Search results for: medication compliance

Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan

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The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.

Keywords: anxiety, chronic headaches, depression, HAM-A, HAM

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Authors: Ksenia Siadkowska, Łukasz Grabowski, Michał Gęca

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The dynamic development of photovoltaics in the 21st century has resulted in more possibilities for using photovoltaic systems. In order to reduce emissions, a retrofitting of vehicles with photovoltaic modules has recently become increasingly popular. Preparing such an installation, however, requires professional knowledge and compliance with safety rules. The paper discusses the advantages and disadvantages of some types of flexible photovoltaic modules that can be applied to mobile installations, types and causes of damage to photovoltaic modules as well as the most frequent types of misinstallation. Our attention has been drawn to the risk of fire caused by misintallation or defective insulation and the need to closely monitor mobile installations, for example by a non-destructive testing with a thermal imaging camera. The paper also presents certain selected results of the research conducted at the Lublin University of Technology. This work has been financed by the Polish National Centre for Research and Development, under Grant Agreement No. PBS2/A6/16/2013.

Keywords: flexible PV module, mobile PV module, photovoltaic module, photovoltaic

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Authors: Ayyoub Jamali, Jennie Edlund, Alena Kozlová

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This paper evaluates the monitoring, prevention, and enforcing mechanisms of the core values of international organisations (IOs) in a comparative human rights perspective. The IOs in focus are the European Union, the Council of Europe, the African Union, and the Organization of American States. The paper will take the founding treaties of these IOs and their relevant protocols as a starting point to identify the values and the mechanisms used for their implementation. It will explore the scope of violations, the procedures in place and evaluate what type of response to those breaches seems to work best in terms of achieving its declared objectives. The study will identify and compare the weaknesses and strengths of each mechanism used by the IOs and recognize common challenges and means, thereby drawing inter-organizational comparisons. Consequently, the findings of this paper can be used among the IOs to improve their system and thus enhance their effectiveness.

Keywords: international organizations, core values, human rights, enforcement mechanism, compliance

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Authors: Christopher Wearmouth, Jacob Smith

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Administration of tranexamic acid (TXA) reduces all-cause mortality in trauma patients when given within 3 hours of injury. Due to geographical distance and lack of emergency medical services patients often present late, following trauma, to our emergency department. Additionally, we found patients that may have benefited from TXA did not receive it, often due to lack of staff awareness, staff shortages out of hours and lack of equipment for delivering infusions. Our objective was to develop a protocol for nurse-led administration of TXA in the emergency department. We developed a protocol using physiological observations along with criteria from the South African Triage Scale to allow nursing staff to identify patients with, or at risk of, significant haemorrhage. We will monitor the use of the protocol to ensure appropriate compliance and for any adverse events reported.

Keywords: emergency department, emergency nursing, rural healthcare, tranexamic acid, trauma, triage

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Authors: Manal Rayes

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In its efforts to utilize the information and communication technology to enhance the quality of public service delivery, national and local governments around the world are competing to introduce more ICT applications as tools to automate processes related to law enforcement or policy execution, increase citizen orientation, trust, and satisfaction, and create one-stop-shops for public services. In its implementation, e-Government ICTs need to maintain transparency, participation, and collaboration. Due to this diverse of mixed goals and requirements, e-Government systems need to be designed based on special design considerations in order to eliminate the risks of failure to compliance to government regulations, citizen dissatisfaction, or market repulsion. In this article we suggest a framework with guidelines for designing government information systems that takes into consideration the special requirements of the public sector. Then we introduce two case studies and show how applying those guidelines would result in a more solid system design.

Keywords: e-government, framework, guidelines, system design

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Authors: A. D. Usman, W. F. Wan Ahmad, H. H. Danjuma

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Exposure due to GSM frequencies is subject of daily debate. Though regulatory bodies provide guidelines for exposure, people still exercise fear on the possible health hazard that may result due to long term usage. In this study, exposure due to electromagnetic field emitted by GSM base stations in industrial areas was investigated. The aimed was to determine whether industrial area exposure is higher as compared to residential as well as compliance with ICNIRP guidelines. Influence of reflection and absorption with respect to inverse square law was also investigated. Measurements from GSM base stations were performed at various distances in far field region. The highest measured peak power densities as well as the calculated values at GSM 1.8 GHz were 6.05 and 90 mW/m2 respectively. This corresponds to 0.07 and 1% of ICNIRP guidelines. The highest peak power densities as well as the calculated values at GSM 0.9 GHz were 11.92 and 49.7 mW/m2 respectively. These values were 0.3 and 1.1% of ICNIRP guidelines.

Keywords: Global System for Mobile Communications (GSM), Electromagnetic Field (EMF), far field, power density, Radiofrequency (RF)

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Authors: Tsai Su Hui

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Background: Hyperphosphatemia in patients receiving dialysis can cause hyperparathyroidism, which can lead to renal osteodystrophy, cardiovascular disease and mortality. Data showed that 26% of patients receiving dialysis had blood phosphate levels of >6.0 mg/dl at this unit from January to March 2017, higher than the Taiwan Society of Nephrology evaluation criteria of < 20%. After analysis, possible reasons included: 1. Incomprehensive education for nurse and lack of relevant training. 2. Insufficient assistive aids for nursing health education instruction. 3. Patients were unsure which foods are high or low in phosphate. 4. Patients did not have habits of taking medicine with them and how to correctly administer the medication. Purpose: To reduce the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl to less than 20% at this unit. Method: (1) Improve understanding of hyperphosphatemia and food for patients receiving dialysis and their families, (2) Acquire more nursing instruction assistive aids and improve knowledge of hyperphosphatemia for nurse. Results: After implementing the project, the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl decreased from 26.0% to 18.8% at this unit. By implementing the project, the professional skills of nurse improved, blood phosphate levels of patients receiving dialysis were reduced, and the quality of care for patients receiving dialysis at this unit was enhanced.

Keywords: hemodialysis, hyperphosphatemia, incidence, reducing

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Authors: Kocakaya Eda, Argun Doğan

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This study analyzed the present state of information technology in the field of accounting by bibliometric analysis of scientific studies on the impact on the transformation of e-billing and tax managementin Turkey. With comparative bibliometric analysis, the innovation and positive effects of the process that changed with e-transformation in the field of accounting with e-transformation in businesses and the information technologies used in accounting and tax management were analyzed comparatively. By evaluating the data obtained as a result of these analyzes, suggestions on the use of information technologies in accounting and tax management and the positive and negative effects of e-transformation on the analyzed activities of the enterprises were emphasized. With the e-transformation, which will be realized with the most efficient use of information technologies in Turkey. The synergy and efficiency of IT technology developments in avcoounting and finance should be revealed in the light of scientific data, from the smallest business to the largest economic enterprises.

Keywords: information technologies, E-invoice, E-Tax management, E-transformation, accounting programs

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Authors: Lloyd A. Taylor

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An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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Authors: Navarro, Delaup, Lacreusette, Jahier, Destaing, Gard

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Background: A complementary feed designed to support joint metabolism and contribute to cartilage integrity in dogs was evaluated through a pet-owner study involving 21 senior dogs experiencing a decrease in mobility. The study aimed to assess the product's benefits, ease of use, and impact on quality of life over a 56-day period. Methods: Privately owned dogs over six years old with reduced mobility and no change in their mobility management within the last three months were recruited. They received a chicken cartilage hydrolysate complementary feed containing a complex of glycosaminoglycans and type II collagen (Glycosane®, MP Labo, France. One capsule per dog up to 40 kg, 2 capsules beyond) once a day for 56 days. Assessments were performed at baseline (D0), and subsequent follow-ups at D7, D28, and D56: revised LOAD (Liverpool Osteoarthritis in Dogs) and CBPI (Canine Brief Pain Inventory) were used to evaluate mobility, pain intensity, and pain interference. Owners also completed a questionnaire on quality of life (QoL), comprising 7 questions on the animal’s well-being (QoL1) and 7 questions on the owner’s well-being (QoL2). Statistical analyses were performed using mixed models for repeated measures. The significance levels were set at p<0.05. Results: (1) Population: 21 dogs were included. The mean age was 10.2 years [6 – 14.5]. (2) Mobility: 71% of owners reported enhanced mobility by D56. Improvements were observed in half of the cases after 21 days of supplementation, with notable changes evident as early as 14 days in 39% of cases. LOAD scores showed significant improvement over time (p=0.0019). (3) Comfort: CBPI severity scores decreased significantly from baseline to D28 and D56 (p=0.0300 and p=0.0271, respectively). CBPI QoL score was also significantly improved at D56 compared to D7 (p=0.0440). (4) Quality of life: The QoL total score improved significantly by D56 compared to baseline (p=0.0089), with a specific improvement of the QoL1 (p=0.0015). (4) Owners' insights: Glycosane® received a high ease-of-use rating (mean score 4.4/5), with excellent compliance (95%). Oral intake was rated at 4.3/5. Willingness to walk (19%), Increased activity, Ability to run and/or jump from short heights and a Happier animal (11%) were among the most cited benefits. Owners noted enhanced comfort (78%) and happiness (79%) in their dogs, with a 60% perception of restored good mobility. Conclusion: The complementary feed demonstrates significant benefits in enhancing mobility and quality of life in senior dogs. Its high ease of administration supports owner compliance and satisfaction. These findings support Glycosane® as a valuable nutritional aid in helping to maintain canine mobility. Further studies with larger cohorts and a controlled group are recommended to validate these results.

Keywords: canine mobility, complementary feed, LOAD, CBPI, quality of life, Glycosane

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Authors: Seini G. Kaufusi

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Background. Physician-assisted death (PAD) has and continues to be a controversial issue in the U.S. Dying with dignity statutes exists in 9 U.S. jurisdictions that permit competent adults diagnosed with a terminal illness and given a prognosis of 6 month or less to live to request medication to hasten death. Robust advocacy for and against PAD influences policy, and opinions vary. Aim. This study aims to explore the association between race and the attitudes toward physician-assisted death in the U.S. Methods. Data for this study derives from the General Social Survey (GSS) dataset, a national survey conducted by the National Opinion Research Center (NORC) that focuses on the opinions and values of American’s. A cross-sectional design and probability sample from the 2018 data set was used to randomly select respondents. Results. The results indicated that race is significantly associated with attitudes towards physician-assisted death. The level of significance suggests a strong positive association, and the direction indicated that Black and Other racial groups have higher rates of positive decision about PAD. Conclusion. Although attitudes towards PAD varied, Black and other racial groups had favorable decisions for PAD. Further research is crucial in the continuous debate on PAD and understanding the influences of predictors for or against PAD.

Keywords: attitudes, euthanasia, physician-assisted death, race

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Authors: Olushola Ayanda, Simphiwe Nelana, Eliazer Naidoo

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In the present study, the kinetics, equilibrium and thermodynamics of the adsorption of As(III) ions from aqueous solution onto fly ash (FA) was investigated in batch adsorption system. Prior to the adsorption studies, the FA was characterized by means of x-ray fluorescence (XRF), x-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Brunauer-Emmett-Teller (BET) surface area determination. The effect of contact time, initial As(III) concentration, FA dosage, stirring speed, solution pH and temperature was examined on the adsorption rate. Experimental results showed a very good compliance with the pseudo-second-order equation, while the equilibrium study showed that the sorption of As(III) ions onto FA fitted the Langmuir and Freundlich isotherms. The adsorption process is endothermic and spontaneous, moreover, the maximum percentage removal of As(III) achieved with approx. 2.5 g FA mixed with 25 mL of 100 mg/L As(III) solution was 65.4 % at pH 10, 60 min contact time, temperature of 353 K and a stirring speed of 120 rpm.

Keywords: arsenic, fly ash, kinetics, isotherm, thermodynamics

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Authors: Ravindra B. Patil, P. Krishnamoorthy, Shriram Sethuraman

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This work proposes a novel Gaussian Mixture Model (GMM) based approach for accurate tracking of the arterial wall and subsequent computation of the distension waveform using Radio Frequency (RF) ultrasound signal. The approach was evaluated on ultrasound RF data acquired using a prototype ultrasound system from an artery mimicking flow phantom. The effectiveness of the proposed algorithm is demonstrated by comparing with existing wall tracking algorithms. The experimental results show that the proposed method provides 20% reduction in the error margin compared to the existing approaches in tracking the arterial wall movement. This approach coupled with ultrasound system can be used to estimate the arterial compliance parameters required for screening of cardiovascular related disorders.

Keywords: distension waveform, Gaussian Mixture Model, RF ultrasound, arterial wall movement

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Authors: Uche A. Nnawulezi

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This paper examines an essential and complex part of International humanitarian law standards of military necessity. Military necessity is an unpredictable phenomenon. The unpredictability of this regulation likewise originates from the fact that is one of the most fundamental, yet most misjudged and distorted standards of international law of armed conflict. This rule has been censured as essentially wrong in light of its non-compliance with the principles of international humanitarian law in recent past. The author noted in this study that military necessity runs counter to humanitarian exigencies. These have generated debate among researchers for them to propose that for international law to be considered more important, it is indispensable that the procedures and substance of custom be illuminated and made accessible to every one of the individuals who may utilize it or be influenced by it. However, a significant number of analysts have attributed particular weaknesses to this doctrine. This study relied on both primary and secondary sources of data collection. Significantly, the recommendation made in this paper, if completely adopted, shall go a long way in guaranteeing a better application of the principles of international humanitarian law.

Keywords: military necessity, international law, international humanitarian law, customary law

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

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Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

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Authors: Qazi Mahdia Ghyas

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Electronic Government Procurement (e-GP) has implemented in Bangladesh to ensure the good Governance. e-GP has transformed Bangladesh's procurement process electronically. But, to our best knowledge, there is no study to understand the key features of e-GP in Bangladesh. So, this study tries to identify the features of performance improvement after implementing an e-GP system that will help for further improvements. Data was collected from the PROMIS Overall Report (Central Procurement Technical Unit website) for the financial year from Q1 _July- Sep 2015-16 to Q4 _Apr- Jun 2021-22. This study did component factor analysis on KPIs and found nineteen KPIs that are statistically significant and represent time savings, efficiency, accountability, anti-corruption and compliance key features in procurement activities of e-GP. Based on the analysis, some practical measures have been recommended for better improvement of e-GP. This study has some limitations. Because of having multicollinearity issues, all the 42 KPIs (except 19) did not show a good fit for component factor analysis.

Keywords: public procurement, electronic government procurement, KPI, performance evaluation

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Risk management has been gaining extensive focus from international organizations like Committee of Sponsoring Organizations and Financial Stability Board, and, the foundation of such an effective and efficient risk management system lies in a strong risk governance structure. In view of this, an attempt (perhaps a first of its kind) has been made to develop a risk governance index, which could be used as proxy for quality of risk governance structures. The index (normative framework) is based on eleven variables, namely, size of board, board diversity in terms of gender, proportion of executive directors, executive/non-executive status of chairperson, proportion of independent directors, CEO duality, chief risk officer (CRO), risk management committee, mandatory committees, voluntary committees and existence/non-existence of whistle blower policy. These variables are scored on a scale of 1 to 5 with the exception of the variables, namely, status of chairperson and CEO duality (which have been scored on a dichotomous scale with the score of 3 or 5). In case there is a legal/statutory requirement in respect of above-mentioned variables and there is a non-compliance with such requirement a score of one has been envisaged. Though there is no legal requirement, for the larger part of study, in context of CRO, risk management committee and whistle blower policy, still a score of 1 has been assigned in the event of their non-existence. Recognizing the importance of these variables in context of risk governance structure and the fact that the study basically focuses on risk governance, the absence of these variables has been equated to non-compliance with a legal/statutory requirement. Therefore, based on this the minimum score is 15 and the maximum possible is 55. In addition, an attempt has been made to explore the determinants of this index. For this purpose, the sample consists of non-financial companies (429) that constitute S&P CNX500 index. The study covers a 10 years period from April 1, 2005 to March 31, 2015. Given the panel nature of data, Hausman test was applied, and it suggested that fixed effects regression would be appropriate. The results indicate that age and size of firms have significant positive impact on its risk governance structures. Further, post-recession period (2009-2015) has witnessed significant improvement in quality of governance structures. In contrast, profitability (positive relationship), leverage (negative relationship) and growth (negative relationship) do not have significant impact on quality of risk governance structures. The value of rho indicates that about 77.74% variation in risk governance structures is due to firm specific factors. Given the fact that each firm is unique in terms of its risk exposure, risk culture, risk appetite, and risk tolerance levels, it appears reasonable to assume that the specific conditions and circumstances that a company is beset with, could be the biggest determinants of its risk governance structures. Given the recommendations put forth in the paper (particularly for regulators and companies), the study is expected to be of immense utility in an important yet neglected aspect of risk management.

Keywords: corporate governance, ERM, risk governance, risk management

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Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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Authors: Asyraf Abdul Halim, Mohd Edil Abd Sukor, Obiyathulla Ismath Bacha

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This paper attempts to investigate the capital structure behavior of Shariah compliant firms of various levels as well those firms who are consistently Shariah non-compliant in Malaysia. The paper utilizes a unique dataset of firms of the heterogeneous level of Shariah-compliancy status over a 20 year period from the year 1997 to 2016. The paper focuses on the effects of dynamic forces behind capital structure variation such as the optimal capital structure behavior based on the trade-off, pecking order, market timing and firmly fixed effect models of capital structure. This study documents significant evidence in support of the trade-off theory with a high speed of adjustment (SOA) as well as for the time-invariant firm fixed effects across all Shariah compliance group.

Keywords: capital structure, market timing, trade-off theory, equity risk premium, Shariah-compliant firms

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Authors: Anat Achiron

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Background: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system in young adults. It involves the immune system attacking the protective covering of nerve fibers (myelin), leading to inflammation and damage. MS can result in various neurological symptoms, such as muscle weakness, coordination problems, and sensory disturbances. Seizures are not common in MS, and the frequency is estimated between 0.4 to 6.4% over the disease course. Objective: Investigate the frequency of seizures in individuals with multiple sclerosis and to identify associated risk factors. Methods: We evaluated the frequency of seizures in a large cohort of 5686 MS patients followed at the Sheba Multiple Sclerosis Center and studied associated risk factors and comorbidities. Our research was based on data collection using a cohort study design. We applied logistic regression analysis to assess the strength of associations. Results: We found that younger age at onset, longer disease duration, and prolonged time to immunomodulatory treatment initiation were associated with increased risk for seizures. Conclusions: Our findings suggest that seizures in people with MS are directly related to the demyelination process and not associated with other factors like medication side effects or comorbid conditions. Therefore, initiating immunomodulatory treatment early in the disease course could reduce not only disease activity but also decrease seizure risk.

Keywords: epilepsy, seizures, multiple sclerosis, white matter, age

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Authors: Shu-Hui Wen, Wei-Chuan Chang, Hsien-Chang Wu

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Background: Little is known about the benefits and risks of use of Chinese herbal medicine (CHM) in conditions related to hormone therapy (HT) use on the risk of ischemic stroke (IS). The aim of this study is to explore the risk of IS in menopausal women treated with HT and CHM. Materials and methods: A total of 32,441 menopausal women without surgical menopause aged 40- 65 years were selected from 2003 to 2010 using the 2-million random samples of the National Health Insurance Research Database in Taiwan. According to the medication usage of HT and CHM, we divided the current and recent users into two groups: an HT use-only group (n = 4,989) and an HT/CHM group (n = 9,265). Propensity-score matching samples (4,079 pairs) were further created to deal with confounding by indication. The adjusted hazard ratios (HR) of IS during HT or CHM treatment were estimated by the robust Cox proportional hazards model. Results: The incidence rate of IS in the HT/CHM group was significantly lower than in the HT group (4.5 vs. 12.8 per 1000 person-year, p < 0.001). Multivariate analysis results indicated that additional CHM use was significant with a lower risk of IS (HR = 0.3; 95% confidence interval, 0.21-0.43). Further subgroup analyses and sensitivity analyses had similar findings. Conclusion: We found that combined use of HT and CHM was associated with a lower risk for IS than HT use only. Further study is needed to examine possible mechanism underlying this association.

Keywords: Chinese herbal medicine, hormone therapy, ischemic stroke, menopause

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Authors: Eunhwa Jun

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This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.

Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer

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Authors: Zahra Abdolkarimi, Naser Zourikalatehsamad,

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Up to 40 years ago, after recognition of epilepsy, it was generally believed that these attacks occurred randomly and suddenly. However, thanks to the advance of mathematics and engineering, such attacks can be predicted within a few minutes or hours. In this way, various algorithms for long-term prediction of the time and frequency of the first attack are presented. In this paper, by considering the nonlinear nature of brain signals and dynamic recorded brain signals, ANFIS model is presented to predict the brain signals, since according to physiologic structure of the onset of attacks, more complex neural structures can better model the signal during attacks. Contribution of this work is the co-evolution algorithm for optimization of ANFIS network parameters. Our objective is to predict brain signals based on time series obtained from brain signals of the people suffering from epilepsy using ANFIS. Results reveal that compared to other methods, this method has less sensitivity to uncertainties such as presence of noise and interruption in recorded signals of the brain as well as more accuracy. Long-term prediction capacity of the model illustrates the usage of planted systems for warning medication and preventing brain signals.

Keywords: co-evolution algorithms, brain signals, time series, neural networks, ANFIS model, physiologic structure, time prediction, epilepsy suffering, illustrates model

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Authors: Mohammed A. A. Sarhan, Issam A. Al-Khatib

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Complying with the technical specifications of compost production is of high importance not only for environmental protection but also for increasing the productivity and promotion of compost use by farmers in agriculture. This study focuses on the compost quality of the Palestinian market and farmers’ attitudes toward agricultural use of compost. The quality is assessed through selection of 20 compost samples of different suppliers and producers and lab testing for quality parameters, while the farmers’ attitudes to compost use for agriculture are evaluated through survey questionnaire of 321 farmers in the Hebron area. The results showed that the compost in the Palestinian markets is of medium quality due to partial or non-compliance with the quality standards and guidelines. The Palestinian farmers showed a positive attitude since 91.2% of them have the desire to use compost in agriculture. The results also showed that knowledge of difference between compost and chemical fertilizers, perception of compost benefits and previously experiencing problems in compost use, are significant factors affecting the farmers’ attitude toward the use of compost as an organic fertilizer.

Keywords: attitude, compost, compost quality, organic fertilizer, manure

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Authors: Alireza Jafarzadeh, Bahram Amu-Oqhli Tabrizi, Hadi Khayat Nouri, Arash Khaki

Abstract:

30 head of adult Vistar rats were chosen to evaluate the chronic narcotic effects of crack on some biochemical parameters. The rats weighted approximately 200 to 250 g. They were divided into 5 groups of 6 and were housed in identical condition in terms of food and ambience. Rats were maintained at 12 hours light and 12 hours darkness. Rats were injected 7.8 mg/kg BW crack intraperitoneally. The groups one to four received daily medication for one to four weeks respectively. The control groups were injected identical dose of saline. The blood was taken from control and test groups then serum was separated from. Serum biochemical parameters of amylase, lipase, triglycerides, cholesterol, HDL, LDL, VLDL, protein and albumin were measured by diagnostic kits. Serum protein and albumin levels did not show statistically significant changes. Serum lipase and amylase showed significant changes both of which were increased. The serum levels of cholesterol, LDL and HDL demonstrated no significant changes. Triglycerides values showed a significant increase in serum. Serum VLDL in groups 3 and 4 exhibited significant changes compare to other groups.

Keywords: albumin, amylase, cholesterol, crack, HDL, LDL, lipase, protein, rat, triglycerides, VLDL

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Authors: Khodamorad Nabaki, Jianhu Shen, Xiaodong Huang

Abstract:

This paper develops a method for considering the critical fatigue stress as a constraint in the Bi-directional Evolutionary Structural Optimization (BESO) method. Our aim is to reach an optimal design in which high cycle fatigue failure does not occur for a specific life time. The critical fatigue stress is calculated based on modified Goodman criteria and used as a stress constraint in our topology optimization problem. Since fatigue generally does not occur for compressive stresses, we use the p-norm approach of the stress measurement that considers the highest tensile principal stress in each point as stress measure to calculate the sensitivity numbers. The BESO method has been extended to minimize volume an object subjected to the critical fatigue stress constraint. The optimization results are compared with the results from the compliance minimization problem which shows clearly the merits of our newly developed approach.

Keywords: topology optimization, BESO method, p-norm, fatigue constraint

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Authors: Paolo Castaldo, Bruno Palazzo, Laura Lodato

Abstract:

This study deals with the seizure effects of friction pendulum (FP) bearings on the seismic reliability of a 3D base-isolated nonlinear structural system, designed according to Italian seismic code (NTC08). The isolated system consists in a 3D reinforced concrete superstructure, a r.c. substructure and the FP devices, described by employing a velocity dependent model. The seismic input uncertainty is considered as a random variable relevant to the problem, by employing a set of natural seismic records selected in compliance with L’Aquila (Italy) seismic hazard as provided from NTC08. Several non-linear dynamic analyses considering the three components of each ground motion have been performed with the aim to evaluate the seismic reliability of the superstructure, substructure, and isolation level, also taking into account the seizure event of the isolation devices. Finally, a design solution aimed at increasing the seismic robustness of the base-isolated systems with FPS is analyzed.

Keywords: FP devices, seismic reliability, seismic robustness, seizure

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Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

Abstract:

Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

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Authors: Jeevan Balaji, Shreyas Chigurupati

Abstract:

Pneumatic gripper use compressed air to operate its actuators (fingers). Unlike the conventional metallic gripper, a soft pneumatic actuator (SPA) can be used for relocating fragile objects. An added advantage for this gripper is that the pressure exerted on the object can be varied by changing the dimensions of the air chambers and also by the number of chambers. SPAs have many benefits over conventional robots in the military, medical fields because of their compliance nature and are easily produced using the 3D printing process. In the paper, SPA is proposed to perform pick and place tasks. A design was developed for the actuators, which is convenient for gripping any fragile objects. Thermoplastic polyurethane (TPU) is used for 3D printing the actuators. The actuator model behaves differently as the parameters such as its chamber height, number of chambers change. A detailed FEM model of the actuator is drafted for different pressure inputs using ABAQUS CAE software, and a safe loading pressure range is found.

Keywords: soft robotics, pneumatic actuator, design and modelling, bending analysis

Procedia PDF Downloads 167