Search results for: delayed diagnosis and poor outcome

Authors: Akachi Odoemene

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Climate change and land grabbing are tightly interconnected in ways that are both diverse and complex. They have impacted each other in significant ways too. Both phenomena are not only a political reality, but have diverse dire implications, especially for food and livelihood security of vulnerable populations in developing economies. The critical nexus and interactions of climate change and land grabbing remain one of the challenges of sustainable development in modern times. The nuanced understanding of the nexus, importance and implications of climate change and land grabbing are the primary focus of this chapter. It begins with conceptual clarifications, particularly arguing that the absence of some important principles of engagement underline and define a land grab. It also analyses and notes a good number of contemporary land deals as 'one-sided', in which wealthy entities connive with local elites to exploit and disposes rural poor populations. The paper not only examines both global and local factors that drive land grabbing and, in some cases, their connections with the incidence of climate change, but also explores their crucial links with such sector as agriculture. It is argued and exhibited in the paper why certain societies are susceptible to the incidence of climate change and land grabbing, while the overall consequences of these phenomena on the affected societies are further interrogated. The paper concludes that the lack of political will by global political leaders to effectively combat and resolve critical issues associated with both climate change and land grabbing remains a daunting challenge. It notes that these phenomena – climate change and land grabbing – if not abated, will certainly become another set of global tragic episodes to be regretted in the future.

Keywords: climate change, land grabbing, global governance, developing economies

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Authors: Ada Yurman

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Social reactions to deviant groups with political goals follow two central patterns; one that associates personal characteristics with deviant behavior, and the other that claims that society is to be blamed for deviant behavior. The establishment usually tends towards the former notion and thus disclaims any responsibility for the distress of the underprivileged, while it is usually those who oppose government policies who believe that the fault lies with society. The purpose of the present research was to examine social reactions to the Wadi Salib riots that occurred in Haifa in 1959. These riots represented the first ethnic protest within Israeli society with its ideology of the ingathering of the exiles. The central question was whether this ideology contributed to the development of a different reaction when compared to reactions to similar events abroad. This question was examined by means of analyzing articles in the Israeli press of that period. The Israeli press representing the views of the establishment was at pains to point out that the rioters were criminals, their object being to obstruct the development of society. Opposition party leaders claimed that the rioters lived in poor circumstances, which constituted a direct result of government policies. An analysis of press reports on the Wadi Salib riots indicates a correspondence between the reaction to these events and similar events abroad. Nevertheless, the reaction to the Wadi Salib riots did not only express a conflict between different political camps, but also different symbolic universes. Each group exploited the events at Wadi Salib to prove that their ideology was the legitimate one.

Keywords: riots, media, political deviance, symbolic universe

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Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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Authors: Suhib A. Abu-Seini, Kyung-Doo Kim

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A heat loss model for ATLAS facility was introduced using SPACE code predefined correlations and various dialing factors. As all previous simulations were carried out using a heat loss free input; the facility was considered to be completely insulated and the core power was reduced by the experimentally measured values of heat loss to compensate to the account for the loss of heat, this study will consider heat loss throughout the simulation. The new heat loss model will be affecting SPACE code simulation as heat being leaked out of the system throughout a transient will alter many parameters corresponding to temperature and temperature difference. For that, a Station Blackout followed by a multiple Steam Generator Tube Rupture accident will be simulated using both the insulated system approach and the newly introduced heat loss input of the steady state. Major parameters such as system temperatures, pressure values, and flow rates to be put into comparison and various analysis will be suggested upon it as the experimental values will not be the reference to validate the expected outcome. This study will not only show the significance of heat loss consideration in the processes of prevention and mitigation of various incidents, design basis and beyond accidents as it will give a detailed behavior of ATLAS facility during both processes of steady state and major transient, but will also present a verification of how credible the data acquired of ATLAS are; since heat loss values for steady state were already mismatched between SPACE simulation results and ATLAS data acquiring system. Acknowledgement- This work was supported by the Korean institute of Energy Technology Evaluation and Planning (KETEP) and the Ministry of Trade, Industry & Energy (MOTIE) of the Republic of Korea.

Keywords: ATLAS, heat loss, simulation, SPACE, station blackout, steam generator tube rupture, verification

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Authors: Farshad Ghodoosi

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This article analyzes the effect of supervening events in contracts. Contracts serve an important function: allocation of risks. In spite of its importance, the case law and the doctrine are messy and inconsistent. This article provides a fresh look at excuse doctrines (i.e., force majeure, impracticability, impossibility, and frustration) with a focus on force majeure clauses. The article makes the following contributions: First, it furnishes a new conceptual and theoretical framework of excuse doctrines. By distilling the decisions, it shows that excuse doctrines rests on the triangle of control, foreseeability, and contract language. Second, it analyzes force majeure clauses used by S&P 500 companies to understand the stickiness and similarity of such clauses and the events they cover. Third, using computational and statistical tools, it analyzes US cases since 1810 in order to assess the weight given to the triangle of control, foreseeability, and contract language. It shows that the control factor plays an important role in force majeure analysis, while the contractual interpretation is the least important factor. The Article concludes that it is the standard for control -whether the supervening event is beyond the control of the party- that determines the outcome of cases in the force majeure context and not necessarily the contractual language. This article has important implications on COVID-19-related contractual cases. Unlike the prevailing narrative that it is the language of the force majeure clause that’s determinative, this article shows that the primarily focus of the inquiry will be on whether the effects of COVID-19 have been beyond the control of the promisee. Normatively, the Article suggests that the trifactor of control, foreseeability, and contractual language are not effective for allocation of legal risks in times of crises. It puts forward a novel approach to force majeure clauses whereby that the courts should instead focus on the degree to which parties have relied on (expected) performance, in particular during the time of crisis.

Keywords: contractual risks, force majeure clauses, foreseeability, control, contractual language, computational analysis

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Vyacheslav Furtak, Merja Roivainen, Olga Mirochnichenko, Majid Laassri, Bella Bidzhieva, Tatiana Zagorodnyaya, Vladimir Chizhikov, Konstantin Chumakov

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Molecular epidemiology and environmental surveillance are parts of a rational strategy to control infectious diseases. They have been widely used in the worldwide campaign to eradicate poliomyelitis, which otherwise would be complicated by the inability to rapidly respond to outbreaks and determine sources of the infection. The conventional scheme involves isolation of viruses from patients and the environment, followed by their identification by nucleotide sequences analysis to determine phylogenetic relationships. This is a tedious and time-consuming process that yields definitive results when it may be too late to implement countermeasures. Because of the difficulty of high-throughput full-genome sequencing, most such studies are conducted by sequencing only capsid genes or their parts. Therefore the important information about the contribution of other parts of the genome and inter- and intra-species recombination to viral evolution is not captured. Here we propose a new approach based on the rapid concentration of sewage samples with tangential flow filtration followed by deep sequencing and reconstruction of nucleotide sequences of viruses present in the samples. The entire nucleic acids content of each sample is sequenced, thus preserving in digital format the complete spectrum of viruses. A set of rapid algorithms was developed to separate deep sequence reads into discrete populations corresponding to each virus and assemble them into full-length consensus contigs, as well as to generate a complete profile of sequence heterogeneities in each of them. This provides an effective approach to study molecular epidemiology and evolution of natural viral populations.

Keywords: poliovirus, eradication, environmental surveillance, laboratory diagnosis

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Authors: Tobias Schramm, Günther Prokop

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Degraded vehicle shock absorbers represent a risk for road safety. The exact effect of degraded vehicle dampers on road safety is still the subject of research. This work is intended to contribute to estimating the effect of degraded twin-tube dampers of passenger cars on road safety. An axle model was built using a damper model to simulate different degradation levels. To parameterize the model, a realistic parameter space was estimated based on test rig measurements and database analyses, which is intended to represent the vehicle field in Germany. Within the parameter space, simulations of the axle model were carried out, which calculated the transmittable lateral forces of the various axle configurations as a function of vehicle speed, road surface, damper conditions and axle parameters. A degraded damper has the greatest effect on the transmittable lateral forces at high speeds and in poor road conditions. If a vehicle is traveling at a speed of 100 kph on a Class D road, a degraded damper reduces the transmissible lateral forces of an axle by 20 % on average. For individual parameter configurations, this value can rise to 50 %. The axle parameters that most influence the effect of a degraded damper are the vertical stiffness of the tire, the unsprung mass and the stabilizer stiffness of the axle.

Keywords: vehicle dynamics, vehicle simulation, vehicle component degradation, shock absorber model, shock absorber degradation

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Nazila Esmaeili, Ahmad Alipour, Amin Asadi Hieh

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Headache disorders are one of the most common disorders of the nervous system and are associated with suffering, disability, and financial costs for patients. Mindfulness as a lifestyle, in line with human nature, has the ability to affect the emotional system, i.e. thoughts, body sensations, raw emotions and action impulses of people. The aim of this study was to test the fit of structural model of mindfulness and severity of headache mediated by resilience and perfectionism in patients with migraine. Methods: The statistical population of this study included all patients with migraine referred to neurologists in Tehran in the spring and summer of 1401. The inclusion criteria were diagnosis of migraine by a neurologist, not having mental disorders or other physical diseases, and having at least a diploma. According to the number of research variables, 180 people were selected by convenience sampling method, which online answered the Ahvaz perfectionism questionnaire (AMQ), Connor and Davidson resilience questionnaire (CD-RISC), Ahvaz migraine headache questionnaire (APS) and 5-factor mindfulness questionnaire ((MAAS). Data were analyzed using structural equation modeling and Amos software. Results: The results showed that the direct pathways of mindfulness were not significant for severe headache (P <0.05), but other direct pathways - mindfulness to resilience, mindfulness to perfectionism, resilience to severe headache and perfectionism to severe headache), Was significant (P <0.01). After modifying and removing the non-significant paths, the final model fitted. Mediating variables Resilience and perfectionism mediated all paths of predictor variables to the criterion. Conclusion: According to the findings of the present study, mindfulness in migraine patients reduces the severity of headache by promoting resilience and reducing perfectionism.

Keywords: migraine, headache severity, mindfulness, resilience, perfectionism

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Authors: Supreet Singh, Manpreet Kaur, Manoj Kumar

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High temperature corrosion is an imperative material degradation method experienced in thermal power plants and other energy generation sectors. Metallic materials such as ferritic steels have special properties such as easy fabrication and machinibilty, low cost, but a serious drawback of these materials is the worsening in properties initiating from the interaction with the environments. The metallic materials do not endure higher temperatures for extensive period of time because of their poor corrosion resistance. Friction Stir Processing (FSP), has emerged as the potent surface modification means and control of microstructure in thermo mechanically heat affecting zones of various metal alloys. In the current research work, FSP was done on the boiler tube of SA 210 Grade A1 material which is regularly used by thermal power plants. The strengthening of SA210 Grade A1 boiler steel through microstructural refinement by Friction Stir Processing (FSP) and analyze the effect of the same on high temperature corrosion behavior. The high temperature corrosion performance of the unprocessed and the FSPed specimens were evaluated in the laboratory using molten salt environment of Na₂SO₄-82%Fe₂(SO₄). The unprocessed and FSPed low carbon steel Gr A1 evaluation was done in terms of microstructure, corrosion resistance, mechanical properties like hardness- tensile. The in-depth characterization was done by EBSD, SEM/EDS and X-ray mapping analyses with an aim to propose the mechanism behind high temperature corrosion behavior of the FSPed steel.

Keywords: boiler steel, characterization, corrosion, EBSD/SEM/EDS/XRD, friction stir processing

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Authors: Vibha Sinha, Sumedha Chakma

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Arsenic (As) contamination in drinking water is a serious concern worldwide resulting in severe health maladies. To tackle this problem, several hydrogel based matrix which selectively uptake toxic metals from contaminated water has increasingly been examined as a potential practical method for metal removal. The major concern in hydrogels is low stability of matrix, resulting in poor performance. In this study, the potential of hybrid hydrogel-biochar matrix synthesized from natural plant polymers, specific for As removal was explored. Various compositional and functional group changes of the elements contained in the matrix due to the adsorption of As were identified. Moreover, to resolve the stability issue in hydrogel matrix, optimum and effective mixing of hydrogel with biochar was studied. Mixing varied proportions of matrix components at the time of digestion process was tested. Preliminary results suggest that partial premixing methods may increase the stability and reduce cost. Addition of nanoparticles and specific catalysts with different concentrations of As(III) and As(V) under batch conditions was performed to study their role in performance enhancement of the hydrogel matrix. Further, effect of process parameters, optimal uptake conditions and detailed mechanism derived from experimental studies were suitably conducted. This study provides an efficient, specific and a low-cost As removal method that offers excellent regeneration abilities which can be reused for value.

Keywords: arsenic, catalysts, hybrid hydrogel-biochar, water purification

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Authors: Q. Toufeeq, R. Kauser, U. R. Jamil, N. Sohaib

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Foundation design of a structure needs soil investigation to avoid failures due to settlements. This soil investigation is expensive and time-consuming. Developments of new residential societies involve huge leveling of large sites that is accompanied by heavy land filling. Poor practices of land fill for deep depths cause differential settlements and consolidations of underneath soil that sometimes result in the collapse of structures. The extent of filling remains unknown to the individual developer unless soil investigation is carried out. Soil investigation cannot be performed on each available site due to involved costs. However, fair estimate of bearing capacity can be made if such tests are already done in the surrounding areas. The geotechnical guidance maps can provide a fair assessment of soil properties. Previously, GIS-based approaches have been used to develop maps using extrapolation and interpolations techniques for bearing capacities, underground recharge, soil classification, geological hazards, landslide hazards, socio-economic, and soil liquefaction mapping. Standard penetration test (SPT) data of surrounding sites were already available. Google Earth is used for digitization of collected data. Few points were considered for data calibration and validation. Resultant Geographic information system (GIS)-based guidance maps are helpful to anticipate the bearing capacity in the real estate industry.

Keywords: bearing capacity, soil classification, geographical information system, inverse distance weighted, radial basis function

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Authors: Muhammad Shahbaz Akhtar

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Background; Tuberculosis remains a significant public health challenge in Pakistan, with high incidence and prevalence rates, particularly among vulnerable populations. Addressing the TB burden requires comprehensive efforts to improve healthcare infrastructure, increase access to quality diagnosis and treatment services, raise public awareness, and address socioeconomic determinants of health. Objective; To assess the knowledge and practices of healthcare workers and patients regarding prevention of tuberculosis at a tertiary care hospital of Southern Punjab.Material and methods; Data will be collected from 135 healthcare workers and 135 TB patients visiting Nishtar Hospital, Multan in this descriptive cross – sectional study using non – probability consecutive sampling technique. Proper approval will be taken from Hospital authorities to conduct this study. Study participants will be recruited after taking informed written consent, describing them objectives of this study. The study participants will be ensured of their confidentiality of the data and interviewed to assess their knowledge and practices regarding prevention of tuberculosis. Data Analysis Procedure; Data will be entered and analyzed by using SPSS version 25 to calculated mean and standard deviation for the numerical data such as age, duration of disease and duration of experience. Frequencies and percentages will be calculated for gender, age groups, level of knowledge, qualification, designation and practices. Impact of confounders like gender, age groups, duration of experience, disease duration, years of experience and designation will be assessed by stratification. Post stratification chi – square test will be applied at 0.05 level of significance at 95 % CI.

Keywords: tuberculosis, data analysis, HIV/AIDS, preventable

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Authors: Mohand Yaghi, O. Kehinde

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Background: For the diagnosis of prostate cancer Trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. Aim: To systematically review different regimens of prophylactic oral antibiotics in TRPB. Design: Medline, Embase, Clinical trials site, and Cochrane library were searched, experts were consulted about relevant studies. Randomized clinical trials (RCT) conducted in the last twenty years, which investigated different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Measurements: Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, sepsis. Secondary outcomes were hospitalization rate, and the prevalence of ABx-resistant bacteria. Results: Nine trials were eligible with 3012 patients. Antibiotics prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple dose except in Bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other antibiotics. Lastly, Ciprofloxacin is the best Quinolone to prevent UTI, and hospitalization. Conclusion: it is essential to prescribe prophylactic Antibiotics in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria was identified more often in the single dose cohorts.

Keywords: infection, prostate cancer, sepsis, TRPB

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Authors: Maysoon Khalil Askar

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The delineation of possible areas of corrosion along the external face of an underground oil pipeline in Trunk line of Al- Garraf oil field was investigated using the horizontal electrical resistivity profiling technique and study the contribution of pH, Moisture Content in Soil and Presence chlorides, sulfates and total dissolve salts in soil and water. The test sites represent a physical and chemical properties of soils. The hydrogen-ion concentration of soil and groundwater range from 7.2 to 9.6, and the resistivity values of the soil along the pipeline were obtained using the YH302B model resistivity meter having values between 1588 and 720 Ohm-cm. the chloride concentration in soil and groundwater is high (more than 1000 ppm), total soulable salt is more than 5000 ppm, and sulphate range from 0.17% and 0.98% in soil and more than 600 ppm in groundwater. The soil is poor aeration, the soil texture is fine (clay and silt soil), the water content is high (the groundwater is close to surface), the chloride and sulphate is high in the soil and groundwater, the total soulable salt is high in ground water and finally the soil electric resistivity is low that the soil is very corrosive and there is the possibility of the pipeline failure. These methods applied in the study are quick, economic and efficient for detecting along buried pipelines which need to be protected. Routine electrical geophysical investigations along buried oil pipelines should be undertaken for the early detection and prevention of pipeline failure with its attendant environmental, human and economic consequences.

Keywords: soil resistivity, corrosion, cathodic protection, chloride concentration, water content

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Authors: Marco Antonio Lara De la Calleja, María Catalina Ovando Chico, Eduardo Lopez Ruiz

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Community empowerment has been proved to be a key element in the solution of the food security problem. As a result of a conceptual analysis, it was found that agricultural production, economic development and governance, are the traditional basis of food security models. Although the literature points to social inclusion as an important factor for food security, no model has considered it as the basis of it. The aim of this research is to identify different dimensions that make an integral model for food security, with emphasis on community empowerment. A diagnosis was made in the study community (Tatoxcac, Zacapoaxtla, Puebla), to know the aspects that impact the level of food insecurity. With a statistical sample integrated by 200 families, the Latin American and Caribbean Food Security Scale (ELCSA) was applied, finding that: in households composed by adults and children, have moderated food insecurity, (ELCSA scale has three levels, low, moderated and high); that result is produced mainly by the economic income capacity and the diversity of the diet on its food. With that being said, a model was developed to promote food security through five dimensions: 1. Regional context of the community; 2. Structure and system of local food; 3. Health and nutrition; 4. Information and technology access; and 5. Self-awareness and empowerment. The specific actions on each axis of the model, allowed a systemic approach needed to attend food security in the community, through the empowerment of society. It is concluded that the self-awareness of local communities is an area of extreme importance, which must be taken into account for participatory schemes to improve food security. In the long term, the model requires the integrated participation of different actors, such as government, companies and universities, to solve something such vital as food security.

Keywords: community empowerment, food security, model, systemic approach

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Authors: Bal Deep Sharma, Suresh Ray Yadav

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Local soils are often chosen due to their widespread availability and low cost. However, these soils typically have poor durability, which can lead to significant limitations in their use for construction. To address this issue, various soil stabilization techniques have been developed and used over the years. This study investigates the viability of employing the mineral polymerization (MIP) technique to stabilize black soils, intending to enhance their suitability for construction applications. This technique involves the microstructural transformation of certain clay minerals into solid and stable compounds exhibiting characteristics similar to hydroxy sodalite, feldspathoid, or zeolite. This transformation occurs through the action of an alkaline reactant at atmospheric pressure and low temperature. The soil sample was characterized using grain size distribution, Atterberg limit test, organic content test, and pH-value tests. The unconfined compressive strength of the soil specimens, prepared with varying percentages of sodium hydroxide as an additive and sand as a filler by weight, was determined at the optimum moisture content. The unconfined compressive strength of the specimens was tested under three different conditions: dry, wet, and cycling. The maximum unconfined compressive strengths were 77.568 kg/cm², 38.85 kg/cm², and 56.3 kg/cm² for the dry, wet, and cycling specimens, respectively, while the unconfined compressive strength of the untreated soil was 7.38 kg/cm². The minimum unconfined compressive strength of the wet and cycling specimens was greater than that of the untreated soil. Based on these findings, it can be concluded that these soils can be effectively used as construction material after treatment with sodium hydroxide.

Keywords: soil stabilization technique, soft soil treatment, sodium hydroxide, unconfined compressive strength

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Authors: Isabel Medina, Mario Duran

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Although Problem-based learning provides students with multiple opportunities for rigorous instructional experiences in which students are challenged to address problems in the community; there are still gaps in connecting community leaders to the PBL process. At a south Texas high school, community participation serves as an integral component of the PBL process. Problem-based learning (PBL) has recently gained momentum due to the increase in global communities that value collaboration and critical thinking. As an instructional approach, PBL engages high school students in meaningful learning experiences. Furthermore, PBL focuses on providing students with a connection to real-world situations that require effective peer collaboration. For PBL leaders, providing students with a meaningful process is as important as the final PBL outcome. To achieve this goal, STEM high school strategically created a space for community involvement to be woven within the PBL fabric. This study examines the impact community members had on PBL students attending a STEM high school in South Texas. At STEM High School, community members represent a support system that works through the PBL process to ensure students receive real-life mentoring from business and industry leaders situated in the community. A phenomenological study using a semi-structured approach was used to collect data about students’ perception of community involvement within the PBL process for one South Texas high school. In our proposed presentation, we will discuss how community involvement in the PBL process academically impacted the educational experience of high school students at STEM high school. We address the instructional concerns PBL critics have with the lack of direct instruction, by providing a representation of how STEM high school utilizes community members to assist in impacting the academic experience of students.

Keywords: phenomenological, STEM education, student engagement, community involvement

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Authors: W. Kongnoo, J. Loysongkroa, S. Chotivichien, N. Viriyautsahakul, N. Saiwongse

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Obesity, stunting and wasting problems among Thai school-aged children are increasing due to inappropriate food consumption behavior and poor environments for desirable nutritional behavior. Because of a low school lunch budget of only 0.40 USD per person per day, food quality is not up to nutritional standards. Therefore, the Health Department with the Education Ministry and the Thai Health Promotion Foundation have developed a quality school lunch project during 2009–2013. The program objectives were development and management of public policy to increase school lunch budget. The methods used a healthy public policy motivation process and movement in 241 local administrative organizations and 538 schools. The problem and solution research was organized to study school food and nutrition management, create a best practice policy mobilization model and hold a public hearing to motivate an increase of school meal funding. The results showed that local public policy has been motivated during 2009-2011 to increase school meal budget using local budgets. School children with best food consumption behavior and exercise increased from 13.2% in 2009 to 51.6% in 2013 and stunting decreased from 6.0% in 2009 to 4.7% in 2013. As the result of national policy motivation (2012-2013), the cabinet meeting on October 22, 2013 has approved an increase of school lunch budget from 0.40 USD to 0.62 USD per person per day. Thus, 5,800,469 school children nationwide have benefited from the budget increase.

Keywords: public policy, quality school lunch, Thailand, obesity

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Authors: Nitesh Kumar, Eoin Twohig, jasparl cheema, Sadiq mawji, Yousif al najjar

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Basal cell carcinoma (BCC) is the commonest cutaneous malignancy affecting humans. Despite this, distant spread is exceptionally rare. Metastatic BCC (mBCC) is estimated to occur in 0.0028 - 0.5%. it aim to illustrate with the aid of histological slides, a case of mBCC occurring in a fit and well 67-year-old. Initial diagnosis of desmoplastic BCC was made in 2006 from a scalp biopsy with the lesion then being excised. Re-excision of local recurrence was undertaken the following year. In 2014 the patient presented with an ipsilateral level 2a mass. Fine Needle Aspiration raised the suspicion of metastatic carcinoma. The patient had excision of two nodes from the left neck alongside pharyngeal tonsillectomy and tongue base biopsies. Histologically, the nodes closely resembled the immunophenotype of the initial scalp lesion. The patient subsequently had a modified radical neck dissection, and residual mBCC was excised from the left Sternocleidomastoid muscle. In 2023 the patient developed haematuria. On further investigation bilateral lung lesions on CT were noted with subsequent biopsy confirming mBCC. Spinal and renal lesions have also been found. Histopathology showed clear resemblance of the lung metastases to both those in the neck and the primary (scalp BCC) – with no squamous differentiation seen. The time span from primary to occurrence of lung metastasis (18 years) affirms the indolent and slow growing nature of BCC.  This case fulfils Lattes and Kessler diagnostic criteria. High risk cases are described as those with advanced local presentation, primary tumour on the Head and Neck and locally recurrent lesions.

Keywords: BCC, metastasis, rare, skin cancer

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Authors: Mammar Khames, Mustapha Oumouna

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Brucellosis is one of the most common zoonoses in the world. It represents a serious threat to human health; the existence of brucellosis in Algeria dates back to the beginning of the 19th century. Its transmission to humans is through coccobacilli of the genus Brucella following direct contact with contaminated animals or indirectly through the consumption of their unpasteurized dairy products. The present investigation covers a retrospective study on human brucellosis in the district of Medea over a period from 2011 to 2021 at the level of two public health establishments. In the first place, it is at the level of the Directorate of Public Health and in the infectious department level at Medea Hospital, and at the level of the directorate of agricultural services in the third place. The results showed that during these eleven years of study, 795 cases were collected from the department of health and population, and 141 cases were collected from the infectious department of the district of Medea. A total of 56 cases of bovine brucellosis were obtained from the directorate of agricultural services of the district of Medea. Human brucellosis affects all age groups with different percentages, but the rate has been higher in the 20-44 age group, with a predominance of men. However, the geographic distribution map of the cases shows that the western part of the district was the most affected. A cohort of 141 cases was hospitalized at the infectious service level of Medea Hospital. They were 89 men and 52 women. The most common age reached is [20-44] years. The majority were of rural origin. Two serological reactions were performed for diagnosis: the buffered antigen test and Wright's serodiagnosis. Bovine brucellosis affects all age groups with different percentages, but the rate was higher in the 2-to-4-year age group, with a predominance of females. From these data, we conclude that brucellosis has a strong spread in the region studied.

Keywords: human brucellosis, serology, Medea, Algeria

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Authors: Jesmin Akter, Chang Hyuk Ahn, Ilho Kim, Jaiyeop Lee

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Global pandemic coronavirus disease (COVID-19) caused by Severe acute respiratory syndrome SARS-CoV-2, to control the spread of the COVID-19 pandemic, wastewater surveillance has been used to monitor SARS-CoV2 prevalence in the community. The challenging part is establishing wastewater surveillance; there is a need for a well-equipped laboratory for wastewater sample analysis. According to many previous studies, reverse transcription-polymerase chain reaction (RT-PCR) based molecular tests are the most widely used and popular detection method worldwide. However, the RT-qPCR based approaches for the detection or quantification of SARS-CoV-2 genetic fragments ribonucleic acid (RNA) from wastewater require a specialized laboratory, skilled personnel, expensive instruments, and a workflow that typically requires 6 to 8 hours to provide results for just minimum samples. Rapid and reliable alternative detection methods are needed to enable less-well-qualified practitioners to set up and provide sensitive detection of SARS-CoV-2 within wastewater at less-specialized regional laboratories. Therefore, scientists and researchers are conducting experiments for rapid detection methods of COVID-19; in some cases, the structural and molecular characteristics of SARS-CoV-2 are unknown, and various strategies for the correct diagnosis of COVID-19 have been proposed by research laboratories, which are presented in the present study. The ongoing research and development of these highly sensitive and rapid technologies, namely RT-LAMP, ELISA, Biosensors, GeneXpert, allows a wide range of potential options not only for SARS-CoV-2 detection but also for other viruses as well. The effort of this study is to discuss the above effective and regional rapid detection and quantification methods in community wastewater as an essential step in advancing scientific goals.

Keywords: rapid detection, SARS-CoV-2, sensitive detection, wastewater surveillance

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Authors: C. van den Berg, C. Pokpas

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Popular discourse touts entrepreneurship as a universal solution for underdevelopment, unemployment, and poverty. Moreover, claims are made that women and other disadvantaged groups can achieve material and personal success through digital entrepreneurship. This paper examines the potential of digital technology in entrepreneurial ventures to stimulate economic growth for marginalized groups and communities. Although digital entrepreneurship is hailed as a means to empower under-resourced and socially marginalized people, these opportunities still exist within the confines of existing social and cultural practices. The perspectives of female digital entrepreneurs in developing countries are sorely understudied, particularly concerning an understanding of the complex underlying socio-cultural factors impeding women’s entrepreneurial behaviors. This qualitative study, guided by a feminist phenomenological perspective, focused on the experiences of digital female entrepreneurs in the Western Cape of South Africa. Data were collected via semi-structured interviews and analyzed through the interpretative phenomenological analysis (IPA) approach to determine the relationships between digital entrepreneurship and structural and agential enabling conditions. Findings show that digital entrepreneurship is not a panacea for economic growth in marginalized groups and communities and highlight the importance of addressing socio-cultural gender inequality to enable successful entrepreneurial activity. The paper concludes with recommendations for specialized training initiatives aimed at female entrepreneurs that address internalized constraints and barriers that keep women subservient and measures to shift gender and power beliefs. The outcome will benefit the stimulation of gender-specific public policies to develop a successful digital start-up ecosystem further.

Keywords: digital innovation, female digital entrepreneurs, feminist phenomenology, gender, marginalised communities

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Authors: Krenare Shabani, Kreshnike Dedushi Hoti, Serbeze Kabashi, Jeton Shatri, Arben Rroji, Mrikë Bunjaku, Leotrim Berisha, Jona Kosova, Edmond Puca, Bleriana Shabani

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Introduction: Workers in Kosovo's mining industry are subjected to hazardous working conditions and airborne particles, such as silica dust, which can cause silicosis and other severe respiratory illnesses. The purpose of this research is to assess the health impacts of such exposures, as well as the importance of imaging and functional testing in detecting pathological changes early on. Methodology: The study is prospective and cross-sectional and was carried out during the year 2024. 626 people (446 miners and 180 non-miners) were enrolled in the study. Subjects underwent spirometry and chest radiography. Data were analysed with SPSS24. Results: The average age of the participants is 48 years. Demographics and Smoking: Smoking was common among young miners. Radiological Changes: Radiographic abnormalities in the lungs were seen in 23.1% of miners and 10.6% of non-miners, including small irregular opacities and emphysematous changes. Lung Function: The FEV1/FVC ratio decreased with increased exposure time, indicating a decline in pulmonary function.Impact of Exposure Duration: Longer exposure duration was associated with a higher number of miners experiencing coughs and requiring medical consultations such as CT scans and biopsies. Conclusions: Medical imaging and functional testing are critical for early diagnosis of lung abnormalities in miners.Findings demonstrate a strong correlation between extended exposure to mine dust and the development of respiratory disorders, emphasising the importance of preventative measures and routine health monitoring.

Keywords: silicosis, miners, imaging, spirometry

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Authors: Thavasimuthu Citarasu, Mariavincent Michaelbabu, Vikram Vakharia

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The rhizome of Java grass, Cyperus rotundus was extracted different organic polar and non-polar solvents and performed the in vitro antiviral and immunostimulant activities against White Spot Syndrome Virus (WSSV) and Vibrio harveyi respectively. Based on the initial screening the ethyl acetate extract of C. rotundus was strong activities and further it was purified through silica column chromatography and the fractions were screened again for antiviral and immunostimulant activity. Among the different fractions screened against the WSSV and V. harveyi, the fractions, F-III to FV had strong activities. In order to study the in vivo influence of C. rotundus, the fractions (F-III to FV) were pooled and delivered to the F. indicus through artificial feed for 30 days. After the feeding trail the experimental and control diet fed F. indicus were challenged with virulent WSSV and studied the survival, molecular diagnosis, biochemical, haematological and immunological parameters. Surprisingly, the pooled fractions (F-III to FV) incorporated diets helped to significantly (P < 0.01) suppressed viral multiplication, showed significant (P < 0.01) differences in protein and glucose levels, improved total haemocyte count (THC), coagulase activity, significantly increased (P < =0.001) prophenol oxidase and intracellular superoxide anion production compared to the control shrimps. Based on the results, C. rotundus extracts effectively suppressed WSSV multiplication and improve the immune system in F. indicus against WSSV infection and this knowledge will helps to develop novel drugs from C. rotundus against WSSV.

Keywords: antiviral drugs, cyperus rotundus, fenneropenaeus indicus, WSSV

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Authors: Gabriel Sepulveda Navarro

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Traditional interventions for young offenders are necessary but not sufficient to tackle the multiple causes of juvenile crime. For instance, interventions offered to young offenders often are verbally mediated and dialogue based, requiring important metacognitive abilities as well as abstract thinking, assuming average performance in a wide variety of skills. It seems necessary to assess a broader set of abilities and functions in order to increase the efficiency of interventions while addressing offending. In order to clarify these assumptions, Stroop Test, as well as Rey-Osterrieth Complex Figure Test were applied to juvenile offenders tried and sentenced for violent crimes in Santiago de Chile. A random sample was drawn from La Cisterna Half-Open Program, consisting of 50 young males between 18 and 24 years old, residing in different districts of Santiago de Chile. The analysis of results suggests a disproportionately elevated incidence of impairments in executive functions and visuospatial skills. As an outcome, over 40% of the sample shows a significant low performance in both assessments, exceeding four times the same prevalence rates among young people in the general population. While executive functions entail working memory (being able to keep information and use it in some way), cognitive flexibility (to think about something in more than one way) and inhibitory control (being able to self-control, ignore distractions and delay immediate gratification), visuospatial skills permit to orientate and organize a planned conduct. All of these abilities are fundamental to the skill of avoiding violent behaviour and abiding by social rules. Understanding the relevance of neurodevelopmental impairments in the onset of violent and criminal behaviour, as well as recidivism, eventually may guide the deployment of a more comprehensive assessment and treatment for juvenile offenders.

Keywords: executive functions, half-open program, juvenile offenders, neurodisabilities, visuospatial skills

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Authors: Pornthip Seangsanga

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Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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Authors: Pechpailin Kortnoi, Tanitnun Paprad

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Background: Myasthenia gravis (MG) is an autoimmune disorder characterized by impaired neuromuscular transmission due to antibodies against nicotinic receptors, leading to muscle weakness, ptosis, and respiratory issues. The incidence of MG has risen globally, emphasizing the need for effective diagnostics. Objective: This study evaluates the validity of a combined bedside test (the ice pack test and fatigability test) for diagnosing juvenile myasthenia gravis (JMG) in pediatric patients with ptosis. Methods: This cross-sectional study, conducted from January 2012 to May 2024 at King Chulalongkorn Memorial Hospital, Thailand, included pediatric patients (1 month to 18 years) with ptosis undergoing ice pack and fatigability tests. Data included demographics, clinical findings, and test results. Diagnostic efficacy was assessed using sensitivity, specificity, accuracy, PPV, NPV, Fagan Nomogram, Kappa Statistics, and McNemar’s Chi-Square. Results: Of 43 identified patients, 32 were included, with 47% male and a mean age of 7 years. The combined bedside test had high sensitivity (92.8%) and accuracy (87.5%) but moderate specificity (50%). It significantly outperformed the ice pack test (P = 0.0005), which showed low sensitivity (42.8%) and accuracy (43.8%). The fatigability test had 82% sensitivity and 92% PPV. Confirmatory tests (AChR-Ab, MuSK-Ab, neostigmine, repetitive nerve stimulation) supported most diagnoses. Conclusions: The combined bedside test, with high sensitivity (92.8%) and accuracy (87.5%), is an effective screening tool for juvenile myasthenia gravis, outperforming the ice pack test. Integrating it into clinical practice may improve diagnosis and enable timely treatment. The fatigability test (82% sensitivity) is also useful as an adjunct screening tool.

Keywords: myasthenia gravis, the fatigability test, the ice pack test, the combined bedside test

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Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

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Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

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Authors: Hiroshi Kinoshita, Yasuto Nakanishi, Ryuhei Okuno, Toshio Higashi

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Various kinds of pegboards have been developed and used widely in research and clinics of rehabilitation for evaluation and training of patient’s hand function. A common measure in these peg boards is a total time of performance execution assessed by a tester’s stopwatch. Introduction of electrical and automatic measurement technology to the apparatus, on the other hand, has been delayed. The present work introduces the development of a pegboard with an electric sensor to detect moments of individual peg’s insertion and removal. The work also gives fundamental data obtained from a group of healthy young individuals who performed peg transfer tasks using the pegboard developed. Through trails and errors in pilot tests, two 10-hole peg-board boxes installed with a small photo-reflector and a DC amplifier at the bottom of each hole were designed and built by the present authors. The amplified electric analogue signals from the 20 reflectors were automatically digitized at 500 Hz per channel, and stored in a PC. The boxes were set on a test table at different distances (25, 50, 75, and 125 mm) in parallel to examine the effect of hole-to-hole distance. Fifty healthy young volunteers (25 in each gender) as subjects of the study performed successive fast 80 time peg transfers at each distance using their dominant and non-dominant hands. The data gathered showed a clear-cut light interruption/continuation moment by the pegs, allowing accurately (no tester’s error involved) and precisely (an order of milliseconds) to determine the pull out and insertion times of each peg. This further permitted computation of individual peg movement duration (PMD: from peg-lift-off to insertion) apart from hand reaching duration (HRD: from peg insertion to lift-off). An accidental drop of a peg led to an exceptionally long ( < mean + 3 SD) PMD, which was readily detected from an examination of data distribution. The PMD data were commonly right-skewed, suggesting that the median can be a better estimate of individual PMD than the mean. Repeated measures ANOVA using the median values revealed significant hole-to-hole distance, and hand dominance effects, suggesting that these need to be fixed in the accurate evaluation of PMD. The gender effect was non-significant. Performance consistency was also evaluated by the use of quartile variation coefficient values, which revealed no gender, hole-to-hole, and hand dominance effects. The measurement reliability was further examined using interclass correlation obtained from 14 subjects who performed the 25 and 125 mm hole distance tasks at two 7-10 days separate test sessions. Inter-class correlation values between the two tests showed fair reliability for PMD (0.65-0.75), and for HRD (0.77-0.94). We concluded that a sensor peg board developed in the present study could provide accurate (excluding tester’s errors), and precise (at a millisecond rate) time information of peg movement separated from that used for hand movement. It could also easily detect and automatically exclude erroneous execution data from his/her standard data. These would lead to a better evaluation of hand dexterity function compared to the widely used conventional used peg boards.

Keywords: hand, dexterity test, peg movement time, performance consistency

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