALL, IL-8, leukemia pathogenesis, cancer therapeutics

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Authors: Murat Emre, Zeynep Tufekcioglu

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Objective: We describe a patient with late onset phenylketonuria which presented with rapidly progressive dementia and parkinsonism that were reversible after management. Background: Phenylketonuria is an autosomal recessive disorder due to mutations in the phenylalanine hydroxlase gene. It normally presents in childhood, in rare cases, however, it may have its onset in adulthood and may mimic other neurological disorders. Case description: A previously normal functioning, 59 year old man was admitted for blurred vision, cognitive impairment and gait difficulty which emerged over the past eight months. In neurological examination he had brisk reflexes, slow gait and left-dominant parkinsonism. Mini-mental state examination score was 25/30, neuropsychological testing revealed a dysexecutive syndrome with constructional apraxia and simultanagnosia. In cranial MRI there were bilateral diffuse hyper-intense lesions in parietal and occipital white matter with no significant atrophy. Electroencephalography showed diffuse slowing with predominance of teta waves. In cerebrospinal fluid examination protein level was slightly elevated (61mg/dL), oligoclonal bands were negative. Electromyography was normal. Routine laboratory examinations for rapidly progressive dementia and parkinsonism were also normal. Serum amino acid levels were determined to explore metabolic leukodystrophies and phenylalanine level was found to be highly elevated (1075 µmol/L) with normal tyrosine (61,20 µmol/L). His cognitive impairment and parkinsonian symptoms improved following three months of phenylalanine restricted diet. Conclusions: Late onset phenylketonuria is a rare, potentially reversible cause of rapidly progressive parkinsonism with dementia. It should be considered in the differential diagnosis of patients with suspicious features.

Keywords: dementia, neurology, Phenylketonuria, rapidly progressive parkinsonism

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Authors: Teja Koduru

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Untreated Lyme disease can lead to neurological, cardiac, and dermatological complications. Rapid diagnosis of the erythema migrans (EM) rash, a characteristic symptom of Lyme disease is therefore crucial to early diagnosis and treatment. In this study, we aim to utilize deep learning frameworks including Tensorflow and Keras to create deep convolutional neural networks (DCNN) to detect images of acute Lyme Disease from images of erythema migrans. This study uses a custom database of erythema migrans images of varying quality to train a DCNN capable of classifying images of EM rashes vs. non-EM rashes. Images from publicly available sources were mined to create an initial database. Machine-based removal of duplicate images was then performed, followed by a thorough examination of all images by a clinician. The resulting database was combined with images of confounding rashes and regular skin, resulting in a total of 683 images. This database was then used to create a DCNN with an accuracy of 93% when classifying images of rashes as EM vs. non EM. Finally, this model was converted into a web and mobile application to allow for rapid diagnosis of EM rashes by both patients and clinicians. This tool could be used for patient prescreening prior to treatment and lead to a lower mortality rate from Lyme disease.

Keywords: Lyme, untreated Lyme, erythema migrans rash, EM rash

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Authors: Ghoul Rachid Brahim, Trad Khodja Rafik

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Vertebral localization of the hydatid cyst is a severe form of bone hydatidosis, is a parasitic infection caused by the larval forms of the tapeworms Echinococcus granulosus, The disease is slowly remaining silent (a long incubation period) which may explain why this pathology is often discovered at the stage of neurological complications. The objective of this study is to recall the clinical and radiological aspects of this condition and the importance of early diagnosis and appropriate management. We report a study of 5 patients with vertebral hydatidosis, four men and one woman, four (04) patients operated in the emergency setting for spinal cord compression (decompression by wide laminectomy with evacuation of intra and extra canal vesicles).Albendazole-based medical treatment is instituted in all patients. Results: The evolution was favorable for three patients, the other two patients reoperated for a local recurrence. Conclusion: Vertebral hydatidosis is a rare condition with a poor prognosis due to the risk of neurological damage, the infiltrating nature of bone lesions, the frequency of relapses and therapeutic difficulties. The only curative method remains surgery, which must aim for complete and large excision of the lesions as if it were a “malignant tumour”.

Keywords: hydatidosis, Echinococcosis granulosus, hydatid cyst, spinal cord compression, laminectomy

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Authors: Hayder Kamil Shanbara, Felicite Ruddock, William Atherton, Nassier A. Nassir

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Cold bitumen emulsion mixture (CBEM) offers a series benefits as compared with hot mix asphalt (HMA); these include environmental factors, energy saving, the resolution of logistical challenges that can characterise hot mix, and the potential to reserve funds. However, this mixture has some problems similar to any bituminous mixtures as it has low early strength, long curing time that needed to obtain the maximum performance, high air voids and considered inferior to HMA. Thus, CBEM has been used in limited applications such as lightly trafficked roads, footways and reinstatements. This laboratory study describes the development of CBEM using ordinary Portland cement (OPC) instead of the traditional mineral filler. Stiffness modulus, moisture damage and temperature sensitivity tests were used to evaluate the mechanical properties of the produced mixtures. The study concluded that there is a substantial improvement in the mechanical properties and moisture damage resistance of CBEMs containing OPC. Also, the produced cement modified CBEM shows a considerable lower thermal sensitivity than the conventional CBEM.

Keywords: cold bitumen emulsion mixture, moisture damage, OPC, stiffness modulus, temperature sensitivity

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Authors: Qing Li, Maiko Kobayashi, Shigeyoshi Kumeda, Hiroko Ochiai, Toshiya Ochiai, Takashi Miura, Takahide Kagawa, Michiko Imai, Toshiaki Otsuka, Tomoyuki Kawada

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In the present study, we investigated the effects of a forest bathing program on cardiovascular and metabolic parameters. Nineteen healthy male subjects (mean age: 51.3 ± 8.8 years) were selected after obtaining informed consent. These subjects took day trips to a forest park named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in August 2015. On both trips, they walked 2.6 km for 80 min each in the morning and afternoon on Saturdays. Blood and urine were sampled in the morning before and after each trip. Cardiovascular and metabolic parameters were measured. Blood pressure and pulse rate were measured by an ambulatory automatic blood pressure monitor. The Japanese version of the profile of mood states (POMS) test was conducted before, during and after the trips. Ambient temperature and humidity were monitoring during the trips. The forest bathing program significantly reduced pulse rate, and significantly increased the score for vigor and decreased the scores for depression, fatigue, and confusion in the POMS test. The levels of urinary noradrenaline and dopamine after forest bathing were significantly lower than those after urban area walking, suggesting the relaxing effect of the forest bathing program. The level of adiponectin in serum after the forest bathing program was significantly greater than that after urban area walking. There was no significant difference in blood pressure between forest and urban area trips during the trips.

Keywords: ambient temperature, blood pressure, forest bathing, forest therapy, human health, POMS, pulse rate

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Authors: Hayfa Almutary, Noof Eid Al Shammari

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Aim: The management of depression in patients undergoing hemodialysis remains challenging. The aim of this study was to evaluate the effectiveness of a breathing training program on quality of life and depression among patients on hemodialysis. Design: A one-group pretest-posttest quasi-experimental design was used. Methods: Data were collected from hemodialysis units at three dialysis centers. Initial baseline data were collected, and a breathing training program was implemented. The breathing training program included three types of breathing exercises. The impact of the intervention on outcomes was measured using both the Kidney Disease Quality of Life Short Version and the Beck Depression Inventory-Second Edition from the same participants. The participants were asked to perform the breathing training program three times a day for 30 days. Results: The mean age of the patients was 52.1 (SD:15.0), with nearly two-thirds of them being male (63.4%). Participants who were undergoing hemodialysis for 1–4 years constituted the largest number of the sample (46.3%), and 17.1% of participants had visited a psychiatric clinic 1-3 times. The results show that the breathing training program improved overall quality of life and reduced symptoms and problems. In addition, a significant decrease in the overall depression score was observed after implementing the intervention. Conclusions: The breathing training program is a non-pharmacological intervention that has proven visible effectiveness in hemodialysis. This study demonstrated that using breathing exercises reduced depression levels and improved quality of life. The integration of this intervention in dialysis units to manage psychological issues will offer a simple, safe, easy, and inexpensive intervention. Future research should compare the effectiveness of various breathing exercises in hemodialysis patients using longitudinal studies. Impact: As a safety precaution, nurses should initially use non-pharmacological interventions, such as a breathing training program, to treat depression in those undergoing hemodialysis.

Keywords: breathing training program, depression, exercise, quality of life, hemodialysis

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Authors: S. U. Khan, T. Ayub, N. Shafiq

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The properties of locally produced metakaolin (MK) as cement replacing material and the comparison of reactivity with commercially available micro-silica have been investigated. Compressive strength, splitting tensile strength, and load-deflection behaviour under bending are the properties that have been studied. The amorphous phase of MK with micro-silica was compared through X-ray diffraction (XRD) pattern. Further, interfacial transition zone of concrete with micro-silica and MK was observed through Field Emission Scanning Electron Microscopy (FESEM). Three mixes of concrete were prepared. One of the mix is without cement replacement as control mix, and the remaining two mixes are 10% cement replacement with micro-silica and MK. It has been found that MK, due to its irregular structure and amorphous phase, has high reactivity with portlandite in concrete. The compressive strength at early age is higher with MK as compared to micro-silica. MK concrete showed higher splitting tensile strength and higher load carrying capacity as compared to control and micro-silica concrete at all ages respectively.

Keywords: metakaolin, compressive strength, splitting tensile strength, load deflection, interfacial transition zone

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Authors: Trupti Meher, Harihar Sahoo

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Premature menopause refers to the occurrence of menopause before the age of 40 years. Women who experience premature menopause either due to biological or induced reasons have a longer duration of exposure to severe symptoms and adverse health consequences when compared to those who undergo menopause at a later age, despite the fact that premature menopause has a profound effect on the health of women. This study attempted to determine the prevalence and predictors of premature menopause among women aged 25-39 years, using data from the National Family Health Survey (NFHS-4) conducted during 2015–16 in India. Descriptive statistics and multinomial logistic regression were used to carry out the result. The results revealed that the prevalence of premature menopause in India was 3.7 percent. Out of which, 2.1 percent of women had experienced natural premature menopause, whereas 1.7 percent had premature surgical menopause. The prevalence of premature menopause was highest in the southern region of India. Further, results of the multivariate model indicated that rural women, women with higher parity, early age at childbearing and women with smoking habits were at a greater risk of premature menopause. A sizeable proportion of women in India are attaining menopause prematurely. Unless due attention is given to this matter, it will emerge as a major problem in India in the future. The study also emphasized the need for further research to enhance knowledge on the problems of premature menopausal women in different socio-cultural settings in India.

Keywords: India, natural menopause, premature menopause, surgical menopause

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Authors: Amna J. Ghith, Khaled Abu Zid, Khairia Youssef, Nasser Saad

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Backgrounds: The multikinase and vascular endothelial growth factor (VEGF) receptor inhibitors interrupt the pathway by which angiogenesis becomes established and promulgated, resulting in the inadequate nourishment of metastatic disease. VEGFR-2 has been the principal target of anti-angiogenic therapies. We disclose the new thieno pyrimidines as inhibitors of VEGFR-2 designed by a molecular modeling approach with increased synergistic activity and decreased side effects. Purpose: 2-substituted thieno pyrimidines are designed and synthesized with anticipated anticancer activity based on its in silico molecular docking study that supports the initial pharmacophoric hypothesis with a same binding mode of interaction at the ATP-binding site of VEGFR-2 (PDB 2QU5) with high docking score. Methods: A series of compounds were designed using discovery studio 4.1/CDOCKER with a rational that mimic the pharmacophoric features present in the reported active compounds that targeted VEGFR-2. An in silico ADMET study was also performed to validate the bioavailability of the newly designed compounds. Results: The Compounds to be synthesized showed interaction energy comparable to or within the range of the benzimidazole inhibitor ligand when docked with VEGFR-2. ADMET study showed comparable results most of the compounds showed absorption within (95-99) zone varying according to different substitutions attached to thieno pyrimidine ring system. Conclusions: A series of 2-subsituted thienopyrimidines are to be synthesized with anticipated anticancer activity and according to docking study structure requirement for the design of VEGFR-2 inhibitors which can act as powerful anticancer agents.

Keywords: docking, discovery studio 4.1/CDOCKER, heterocycles based anticancer agents, 2-subsituted thienopyrimidines

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Authors: Papazafeiropoulou Olga

Abstract:

The first Greek expatriates created centers of culture in Australia from the beginning of the 19th century, in the large urban centers of the cities (Sydney, Melbourne, Brisbane, Adelaide, Perth). They created community theater according to their cultural standards, their socio-spiritual progress and development and their relationship with theatrical creation. At the same time, the Greek immigrants of the small towns and, especially of NSW, created their own temples of art, rebuilding theater buildings (theatres and cinemas), many of which are preserved to this day. Hellenism in Australia operated in the field of entertainment, reflecting the currents of the time and the global spread of mechanical developments. The Australian-born young people of the parish, as well as pioneering expatriates joined the theater and cinematographic events of Australia. They mobilized beyond the narrow confines of the parish, gaining recognition and projecting Hellenism to the Australian establishment. G. Paizis (A. Haggard), Dimitrios Ioannidis, Stelios Saligaros, Angela Parselli, Sofia Pergamali, Raoul Kardamatis, Adam Tavlaridis, John Lemonne, Rudy Ricco, Artemis Linou, distinguished themselves by writing their names in the history of Australian theater, as they served consequently the theatrical process, elevating the sentiment of the expatriate during the early years of its settlement in the Australian Commonwealth until 1950.

Keywords: greeks, commubity, australia, theatre

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Authors: Seetanah Boopen, Padachi Kesseven, R. Juwaheer , R. V. Sannassee, M. L. Lamport

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This study aims primarily at investigating the importance of soft infrastructure in tourism development for the case of an island economy namely Mauritius. The study in the first place assesses the level of perceived and actual satisfaction of the present state of the different types of soft tourism infrastructure and the allied services provided by tourism stakeholders in Mauritius and address the identified gaps. In order to address the study objectives, a rigorous survey analysis among 1741 international tourists at the departure lounge of the Sir Seewoosagur International Airport of Mauritius was carried out. The respondents placed significant emphasis on the different elements of the soft infrastructure dimension, where many of the elements falling under this dimension were rated with a high mean score. In particular the visitors rated communication, both internet and telephone services, and security to be most important. Significant gap has been found in the categories of ‘Health’ and ‘Security’. This indicates that the tourists ascribe high importance to the soft infrastructure dimension. The link between the respondent profile and the key variables which influence the tourist choice of the island as a destination are found to be equally important for most of the international tourists. However, these were deemed to be more critical for tourists travelling with family members. Although the survey instrument attempted to measure any gap between on the one hand, the importance of the infrastructure dimension and on the other hand, the level of satisfaction with the infrastructure dimension, overall the results do not show any statistically significant gap among the different elements of the infrastructural dimension. The study dwells into further analysis by engaging into an econometric framework related to a Probit Model, using the data collected, to gauge the effect of soft infrastructure on tourist intention to repeat or recommend the destination. The results confirm that soft infrastructure is found to be sensible to tourists, although relatively less sensitive as compared to tourism and transport and hotel infrastructure.

Keywords: tourism development, soft infrastructure, Mauritius, hotel infrastructure

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