Search results for: blood collection

Authors: Kunyu Yan

Abstract:

Early childhood music education plays a significant role in an individual’s growth. Music can help children understand themselves and relate to others, and make connections between family, school, and society. In recent years, with the development of early childhood education in China, an increasing number of kindergartens have been established, and many of them pay more attention to music education. This research has two main aims. One is to discover how and why music is used in both public and private kindergartens. The second aim is to make recommendations for widening the use of music in kindergartens. In order to achieve these aims, the research uses two main methods. Firstly, it considers the historical background and cultural context of early childhood education in China; and secondly, it uses an approach that compares public and private kindergartens. In this research, six kindergartens were chosen from Qingdao city in Shandong Province as case studies, including 3 public kindergartens and 3 private kindergartens. This research was based on using three types of data collection methods: observation, semi-structured interviews with teachers, and questionnaires with parents. Participant and non-participant observational methods were used and included in daily routines at the kindergartens in order to experience the situation of music education first-hand. Interviews were associated with teachers’ views of teaching and learning music, the perceptions of the music context, and their strategies of using music. Lastly, the questionnaire was designed to obtain the views of current music education from the children’s parents in the respective kindergartens. The results are shown with three main themes: (1) distinct characteristics of public kindergartens (e.g., similar equipment, low tuition fee, qualified teachers, etc); (2) distinct characteristics of private kindergartens (e.g., various tuition fees, own teaching system, trained teachers, etc); and (3) differences between public and private kindergartens (e.g., funding, requirements for teachers, parents’ demands, etc). According to the results, we can see that the main purpose of using music in China is to develop the musical ability of children, and teachers focus on musical learning, such as singing in tune and playing instruments. However, as revealed in this research, there are many other uses and functions of music in these educational settings, including music used for non-musical learning (e.g., counting, learning language, etc.) or in supporting social routines.

Keywords: differences between private and public school, early childhood education, music education, uses and functions of music

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Authors: Donghee Kang

Abstract:

Background: Cancer pain is very difficult to control as the mechanism of pain is varied, and the patient has several co-morbidities. The use of Intravenous Patient-Controlled Analgesia (IV-PCA) can effectively control underlying pain and breakthrough pain. Ketamine is used in many pain patients due to its unique analgesic effect. In this study, it was checked whether there was a difference in the amount of analgesic usage, pain control degree, and side effects between patients who controlled pain with fentanyl-based IV-PCA and those who added Ketamine for pain control. Methods: Among the patients referred to this department for cancer pain, IV-PCA was applied to patients who were taking sufficient oral analgesics but could not control them or had blood clotting disorders that made the procedure difficult, and this patient group was targeted. In IV-PCA, 3000 mcg of Fentanyl, 160 mg of Nefopam, and 0.3 mg of Ramosetrone were mixed with normal saline to make a total volume of 100 ml. Group F used this IV-PCA as it is, and group K mixed 250 mg of Ketamine with normal saline to make a total volume of 100 ml. For IV-PCA, the basal rate was 0.5ml/h, the bolus was set to 1ml when pressed once, and the lockout time was set to 15 minutes. If pain was not controlled after IV-PCA application, 500 mcg of Fentanyl was added, and if excessive sedation or breathing difficulties occurred, the use was stopped for one hour. After that, the degree of daily pain control, analgesic usage, and side effects were investigated for seven days using this IV-PCA. Results: There was no difference between the two groups in the demographic data. Both groups had adequate pain control. Initial morphine milligram equivalents did not differ between the two groups, but the total amount of Fentanyl used for seven days was significantly different between the two groups [p=0.014], and group F used more Fentanyl through IV-PCA. In addition, the amount of sleeping pills used during the seven days was higher in Group F [p<0.01]. Overall, there was no difference in the frequency of side effects between the two groups, but the nausea was more frequent in Group F [p=0.031]. Discussion: When the two groups were compared, pain control was good in both groups. This seems to be because Fentanyl-based IV-PCA showed an adequate pain control effect. However, there was a significant difference in the total amount of opioid (Fentanyl) used, which is thought to be the opioid-sparing effect of Ketamine. Also, among the side effects, nausea was significantly less, which is thought to be possible because the amount of opioids used in the Ketamine group was small. The frequency of requesting sleeping pills was significantly less in the group using Ketamine, and it seems that Ketamine also helped improve sleep quality. In conclusion, using Ketamine with an opioid to control pain seems to have advantages. IV-PCA, which can be used effectively when other procedures are difficult, is more effective and safer when used together with Ketamine than opioids alone.

Keywords: cancer pain, intravenous patient-controlled analgesia, Ketamine, opioid

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Authors: Sadam Elayah, Yang Li, Bing Shi

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Background: The impact of relaxing incisions on maxillofacial growth during palatoplasty remains a topic of debate, and further research is needed to understand its effects fully. Thus, the current study is the first long-term study that aimed to assess the maxillofacial growth of patients with isolated cleft palate following the Sommerlad-Furlow modified (S.F) technique and to estimate the impact of relaxing incisions on maxillofacial growth following S.F technique in patients with isolated cleft palate. Methods: A total of 85 participants, 55 patients with non-syndromic isolated soft and hard cleft palate underwent primary palatoplasty with our technique (30 patients received the Sommerlad-Furlow modified technique without relaxing incision (S.F+RI group), and 25 received Sommerlad-Furlow modified technique without relaxing (S.F-RI group) with no significant difference found between them regarding the cleft type, cleft width, and age at repair. While the other 30 were normal participants with skeletal class I pattern (C group). The control group was matched with the study group in number, age, and sex. All the study variables were measured using stable landmarks, including 12 linear and 10 angular variants. Results: The mean ages at collection of cephalograms were 6.03±0.80 in the S.F+RI group, 5.96±0.76 in the S.F-RI group, and 5.91±0.87 in the C group. Regarding cranial base, the results showed no statistically significant differences between the three groups in S-N and S-N-Ba. The S.F+R.I group had a significantly shorter S-Ba than the S.F-R.I & C groups (P= 0.01). However, there was no statistically significant difference between the S.F-R.I & C groups (P=0.80). Regarding the skeletal maxilla, there was no significant difference between the S.F+R.I and S.F-R.I groups in all linear measurements (N-ANS, S- PM & SN-PP ) except Co-A, the S.F+R.I group had significantly shorter Co-A than the S.F-R.I & C groups (P= <0.01). While the angular measurement, S.F+R.I group had significantly less SNA angle than the S.F-R.I & C groups (P= <0.01). Regarding mandibular bone, there were no statistically significant differences in all linear and angular mandibular measurements between the S.F+R.I and S.F-R.I groups. Regarding intermaxillary relation, the S.F+R.I group had significant differences in Co-Gn - Co-A and ANB compared to the S.F-R.I & C groups (P= <0.01). There was no statistically significant difference in PP-MP among the three groups. Conclusion: As a preliminary report, the Sommerlad-Furlow modified technique without relaxing incisions was found to have good maxillary positioning in the face and a satisfactory intermaxillary relationship compared to the Sommerlad-Furlow modified technique with relaxing incisions.

Keywords: relaxing incisions, cleft palate, palatoplasty, maxillofacial growth

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Authors: Yueh Hsiu Giffen Cheng, Teng Jung Wang

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According to the study of British national advisory council on creative and cultural education（NACCCE, what the present and the future need awesome innovative and creative people from the perspective of commercial human resources. Therefore, we can know from above, creativity plays an important role in today’s enterprise indeed. Besides, many companies are aimed at developing team work as their main goal, so “creativity” and “teamwork” become more and more important factors to succeed and team creativity also turn into an important issue gradually. Then, the study takes in-depth interviews of design companies’ leaders and uses self-designed questionnaire regarding affecting team creativity to conduct cross-analysis. The results show that for those creative-oriented integrated design companies, their design strategies don’t begin until data collection and their scripts are usually the best way to inspire creativity. Besides, passing down a legacy of experiences are their common educational training. Most important of all, their organizational resources and leaders can assist all the team to learn and grow effectively and the good interaction between the leader and the member can also bring work flexibility and efficiency. In short, the leader’s expectation of members’ performance can cause them to encourage each other to progress. Moreover, the analysis of questionnaire indicates that members who are open-minded and leaders who have transformational leadership style can both help to establish a good team interaction. Furthermore, abundant resources and training system are also good approaches to establish a harmonious relationship. Finally, through integrating the outcomes of interviews and questionnaires, we can infer that those integrated design companies’ circumstances of design progress are mainly from their leaders’ guidance. In addition, the analysis of design problems are focused on their creative strategies and their scripts and sketches can also inspire their creativity. In sum, the feature of all team is influenced by 4 factors: leaders who have transformational leadership style, open-minded members, flexible working environment, resources and interactive relationship. Ultimately, the study hopes that the result above can apply to the design-related industries or help general companies elevate the team creativity.

Keywords: creativity, team creativity, integrated design companies, design process

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Authors: Ghazal Faraj, Andras Micsik

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The CIDOC Conceptual Reference Model (CRM) is an extensible ontology that provides integrated access to heterogeneous and digital datasets. The CIDOC-CRM offers a “semantic glue” intended to promote accessibility to several diverse and dispersed sources of cultural heritage data. That is achieved by providing a formal structure for the implicit and explicit concepts and their relationships in the cultural heritage field. The COURAGE (“Cultural Opposition – Understanding the CultuRal HeritAGE of Dissent in the Former Socialist Countries”) project aimed to explore methods about socialist-era cultural resistance during 1950-1990 and planned to serve as a basis for further narratives and digital humanities (DH) research. This project highlights the diversity of flourished alternative cultural scenes in Eastern Europe before 1989. Moreover, the dataset of COURAGE is an online RDF-based registry that consists of historical people, organizations, collections, and featured items. For increasing the inter-links between different datasets and retrieving more relevant data from various data silos, a shared federated ontology for reconciled data is needed. As a first step towards these goals, a full understanding of the CIDOC CRM ontology (target ontology), as well as the COURAGE dataset, was required to start the work. Subsequently, the queries toward the ontology were determined, and a table of equivalent properties from COURAGE and CIDOC CRM was created. The structural diagrams that clarify the mapping process and construct queries are on progress to map person, organization, and collection entities to the ontology. Through mapping the COURAGE dataset to CIDOC-CRM ontology, the dataset will have a common ontological foundation with several other datasets. Therefore, the expected results are: 1) retrieving more detailed data about existing entities, 2) retrieving new entities’ data, 3) aligning COURAGE dataset to a standard vocabulary, 4) running distributed SPARQL queries over several CIDOC-CRM datasets and testing the potentials of distributed query answering using SPARQL. The next plan is to map CIDOC-CRM to other upper-level ontologies or large datasets (e.g., DBpedia, Wikidata), and address similar questions on a wide variety of knowledge bases.

Keywords: CIDOC CRM, cultural heritage data, COURAGE dataset, ontology alignment

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Authors: Yang Yang, Lu Xin

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The study of extant musical sites can provide a side-by-side picture of historical ethnomusicological information. In their data collection on Chinese opera houses, researchers found that one Ming Dynasty opera house reached a width of nearly 18 meters, while all opera houses of the same period and after it was far from such a width, being significantly smaller than 18 meters. The historical transient fluctuations in the data dimension of width that caused Chinese theatres to fluctuate in the absence of construction scale constraints have piqued the interest of researchers as to why there is data variation in width. What factors have contributed to the lack of further expansion in the width of theatres? To address this question, this study used a comparative approach to conduct a venue experiment between this theater stage and another theater stage for non-heritage opera performances, collecting the subjective perceptions of performers and audiences at different theater stages, as well as combining BK Connect platform software to measure data such as echo and delay. From the subjective and objective results, it is inferred that the Chinese ancients discovered and understood the acoustical phenomenon of the Haas effect by exploring the effect of stage width on musical performance and appreciation of listening states during the Ming Dynasty and utilized this discovery to serve music in subsequent stage construction. This discovery marked a node of evolution in Chinese architectural acoustics technology driven by musical demands. It is also instructive to note that, in contrast to many of the world's "unsuccessful civilizations," China can use a combination of heritage and intangible cultural research to chart a clear, demand-driven course for the evolution of human music technology, and that the findings of such research will complete the course of human exploration of music acoustics. The findings of such research will complete the journey of human exploration of music acoustics, and this practical experience can be applied to the exploration and understanding of other musical heritage base data.

Keywords: Haas effect, musical acoustics, history of acoustical technology, Chinese opera stage, structure

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Authors: Asma AlAmri, Ahmed Hassab Errasoul

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Background & Objectives: Psychiatric disorders are common, affecting approximately one of five adults (17.6%) of the population. While most patients can be successfully treated as outpatients, admission to psychiatric wards is required during relapses or as part of crisis intervention. The first 72h of admission could be particularly critical due to increased risk of physical violence, non-medical discharge and absconding. Many patients requiring interventions such as seclusion, physical restrain, PRN psychotropic medications. This study aims to investigate the relationship between demographical, clinical and pharmacological factors in one hand and certain outcomes (physical aggression, use of PRN medications, need for seclusions and non-medical discharges) within the first 72hours of admission to acute psychiatric wards in KKUH/Riyadh Methods: All admissions to psychiatric wards over a 20 month period, between (May 2015- January 2017) were included. Data was collected on demographics, diagnosis, psychotropic medications prescription, documented physical aggression, and seclusion, self-discharge and absconding. Results: 134 males and 171 females were admitted over the study period. Mean age was 34.2 years (SD 11.96).48.9% (n=149) were single and most patients (n=198) were either unemployed or in educations. Bipolar disorder was the most frequent diagnosis recorded on admission (39.3%, n=120); followed by Schizophrenia and related disorders (34.8%; n=106). Most patients (77.4%, n= 236) received regular psychotropic medications on admission. Vis a vis, 223 patients (73%) received PRN medications. Nominal regression model revealed positive relationship between “no psychotropics prescribed on admission” and self-discharge in women but not in men. No statistically significant relationship was found between age, gender, admission diagnosis and use of regular psychotropic medications on admission and need for seclusion, time spent in seclusion, documented physical aggression and use of PRN medications. Conclusion: Contrary to what is expected, our study does not show association between gender, physical aggression and need for seclusion. This could be due to poor documentation practices by nursing staff in male ward comparing with those in the female ward. Use of PRN psychotropics in the first 72 hours of admission was quite high possibly leading to a “ceiling effect”. A limitation of this study is the retrospective data collection.

Keywords: discharge against medical advice, physical aggression, psychotropics, seclusion

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Authors: Gabriela C. Caldas, Fernanda C. Jacome, Arthur da C. Rasinhas, Ortrud M. Barth, Flavia B. dos Santos, Priscila C. G. Nunes, Yuli R. M. de Souza, Pedro Paulo de A. Manso, Marcelo P. Machado, Debora F. Barreto-Vieira

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The establishment of animal models for studies of DENV infections has been challenging, since circulating epidemic viruses do not naturally infect nonhuman species. Such studies are of great relevance to the various areas of dengue research, including immunopathogenesis, drug development and vaccines. In this scenario, the main objective of this study is to verify possible morphological changes, as well as the presence of antigens and viral RNA in lung samples from BALB/c mice experimentally infected with an epidemic and non-neuroadapted DENV-3 strain. Male BALB/c mice, 2 months old, were inoculated with DENV-3 by intravenous route. After 72 hours of infection, the animals were euthanized and the lungs were collected. Part of the samples was processed by standard technique for analysis by light and transmission electronic microscopies and another part was processed for real-time PCR analysis. Morphological analyzes of lungs from uninfected mice showed preserved tissue areas. In mice infected with DENV-3, the analyzes revealed interalveolar septum thickening with presence of inflammatory infiltrate, foci of alveolar atelectasis and hyperventilation, bleeding foci in the interalveolar septum and bronchioles, peripheral capillary congestion, accumulation of fluid in the blood capillary, signs of interstitial cell necrosis presence of platelets and mononuclear inflammatory cells circulating in the capillaries and/or adhered to the endothelium. In addition, activation of endothelial cells, platelets, mononuclear inflammatory cell and neutrophil-type polymorphonuclear inflammatory cell evidenced by the emission of cytoplasmic membrane prolongation was observed. DEN-like particles were seen in the cytoplasm of endothelial cells. The viral genome was recovered from 3 in 12 lung samples. These results demonstrate that the BALB / c mouse represents a suitable model for the study of the histopathological changes induced by DENV infection in the lung, with tissue alterations similar to those observed in human cases of DEN.

Keywords: BALB/c mice, dengue, histopathology, lung, ultrastructure

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Authors: Ruben L. Tagare, Jr

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This study was conducted to determine the parents’ motivating factors for their deaf and mute children to participate in physical and recreational activities. Data were collected from the 17 parents of the deaf and mute children using a specifically designed survey questionnaire as the primary instrument used in the study. Data analysis and interpretation were done with the aid of descriptive statistics, such as frequency, percentage, weighted mean and multiple responses. Most of the respondents were female with a mean average age of 38 years old. The average age of their children was 10 years old. In terms of monthly income, the respondents had an average monthly income of PhP 13,945. Furthermore, most of the respondents lived in the urban area and were all Catholic by faith or religion. As to the factors that parents used to motivate their deaf and mute children to engage in physical and recreational activities, these included the followings: First; to make my child experience and explore more meaningful things through physical and recreational activities; second; to gain other’s respect; third; to build friendship and interact with his peers; fourth; to experience the feeling of belongingness; and fifth: to learn and discover new things. On the other hand, the least chosen factors were: first; to help achieve and maintain a healthy weight; second; to reduce fats and lowering blood pressure; third; to improve balance, coordination and strength; fourth; to improve posture; and fifth; to assist the child in the development of gross motor and fine motor skills. Based on the findings of the study, it is hereby recommended that since the first factor is 'to make my child experience and explore more meaningful things through physical and recreational activities' and the other top factors are more on social aspect, the school should design extra-curricular activities such as theatrical play and other similar activities that the students will find interesting while the parents will be more motivated to engage their children into physical and recreational activities. Also, since the least chosen factors are more on physical aspect, the school should organize or conduct a seminar for the parents to be aware of the benefits of participating in physical and recreational activities for their deaf and mute children. They can also conduct an information campaign to encourage the other parents of deaf and mute children, whom they keep only inside their home to enroll in the school and let their children be exposed to the natural world. Considering that parents are the primary motivators that can best help their children become more interested in physical and recreational activities for their own development, the school should always remain motivated by creating activities for the deaf and mute children with their parents. The study also recommends conducting further study on the level of knowledge/understanding of the parents on the benefits that can be derived from participating in physical and recreational activities.

Keywords: deaf and mute, participation, physical and recreational activities, adaptive PE

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Authors: Deeksha Karunakar

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The gaming industry is one of the biggest industries in the world. Video games are interactive works of authorship that require the execution of a computer programme on specialized hardware but which also incorporate a wide variety of other artistic mediums, such as music, scripts, stories, video, paintings, and characters, into which the player takes an active role. Therefore, video games are not made as singular, simple works but rather as a collection of elements that, if they reach a certain level of originality and creativity, can each be copyrighted on their own. A video game is made up of a wide variety of parts, all of which combine to form the overall sensation that we, the players, have while playing. The entirety of the components is implemented in the form of software code, which is then translated into the game's user interface. Even while copyright protection is already in place for the coding of software, the work that is produced because of that coding can also be protected by copyright. This includes the game's storyline or narrative, its characters, and even elements of the code on their own. In each sector, there is a potential legal framework required, and the gaming industry also requires legal frameworks. This represents the importance of intellectual property laws in each sector. This paper will explore the beginnings of video games, the various aspects of game copyrights, and the approach of the courts, including examples of a few different instances. Although the creative arts have always been known to draw inspiration from and build upon the works of others, it has not always been simple to evaluate whether a game has been cloned. The video game business is experiencing growth as it has never seen before today. The majority of today's video games are both pieces of software and works of audio-visual art. Even though the existing legal framework does not have a clause specifically addressing video games, it is clear that there is a great many alternative means by which this protection can be granted. This paper will represent the importance of copyright and trademark laws in the gaming industry and its regulations with the help of relevant case laws via utilizing doctrinal methodology to support its findings. The aim of the paper is to make aware of the applicability of intellectual property laws in the gaming industry and how the justice system is evolving to adapt to such new industries. Furthermore, it will provide in-depth knowledge of their relationship with each other.

Keywords: copyright, DMCA, gaming industry, trademark, WIPO

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Authors: Kristin Prentice, Carri Hand

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As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

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Authors: Asad Salahuddin

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Crime rates seem to be severely augmenting over the past several years in Pakistan which has perpetuated concerns as to what, when and how this upsurge will be eradicated. State institutions are posed to be in utmost perplexity, given the enormity of worsening law and order situation, compelling government on the flip side to expend more resources in strengthening institutions to confront crime, whereas, the economy has been confronted with massive energy crisis, mass unemployment and considerable inflation which has rendered most of the people into articulate apprehension as to how to satisfy basic necessities. A framework to investigate the variability in the rising street crimes, as affected by social and institutional outcomes, has been established using a cross-sectional study. Questionnaire, entailing 7 sections incorporating numerous patterns of behavior and history of involvement in different crimes for potential street criminals was observed as data collection instrument. In order to specifically explicate the intent of street crimes on micro level, various motivational and de-motivational factors that stimulate people to resort to street crimes were scrutinized. Intent of mobile snatching and intent of street assault as potential dependent variables were examined using numerous variables that influence the occurrence and intent of these crimes using ordered probit along with ordered logit and tobit as competing models. Model Estimates asserts that intent of mobile snatching has been significantly enhanced owing to perceived judicial inefficiency and lower ability of police reforms to operate effectively, which signifies the inefficiency of institutions that are entitled to deliver justice and maintaining law and order respectively. Whereas, intent of street assaults, as an outcome, affirms that people with lack of self-stability and severe childhood punishments were more tempted to be involved in violent acts. Hence, it is imperative for government to render better resources in form of training, equipment and improved salaries to police and judiciary in order to enhance their abilities and potential to curb inflating crime.

Keywords: deprivation, street assault, self control, police reform

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Authors: Mohamed H. Khalil

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Water is one of the most crucial elements which influence human lives and development. Noteworthy, over the last few years, GIS plays a significant role in optimizing water management systems, especially after exponential developing in this sector. In this context, the Egyptian government initiated an advanced ‘GIS-Web Based System’. This system is efficiently designed to tangibly assist and optimize the complement and integration of data between departments of Call Center, Operation and Maintenance, and laboratory. The core of this system is a unified ‘Data Model’ for all the spatial and tabular data of the corresponding departments. The system is professionally built to provide advanced functionalities such as interactive data collection, dynamic monitoring, multi-user editing capabilities, enhancing data retrieval, integrated work-flow, different access levels, and correlative information record/track. Noteworthy, this cost-effective system contributes significantly not only in the completeness of the base-map (93%), the water network (87%) in high level of details GIS format, enhancement of the performance of the customer service, but also in reducing the operating costs/day-to-day operations (~ 5-10 %). In addition, the proposed system facilitates data exchange between different departments (Call Center, Operation and Maintenance, and laboratory), which allowed a better understanding/analyzing of complex situations. Furthermore, this system reflected tangibly on: (i) dynamic environmental monitor/water quality indicators (ammonia, turbidity, TDS, sulfate, iron, pH, etc.), (ii) improved effectiveness of the different water departments, (iii) efficient deep advanced analysis, (iv) advanced web-reporting tools (daily, weekly, monthly, quarterly, and annually), (v) tangible planning synthesizing spatial and tabular data; and finally, (vi) scalable decision support system. It is worth to highlight that the proposed future plan (second phase) of this system encompasses scalability will extend to include integration with departments of Billing and SCADA. This scalability will comprise advanced functionalities in association with the existing one to allow further sustainable contributions.

Keywords: GIS Web-Based, base-map, water network, decision support system

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Authors: T. Wen, Y. Liu, J. Wang, W. Zheng, T. Shao

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Along with the increasing density of urban population, solar energy potential of building facade in high-density residential areas become a question that needs to be addressed. This paper studies how the solar energy utilization potential of building facades in different locations of a residential areas changes with different building layouts and orientations in Xining, a typical city in west China which possesses large solar radiation resource. Solar energy potential of three typical building layouts of residential areas, which are parallel determinant, gable misalignment, transverse misalignment, are discussed in detail. First of all, through the data collection and statistics of Xining new residential area, the most representative building parameters are extracted, including building layout, building height, building layers, and building shape. Secondly, according to the results of building parameters extraction, a general model is established and analyzed with rhinoceros 6.0 and its own plug-in grasshopper. Finally, results of the various simulations and data analyses are presented in a visualized way. The results show that there are great differences in the solar energy potential of building facades in different locations of residential areas under three typical building layouts. Generally speaking, the solar energy potential of the west peripheral location is the largest, followed by the East peripheral location, and the middle location is the smallest. When the deflection angle is the same, the solar energy potential shows the result that the West deflection is greater than the East deflection. In addition, the optimal building azimuth range under these three typical building layouts is obtained. Within this range, the solar energy potential of the residential area can always maintain a high level. Beyond this range, the solar energy potential drops sharply. Finally, it is found that when the solar energy potential is maximum, the deflection angle is not positive south, but 5 °or 15°south by west. The results of this study can provide decision analysis basis for residential design of Xining city to improve solar energy utilization potential and provide a reference for solar energy utilization design of urban residential buildings in other similar areas.

Keywords: building facade, solar energy potential, solar radiation, urban residential area, visualization, Xining city

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Authors: Yuri V. Bykov, V. A. Baturin

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Aim of the study: The aim of the study was to perform a comparative analysis of the levels of autoantibodies (AAB) to the S-100 protein as well as to the dopamine and NMDA receptors in children with type 1 diabetes mellitus (DM) in therapeutic remission. Materials and methods: Blood serum obtained from 42 children ages 4 to 17 years (20 boys and 22 girls) was analyzed. Twenty-one of these children had a diagnosis of type 1 DM and were in therapeutic remission (study group). The mean duration of disease in children with type 1 DM was 9.6±0.36 years. Children without DM were included in a group of "apparently healthy children" (21 children, comparison group). AAB to the S-100 protein, the dopamine, and NMDA receptors were measured by ELISA. The normal range of IgG AAB was specified as up to 10 µg/mL. In order to compare the central parameters of the groups, the following parametric and non-parametric methods were used: Student's t-test or Mann-Whitney U test. The level of significance for inter-group comparisons was set at p<0.05. Results: The mean levels of AAB to the S-100B protein were significantly higher (p=0.0045) in children with DM (16.84±1.54 µg/mL) when compared with "apparently healthy children" (2.09±0.05 µg/mL). The detected elevated levels of AAB to NMDA receptors may indicate that in children with type 1 DM, there is a change in the activity of the glutamatergic system, which in its turn suggests the presence of excitotoxicity. The mean levels of AAB to dopamine receptors were higher (p=0.0082) in patients comprising the study group than in the children of the comparison group (40.47±2.31 µg/mL and 3.91±0.09 µg/mL). The detected elevated levels of AAB to dopamine receptors suggest an altered activity of the dopaminergic system in children with DM. This can also be viewed as indirect evidence of altered activity of the brain's glutamatergic system. The mean levels of AAB to NMDA receptors were higher in patients with type 1 DM compared with the "apparently healthy children," at 13.16±2.07 µg/mL and 1.304±0.05 µg/mL, respectively (p=0.0021). The elevated mean levels of AAB to the S-100B protein may indicate damage to brain tissue in children with type 1 DM. A difference was also detected between the mean values of the measured AABs, and this difference depended on the duration of the disease: mean AAB values were significantly higher in patients whose disease had lasted more than five years. Conclusions: The elevated mean levels of AAB to the S-100B protein may indicate damage to brain tissue in the setting of excitotoxicity in children with type 1 DM. The discovered elevation of the levels of AAB to NMDA and dopamine receptors may indicate the activation of the glutamatergic and dopaminergic systems. The observed abnormalities indicate the presence of central nervous system damage in children with type 1 DM, with a tendency towards the elevation of the levels of the studied AABs with disease progression.

Keywords: autoantibodies, brain damage, children, diabetes mellitus

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Authors: Samane Eftekhari Ranjbar

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Diabetes mellitus, a metabolic disorder characterized by elevated blood glucose levels, ranks among the leading causes of adult mortality. This study investigates the impact of an eight-week high-intensity interval training (HIIT) program combined with sodium nitrite supplementation on TNF- α, MURF1, and PI3K in a type 2 diabetes rodent model. Elevated TNF-α levels have been associated with insulin resistance, while MURF1 and PI3K play roles in muscle atrophy and insulin signaling pathways, respectively. In this experimental study, 15 eight-week-old rats from the Sara Laboratory Center in Tabriz were assigned to one of five groups: healthy control, diabetic control, diabetic with sodium nitrite supplementation, diabetic with eight weeks of intermittent exercise, and diabetic with eight weeks of interval training plus sodium nitrite supplementation. The HIIT protocol was designed to span eight weeks, with five weekly sessions at specified intensities and durations. Sodium nitrite, known for its vasodilatory and cytoprotective properties, was administered via injection. The findings revealed that the HIIT program and sodium nitrite supplementation influenced the examined biomarkers. ANOVA test outcomes indicated statistically significant differences in TNF- α (P=0.001), MURF1 (P=0.001), and PI3K (P=0.001) concentrations among the various groups. The healthy control group exhibited substantially decreased TNF- α, and MURF1 levels, as well as elevated PI3K levels compared to the diabetic control group. The exercise group, in conjunction with sodium nitrite supplementation, demonstrated a significant rise in PI3K levels (P=0.001) and a decline in TNF- α levels (P=0.018) relative to the diabetic control group. These results suggest that the combined intervention may help improve insulin sensitivity and reduce inflammation. However, MURF1 levels, which are related to muscle atrophy, showed no significant difference (P=0.24). In conclusion, in type 2 diabetic rats, an eight-week high-intensity interval training program with sodium nitrite supplementation does not affect MURF1 levels but does influence PI3K and TNF- α levels. This combination may hold potential for improving insulin sensitivity and reducing inflammation in type 2 diabetes patients, warranting further investigation and potential translation to human clinical trials.

Keywords: high-intensity interval training, sodium nitrate supplementation, type 2 diabetes, tumor necrosis factor-alpha, phosphatidylinositol-3-kinase, muscle RING-finger protein-1

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Authors: Subrat Kumar Bhattamisra, Vivian Lee Yean Yan, Chin Koh Lee, Chew Hui Kuean, Yun Khoon Liew, Mayuren Candasamy

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Geraniol, an acyclic monoterpenoid is the main active constituent in the essential oils of rose and palmorosa. Antioxidant, antibacterial, anticancer and antiulcer activity of geraniol was reported by many researchers. The present investigation was designed to study in vivo antiulcer and anti-Helicobacter pylori activity of geraniol. Antiulcer and anti-H. pylori activity of geraniol was evaluated on acetic acid plus H. pylori induced ulcer in rats. Acetic acid (0.03 mL) was injected to the sub-serosal layer of the stomach through laparotomy under anaesthesia. Orogastric inoculation of H. pylori (ATCC 43504) was done twice daily for 7 days. Geraniol (15 and 30 mg/kg), vehicle and standard drugs (Amoxicillin, 50 mg/kg; clarithromycin, 25 mg/kg & omeprazole, 20 mg/kg) was administered twice daily for 14 days. Antiulcer activity of geraniol was examined by the determination of gastric ulcer index, measuring the volume of gastric juice, pH and total acidity, myeloperoxidase activity and histopathological examination. Histopathological investigation for the presence of inflammation, white blood cell infiltration, edema, the mucosal damage was studied. The presence of H. pylori was detected by placing a biopsy sample from antral part of the stomach into rapid urease test. Ulcer index in H. pylori inoculated control group was 4.13 ± 0.85 and was significantly (P < 0.05) lowered in geraniol (30 mg/kg) and reference drug treated group. Geraniol increase the pH of the gastric juice (2.18 ± 0.13 in control vs. 4.14 ± 0.57 in geraniol 30mg/kg) and lower total acidity significantly (P < 0.01) in geraniol (15 & 30 mg/kg). Myeloperoxidase (MPO) activity was measured in stomach homogenate of all the groups. H. pylori control group has significant (P < 0.05) increase in MPO activity compared to normal control group. Geraniol (30 mg/kg) was showed significant (P < 0.05) and most effective among all the groups. Histopathological examination of rat stomach was scored and the total score for H. pylori control group was 8. After geraniol (30 mg/kg) and reference drug treatment, the histopathological score was significantly decreased and it was observed to be 3.5 and 2.0 respectively. Percentage inhibition of H. pylori infection in geraniol (30 mg/kg) and reference drug were found to be 40% and 50% respectively whereas, 100% infection in H. pylori control group was observed. Geraniol exhibited significant antiulcer and anti- H. pylori activity in the rats. Thus, geraniol has the potential for the further development as an effective medication in treating H. pylori associated ulcer.

Keywords: geraniol, helicobacter pylori atcc 43504, myeloperoxidase, ulcer

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Authors: Manjari Srivastsva, Ruta Vyas

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The research in the area of self leadership advocates employee/team empowerment. It is well understood that empowered employees would contribute more and better to their organizational outcomes. This research is a part of an ongoing larger research in the area of empowering leadership behavior. The present research aims to understand some of the antecedents to empowering behavior of leaders such that the organizations can focus on the right elements and invest in the appropriate areas during their leadership development activities. The research is exploratory field study. Sampling is purposive, employing triadic design i.e. a manager and two of his/her subordinates are selected for data collection. The total no. of respondents is 240, with 80 managers and 160 of their direct reports. Initially focus group interview was done and based on the inputs from focus group, quantitative data was collected personally by the researchers using questionnaire. The sample is drawn from seven professionally run organization including those of Indian origin as well as multi-national companies. This study proposes to explore the constituents of empowering behavior both from leaders’ and their subordinates’ perspective and also see the relationship between some of the personal variables of leaders as an antecedent to empowering behavior. Similarly, the study aims to explore the subordinates’ perspectives as an antecedent to empowering behavior. The relationship between antecedent variables and empowering behavior is tested for moderation employing organization culture. Exploratory and confirmatory factor analysis was done to establish the validity of the questionnaires. Further hierarchical regression analysis results revealed that organization based self-esteem and global self-esteem impact leaders’ empowering behavior and this relationship is further moderated by organization culture. Team members’ perspective showed higher importance for task characteristics and members' readiness from the point of view of empowerment. The relation between task characteristics and members’ readiness was not moderated by culture. The finding from this research may be utilized by professionals to guide organizations desiring rapid and sustainable growth, to develop leaders who empower their teams such that they act as leaders themselves and become stimulants for the growth of organizations.

Keywords: empowering behavior, team leaders, subordinates, self-esteem, organization culture, task characteristics, team members readiness

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Authors: Madeleine Cox

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Objective: Discussion of diagnosis and management options for myometrial ectopic pregnancy Case: A 30 yo G1P0 presented to the emergency department with vaginal bleeding for the last 4 days. She had a positive home urine pregnancy test, confirmed with a serum HCG. When she presented for an ultrasound, there was no intrauterine pregnancy, no evidence of adnexal pregnancy, however, the anterior myometrium of the uterus was noted to be markedly abnormal. When she presented to the emergency department of a busy tertiary hospital in Queensland, she had a small amount of vaginal bleeding, was anxious but well, observations normal. Repeat blood testes demonstrated a serum HCG of 9246 IU/L, haemoglobin of 143g/L. The patient had an interesting history of a right oophorectomy and open myomectomy in another country. A repeat ultrasound again showed an abnormality within the myometrium of the uterus, which was initially reported as concerning for an AVM, or potentially invasive gestational trophoblastic disease. An MRI was organised 2 days later, which demonstrated a intramural/subserosal irregularity in the right lateral body measuring 35x38x42mm with peripheral enhancement and central cystic components, favouring a myometrial ectopic most likely at the site of previous myomectomy. Alternative diagnosis of AVM, GTD were considered less likely. After discussion with the patient, IV methotrexate was administered as an in patient 4 days after her initial presentation to emergency. After this, her HCG fell to 1236 IU/L on day 6 post treatment. Weekly reviews showed stable ultrasound appearances with a steadily dropping HCG level. A repeat MRI was performed 3 weeks after methotrexate administration which confirmed involution of the myometrial ectopic, however, showed ongoing progression of vascularity surrounding the site. Despite resolution of HCG, the patient persisted to have ongoing bleeding associated with this and went to have uterine artery embolisation. Follow up ultrasound showed resolution of abnormal vascularity and negative HCG levels. Conclusion: Myometrial ectopic pregnancies are a rare occurrence and require a multidisciplinary approach to achieve timely management for these patients. This patient was in a very well resourced setting with excellent access to Interventional Radiology and specialist Radiologists who could work together with the Obstetrics, Gynaecology, and Maternal Fetal Medicine team to provide multiple options of management which preserved her fertility. This case has a very good outcome, with the patient being referred back to our service 12 months later with an early intrauterine pregnancy.

Keywords: ectopic, pregnancy, miscarriage, gynaecology

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Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

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Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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Authors: Kangana Sengar, Sanjay Deb, Ramesh Dawar

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Introduction: Ki-67 can be a useful marker in determining proliferative activity in patients with multiple myeloma (MM). However, using Ki-67 alone results in the erroneous inclusion of non-myeloma cells leading to false high counts. We have used Dual IHC (immunohistochemistry) staining with Ki-67 and CD138 to enhance specificity in assessing proliferative activity of bone marrow plasma cells. Aims and objectives: To estimate the proportion of proliferating (Ki-67 expressing) plasma cells in patients with MM and correlation of Ki-67 with other known prognostic parameters. Materials and Methods: Fifty FFPE (formalin fixed paraffin embedded) blocks of trephine biopsies of cases diagnosed as MM from 2010 to 2015 are subjected to H & E staining and Dual IHC staining for CD 138 and Ki-67. H & E staining is done to evaluate various histological parameters like percentage of plasma cells, pattern of infiltration (nodular, interstitial, mixed and diffuse), routine parameters of marrow cellularity and hematopoiesis. Clinical data is collected from patient records from Medical Record Department. Each of CD138 expressing cells (cytoplasmic, red) are scored as proliferating plasma cells (containing a brown Ki¬67 nucleus) or non¬proliferating plasma cells (containing a blue, counter-stained, Ki-¬67 negative nucleus). Ki-67 is measured as percentage positivity with a maximum score of hundred percent and lowest of zero percent. The intensity of staining is not relevant. Results: Statistically significant correlation of Ki-67 in D-S Stage (Durie & Salmon Stage) I vs. III (p=0.026) and ISS (International Staging System) Stage I vs. III (p=0.019), β2m (p=0.029) and percentage of plasma cells (p < 0.001) is seen. No statistically significant correlation is seen between Ki-67 and hemoglobin, platelet count, total leukocyte count, total protein, albumin, S. calcium, S. creatinine, S. LDH, blood urea and pattern of infiltration. Conclusion: Ki-67 index correlated with other known prognostic parameters. However, it is not determined routinely in patients with MM due to little information available regarding its relevance and paucity of studies done to correlate with other known prognostic factors in MM patients. To the best of our knowledge, this is the first study in India using Dual IHC staining for Ki-67 and CD138 in MM patients. Routine determination of Ki-67 will help to identify patients who may benefit with more aggressive therapy. Recommendation: In this study follow up of patients is not included, and the sample size is small. Studying with larger sample size and long follow up is advocated to prognosticate Ki-67 as a marker of survival in patients with multiple myeloma.

Keywords: bone marrow, dual IHC, Ki-67, multiple myeloma

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Authors: V. Mathad, S. Shivprasad, P. Shivsharannappa, M. K. Patil

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Introduction: Non-communicable diseases are emerging diseases in India. Government of India launched National Programme for Prevention and Control of Cardiovascular Diseases, Cancer and Stroke (NPCDCS) during the year 2008. The aim of the programme was to reduce the burden of non communicable diseases by health promotion and prompt treatment. Objective: The present study was intended to assess the impact of National Program for prevention and control of Cardiovascular Diseases, Diabetes, Cancer and Stroke Programme on biochemical and physiological factors influencing Type 2 diabetes in Kalaburagi District. Material and Method: NCD Clinic was established at District Hospital during April 2016. All the patients attending District Hospital Kalaburagi above the age of 30 years are screened for Non Communicable Diseases under NPCDCS Programme. A total sample of 7447 patients attending NCD Clinic situated at Kalaburagi district was assessed in this study. Pre structured and pretested schedule seeking information was obtained from all the patients by the counselor working under NPCDCS programme. All the Patients attending District Hospital were screened for Diabetes using Glucometer at NCD clinic. The suspected cases were further confirmed through Biochemical investigations like Fasting Blood glucose, HBA1c, Urine Glucose, Kidney Function test. SPSS 20 version was used for analysis of data. Chi square test, P values and odds ratio was used to study the association of factors. Results: A Total of 7447 patients attended NCD clinic during the year 2017-18 were analyzed, Diabetes was seen among 3028 individuals were as comorbidities along with Hypertension was seen among 757 individuals. The mean age of the population was 50 ± 2.84. 3440(46.2%) were males whereas Female constituted 4007(53.8%) of population. The incidence and prevalence of Diabetes being 8.6 and 12.8 respectively. Diabetes was more commonly seen during the age group of 40 to 69 years. Diabetes was significantly associated with Age group 40 to 69 years, obesity and female gender (p < 0.05). The risk of developing Hypertension and comorbidity conditions of hypertension and Diabetes was 1.224 and 1.305 times higher among males, whereas the risk of diabetes was 1.127 higher among females as compared to males. Conclusion: The screening for NCD has significantly increased after launching of NPCDCS programme. NCD was significantly associated with obesity, female gender, increased age as well as comorbid conditions like hypertension and tuberculosis.

Keywords: non-communicable diseases, NPCDCS programme, type 2 Diabetes, physiological factors

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Authors: Shalini TV, Gangadharan GG, Sriranjini S Jaideep, ASN Seshasayee, Awadhesh Pandit

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Introduction: Prakriti (body-mind constitution of an individual) is a conventional, customized and unique understanding of which is essential for the personalized medicine described in Ayurveda, Indian System of Medicine. Based on the Doshas( functional, bio humoral unit in the body), individuals are categorized into three major Prakriti- Vata, Pitta, and Kapha. The human gut microbiome hosts plenty of highly diverse and metabolically active microorganisms, mainly dominated by the bacteria, which are known to influence the physiology of an individual. Few researches have shown the correlation between the Prakriti and the biochemical parameters. In this study, an attempt was made to explore any correlation between the Prakriti (phenotype of an individual) with the Genetic makeup of the gut microbiome in healthy individuals. Materials and methods: 270 multi-ethnic, healthy volunteers of both sex with the age group between 18 to 40 years, with no history of antibiotics in the last 6 months were recruited into three groups of Vata, Pitta, and Kapha. The Prakriti of the individual was determined using Ayusoft, a software designed by CDAC, Pune, India. The volunteers were subjected to initial screening for the assessment of their height, weight, Body Mass Index, Vital signs and Blood investigations to ensure they are healthy. The stool and saliva samples of the recruited volunteers were collected as per the standard operating procedure developed, and the bacterial DNA was isolated using Qiagen kits. The extracted DNA was subjected to 16s rRNA sequencing using the Illumina kits. The sequencing libraries are targeting the variable V3 and V4 regions of the 16s rRNA gene. Paired sequencing was done on the MiSeq system and data were analyzed using the CLC Genomics workbench 11. Results: The 16s rRNA sequencing of the V3 and V4 regions showed a diverse pattern in both the oral and stool microbial DNA. The study did not reveal any specific pattern of bacterial flora amongst the Prakriti. All the p-values were more than the effective alpha values for all OTUs in both the buccal cavity and stool samples. Therefore, there was no observed significant enrichment of an OTU in the patient samples from either the buccal cavity or stool samples. Conclusion: In healthy volunteers of multi-ethnicity, due to the influence of the various factors, the correlation between the Prakriti and the gut microbiome was not seen.

Keywords: gut microbiome, ayurveda Prakriti, sequencing, multi-ethnic urban population

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Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

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Authors: Amal Saafan, Kareem Al Sofy, Sameh AbdelGhani, Magdy Amin

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Background: Acinetobacter spp. resistance towards β-lactam antibiotics is mediated mainly by different classes of β-lactamases production; detection of some genes responsible for production of β-lactamases is the objective of the study. Methods: One hundred fifty bacterial isolates were recovered from blood, sputum, and urine specimens from different hospitals in Egypt. Sixty-nine isolate were identified as Acinetobacter baumannii using traditional biochemical tests, CHROM agar, MicroScan and PCR amplification of blaoxa-51like gene. Acinetobacterbaumannii isolates were grouped into carbapenem resistant group (GP1), cefotaxime, ceftazidime and cefoxitin resistant group (GP2) and carbapenem and cephalosporin non-resistant group (GP3). Carbapenemase activity was screened using modified Hodge test (MHT) for GP1.Metallo-β-lactamases screening was performed for MHT positive isolates using double disk synergy test (DDST) and combined disk test (CDT). Amp C activity was screened using Amp C disk test with Tris-EDTA, DDST, and CDT for GP2. Finally, PCR amplification of blaoxa-51like, blaoxa-23like, blaIMP-like, blaVIM-like, and blaADC-like genes was performed for isolates that showed, at least, two positive results of three for both AmpC and carbapenemases phenotypic screening tests (obvious activity), in addition to GP3 (for comparison). Detection of blaoxa-51like and blaADC-like genes preceded by ISAba1 was also performed. Results: Antibiogram of 69 pure Acinetobacter baumannii isolates resulted in 57, 64, and 2 isolates enrolled into GP1, GP2, and GP3, respectively. Carbapenemase activity was shown by 49(85.9%) isolate using MHT. Metallo-β-lactamases screening revealed 32(65.3%) and 35(71.4%) using DDST and CDT, respectively.AmpC activity was shown by 43(67.2%) and 50 (78.1%) isolates using AmpC disk test with Tris-EDTA, and both DDST and CDT, respectively. Twenty-seven isolates showed obvious activity, all of them (100%) were harboring blaoxa-51like and blaADC-like genes, while blaoxa-23like, blaIMP-like andblaVIM-like genes were harbored by 23(85.2%), 9 (33.%) and no isolate respectively. Only 12 (44.4%) isolates harbored blaoxa-51like and blaADC-like genes preceded by ISAba1. GP3 isolates showed only positive blaoxa-51like and blaADC-like genes. Conclusion: It is not possible to correlate resistance with presence of blaoxa-51like and blaADC-like genes and presence of ISAba1 was immediate as transcriptional promoter. A blaoxa-23like gene played an important role in carbapenem resistance when compared with blaIMP-like and blaVIM-like gene.

Keywords: acinetobacter, beta-lactams, resistance, antimicrobial agents

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

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Objective: Serratia species are identified as aerobic, motile Gram negative rods. The species Serratia marcescens (S. marcescens) causes both opportunistic and nosocomial infections. The genus Providencia is Gram-negative bacilli and includes urease-producing that is responsible for a wide range of human infections. Although most Providencia infections involve the urinary tract, they are also associated with gastroenteritis, wound infections, and bacteremia. The aim of this study was evaluate the antimicrobial resistance rates of S. marcescens and Providencia spp. strains which had been isolated from various clinical materials obtained from different patients who belongs to intensive care units (ICU) and inpatient clinics. Methods: A total of 35 S. marcescens and Providencia spp. strains isolated from various clinical samples admitted to Medical Microbiology Laboratory, ANS Research and Practice Hospital, Afyon Kocatepe University between October 2013 and September 2015 were included in the study. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bio-Merieux, Marcy l’etoile, France) was used additionally. Antibacterial resistance tests were performed by using Kirby Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: The distribution of clinical samples were as follows: upper and lower respiratory tract samples 26, 74.2 % wound specimen 6, 17.1 % blood cultures 3, 8.5%. Of the 35 S. marcescens and Providencia spp. strains; 28, 80% were isolated from clinical samples sent from ICU. The resistance rates of S. marcescens strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 8.5 %, 22.8 %, 11.4 %, 2.8 %, 17.1 %, 40 %, 28.5 % and 5.7 % respectively. Resistance rates of Providencia spp. strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 10.2 %, 33,3 %, 18.7 %, 8.7 %, 13.2 %, 38.6 %, 26.7%, and 11.8 % respectively. Conclusion: S. marcescens is usually resistant to ampicillin, amoxicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefuroxime, cephamycins, nitrofurantoin, and colistin. The most effective antibiotic on the total of S. marcescens strains was found to be gentamicin 2.8 %, of the totally tested strains the highest resistance rate found against to ceftazidime 40 %. The lowest and highest resistance rates were found against gentamiycin and ceftazidime with the rates of 8.7 % and 38.6 % for Providencia spp.

Keywords: Serratia marcescens, Providencia spp., antibiotic resistance, intensive care unit

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Authors: Alexandra Emmanuelle Membangbi, Jacky Njiki Bikoï, Esther Del-florence Moni Ndedi, Marie Joseph Nkodo Mindimi, Donatien Serge Mbaga, Elsa Nguiffo Makue, André Chris Mikangue Mbongue, Martha Mesembe, George Ikomey Mondinde, Eric Walter Perfura-yone, Sara Honorine Riwom Essama

Abstract:

Background: Tuberculosis (TB) is one of the top lethal infectious diseases worldwide. In recent years, interferon-γ (INF-γ) release assays (IGRAs) have been established as routine tests for diagnosing TB infection. However, produced INF-γ assessment failed to distinguish active TB (ATB) from latent TB infection (LTBI), especially in TB epidemic areas. In addition to IFN-γ, interleukin-2 (IL-2), another cytokine secreted by activated T cells, is also involved in immune response against Mycobacterium tuberculosis. The aim of the study was to assess the capacity of IFN-γ and IL2 to evaluate the therapeutic response of patients on anti-tuberculosis treatment. Material and Methods: We conducted a cross-sectional study in the Pneumonology Departments of the Jamot Hospital in Yaoundé between May and August 2021. After signed the informed consent, the sociodemographic data, as well as 5 mL of blood, were collected in the crook of the elbow of each participant. Sixty-one subjects were selected (n= 61) and divided into 4 groups as followed: group 1: resistant tuberculosis (n=13), group 2: active tuberculosis (n=19), group 3 cured tuberculosis (n=16), and group 4: presumed healthy persons (n=13). The cytokines of interest were determined using an indirect Enzyme-linked Immuno-Sorbent Assay (ELISA) according to the manufacturer's recommendations. P-values < 0.05 were interpreted as statistically significant. All statistical calculations were performed using SPSS version 22.0 Results: The results showed that men were more 14/61 infected (31,8%) with a high presence in active and resistant TB groups. The mean age was 41.3±13.1 years with a 95% CI = [38.2-44.7], the age group with the highest infection rate was ranged between 31 and 40 years. The IL-2 and INF-γ means were respectively 327.6±160.6 pg/mL and 26.6±13.0 pg/mL in active tuberculosis patients, 251.1±30.9 pg/mL and 21.4±9.2 pg/mL in patients with resistant tuberculosis, while it was 149.3±93.3 pg/mL and 17.9±9.4 pg/mL in cured patients, 15.1±8.4 pg/mL and 5.3±2.6 pg/mL in participants presumed healthy (p <0.0001). Significant differences in IFN-γ and IL-2 rates were observed between the different groups. Conclusion: Monitoring the serum levels of INF-γ and IL-2 would be useful to evaluate the therapeutic response of anti-tuberculosis patients, particularly in the both cytokines association case, that could improve the accuracy of routine examinations.

Keywords: antibiotic therapy, interferon gamma, interleukin 2, tuberculosis

Procedia PDF Downloads 102

Authors: Cristian Sirbu-Dragomir, Stefan-Mihai Sofian, Adrian Predescu

Abstract:

This paper aims to study Tesla pumps for circulating biofluids. It is desired to make a small pump for the circulation of biofluids. This type of pump will be studied because it has the following characteristics: It doesn’t have blades which results in very small frictions; Reduced friction forces; Low production cost; Increased adaptability to different types of fluids; Low cavitation (towards 0); Low shocks due to lack of blades; Rare maintenance due to low cavity; Very small turbulences in the fluid; It has a low number of changes in the direction of the fluid (compared to rotors with blades); Increased efficiency at low powers.; Fast acceleration; The need for a low torque; Lack of shocks in blades at sudden starts and stops. All these elements are necessary to be able to make a small pump that could be inserted into the thoracic cavity. The pump will be designed to combat myocardial infarction. Because the pump must be inserted in the thoracic cavity, elements such as Low friction forces, shocks as low as possible, low cavitation and as little maintenance as possible are very important. The operation should be performed once, without having to change the rotor after a certain time. Given the very small size of the pump, the blades of a classic rotor would be very thin and sudden starts and stops could cause considerable damage or require a very expensive material. At the same time, being a medical procedure, the low cost is important in order to be easily accessible to the population. The lack of turbulence or vortices caused by a classic rotor is again a key element because when it comes to blood circulation, the flow must be laminar and not turbulent. The turbulent flow can even cause a heart attack. Due to these aspects, Tesla's model could be ideal for this work. Usually, the pump is considered to reach an efficiency of 40% being used for very high powers. However, the author of this type of pump claimed that the maximum efficiency that the pump can achieve is 98%. The key element that could help to achieve this efficiency or one as close as possible is the fact that the pump will be used for low volumes and pressures. The key elements to obtain the best efficiency for this model are the number of rotors placed in parallel and the distance between them. The distance between them must be small, which helps to obtain a pump as small as possible. The principle of operation of such a rotor is to place in several parallel discs cut inside. Thus the space between the discs creates the vacuum effect by pulling the liquid through the holes in the rotor and throwing it outwards. Also, a very important element is the viscosity of the liquid. It dictates the distance between the disks to achieve a lossless power flow.

Keywords: lubrication, temperature, tesla-pump, viscosity

Procedia PDF Downloads 172