Search results for: group decision

Authors: O. O. Onafowokan, K. Anderson, M. R. Norton, R. G. Middleton

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Revision total hip arthroplasty (THA) is known to be a challenging procedure with potential for poor outcomes. Due to its lack of metaphyseal encroachment, hip resurfacing arthroplasty (HRA) is classified as a bone conserving procedure. Although the literature postulates that this is an advantage at time of revision surgery, there is no evidence to either support or refute this claim. We identified 129 hips that had undergone HRA and 129 controls undergoing first revision THA. We recorded the clinical assessment and survivorship of implants in a multi-surgeon, single centre, retrospective case control series for both arms. These were matched for age and sex. Data collected included demographics, indications for surgery, Oxford Hip Score (OHS), length of surgery, length of hospital stay, blood transfusion, implant complexity and further surgical procedures. Significance was taken as p < 0.05. Mean follow up was 7.5 years (1 to 15). There was a significant 6 point difference in postoperative OHS in favour of the revision resurfacing group (p=0.0001). The revision HRA group recorded 48 minutes less length of surgery (p<0.0001), 2 days less in length of hospital stay (p=0.018), a reduced need for blood transfusion (p=0.0001), a need for less complexity in revision implants (p=0.001) and a reduced probability of further surgery being required (P=0.003). Whilst we acknowledge the limitations of this study our results suggest that, in contrast to THA, the bone conservation element of HRA may make for a less traumatic revision procedure with better functional outcomes. Use of HRA has seen a dramatic decline as a result of concerns regarding metallosis. However, this information remains of relevance when counselling young active patients about their arthroplasty options and may become pertinent in the future if the promise of ceramic hip resurfacing is ever realized.

Keywords: hip resurfacing, metallosis, revision surgery, total hip arthroplasty

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Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

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Authors: Adèle Oliva, Samuel Fosso Wamba

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This study looks at how firms can create competitive advantages through effective reserve logistics strategies. Upon using data collected from reverse supply chain managers of electronic commerce companies, the study found that improved reverse logistics management can have a positive impact on companies’ business benefits. These include playing a role in the implementation of many factors that highly influence the decision to purchase, customers’ loyalty, as well as increasing companies’ turnover. As a result, through an efficient design and management of their reverse flow, companies can decrease the costs associated to returned products.

Keywords: reverse logistics, competitive advantage, case study, business value

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Authors: Thanakorn Thanawat, Nomjit Nualnetr

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Background and Purpose: In Thailand, rice farmers have the most prevalence of low back pain when compared with other manual workers. Exercises have been suggested to be a principal part of treatment programs for low back pain. However, the programs should be tailored to an individual’s readiness to change categorized by a behavioral approach. This study aimed to evaluate a difference between the responses of rice farmers with chronic low back pain who received an exercise program integrated with the transtheoretical model of behavior change (TTM) and those of the comparison group regarding severity of pain and trunk muscle endurance. Materials and Methods: An 8-week exercise program was conducted to rice farmers with chronic low back pain who were randomized to either the TTM (n=62, 52 woman and 10 men, mean age ± SD 45.0±5.4 years) or non-TTM (n=64, 53 woman and 11 men, mean age ± SD 44.7±5.4 years) groups. All participants were tested for their severity of pain and trunk (abdominal and back) muscle endurance at baseline (week 0) and immediately after termination of the program (week 8). Data were analysed by using descriptive statistics and student’s t-tests. The results revealed that both TTM and non-TTM groups could decrease their severity of pain and improve trunk muscle endurance after participating in the 8-week exercise program. When compared with the non-TTM group, however, the TTM showed a significantly greater increase in abdominal muscle endurance than did the non-TTM (P=0.004, 95% CI -12.4 to -2.3). Conclusions and Clinical Relevance: An exercise program integrated with the TTM could provide benefits to rice farmers with chronic low back pain. Future studies with a longitudinal design and more outcome measures such as physical performance and quality of life are suggested to reveal further benefits of the program.

Keywords: chronic low back pain, transtheoretical model, rice farmers, exercise program

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Authors: Emmanouil Papavasileiou, Nikos Bozionelos, Liza Howe-Walsh, Sarah Turnbull

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Purpose: The research focuses on women academics’ insecure identity at work and examines its link with generational identity. The aim is to enrich understanding of identities at work as a crucial attribute of managing academics in the context of the proliferation of managerialist controls of audit, accountability, monitoring, and performativity. Methodology: Positivist quantitative methodology was utilized. Data were collected from the Scientific Women's Academic Network (SWAN) Charter. Responses from 155 women academics based in the British Higher Education system were analysed. Findings: Analysis showed high prevalence of strong imposter feelings among participants, suggesting high insecurity at work among women academics in the United Kingdom. Generational identity was related to imposter feelings. In particular, Millennials scored significantly higher than the other generational groups. Research implications: The study shows that imposter feelings are variously manifested among the prevalent generations of women academics, while generational identity is a significant antecedent of such feelings. Research limitations: Caution should be exercised in generalizing the findings to national cultural contexts beyond the United Kingdom. Practical and social implications: Contrary to popular depictions of Millennials as self-centered, narcissistic, materialistic and demanding, women academics who are members of this generational group appear significantly more insecure than the preceding generations. Value: The study provides insightful understandings into women academics’ identity at work as a function of generational identity, and provides a fruitful avenue for further research within and beyond this gender group and profession.

Keywords: academics, generational diversity, imposter feelings, United Kingdom, women, work identity

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Authors: Bita Mashayekhi, Mohammad Ara

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The purpose of this study is to provide some empirical evidence about implementing Activity-Based Costing (ABC) in the hospitality industry in Iran. For this purpose, we consider the Tabriz International Hotel as our sample hotel and then gather the relevant data from its cost accounting system in 2012. Then, we use ABC as our costing method and compare the cost of each service unit with that cost which had been extracted for the traditional costing method. The results show a different cost per unit for two methods. Also, because of its more precise and detailed provided information, an ABC system facilitates the decision-making process for managers on decisions related to profitability analysis, budgeting, pricing, and so on.

Keywords: Activity-Based Costing (ABC), activity, cost driver, hospitality industry

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Authors: Taweesak Janyacharoen, Lalita Pradubgool, Lalita Wongsorn, Pitchayapa Janyacharoen

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Street dance is a form of exercise that is classified as aerobic and is very suitable for teenagers. Street dance is a dance that can create new dance moves all the time. It often incorporates elements from gymnastics and is accompanied by fast-paced music that emphasizes excitement and energy. It is a combination of high-intensity and low-intensity activities. Few studies have looked at the effects of street dance on cardiovascular endurance, and previous studies have long-term effects. However, no research study in Thailand has studied acute effects before. This study was to investigate the acute effect of street dance exercise on blood pressure, heart rate, oxygen saturation and physical fitness in sedentary subjects. Subjects were divided into 2 groups: the control group (n=15) received health education and rest, and the experimental group (n=15) received street dance exercise. Both groups will measure their blood pressure (BP), mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO₂) and six-minute walk test (6MWT) before and after completing the program. The results found that both groups had significantly different HR when comparing before and after the program (p<0.05). MAP, HR and SpO₂ had significantly different (p<0.05) when compared between groups. This study concluded that the acute effect of street dance exercise could be increased in HR while the SpO₂ decreased. In clinical, it was seen that the values that were changed are still within the range that is considered normal. Therefore, street dance exercises can be used as one choice of alternative exercise.

Keywords: street dance, exercise, blood pressure, heart rate, oxygen saturation

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Authors: Santiago Quesada-García, María Lozano-Gómez, Pablo Valero-Flores

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The recent digital revolution, together with modern technologies, is changing the environment and the way people interact with inhabited space. However, in society, the elderly are a very broad and varied group that presents serious difficulties in understanding these modern technologies. Outpatients with cognitive disabilities, such as those suffering from Alzheimer's disease (AD), are distinguished within this cluster. This population group is in constant growth, and they have specific requirements for their inhabited space. According to architecture, which is one of the health humanities, environments are designed to promote well-being and improve the quality of life for all. Buildings, as well as the tools and technologies integrated into them, must be accessible, inclusive, and foster health. In this new digital paradigm, artificial intelligence (AI) appears as an innovative resource to help this population group improve their autonomy and quality of life. Some experiences and solutions, such as those that interact with users through chatbots and voicebots, show the potential of AI in its practical application. In the design of healthy spaces, the integration of AI in architecture will allow the living environment to become a kind of 'exo-brain' that can make up for certain cognitive deficiencies in this population. The objective of this paper is to address, from the discipline of neuroarchitecture, how modern technologies can be integrated into everyday environments and be an accessible resource for people with cognitive disabilities. For this, the methodology has a mixed structure. On the one hand, from an empirical point of view, the research carries out a review of the existing literature about the applications of AI to build space, following the critical review foundations. As a unconventional architectural research, an experimental analysis is proposed based on people with AD as a resource of data to study how the environment in which they live influences their regular activities. The results presented in this communication are part of the progress achieved in the competitive R&D&I project ALZARQ (PID2020-115790RB-I00). These outcomes are aimed at the specific needs of people with cognitive disabilities, especially those with AD, since, due to the comfort and wellness that the solutions entail, they can also be extrapolated to the whole society. As a provisional conclusion, it can be stated that, in the immediate future, AI will be an essential element in the design and construction of healthy new environments. The discipline of architecture has the compositional resources to, through this emerging technology, build an 'exo-brain' capable of becoming a personal assistant for the inhabitants, with whom to interact proactively and contribute to their general well-being. The main objective of this work is to show how this is possible.

Keywords: Alzheimer’s disease, artificial intelligence, healthy architecture, neuroarchitecture, architectural design

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Authors: Ryoo Hye Jin Agnes

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This study aims to investigate the efficacy of clickers in fostering L2 class interaction. In an L2 classroom, active learner-to-learner interactions and learner-to-teacher interactions play an important role in language acquisition. In light of this, introducing learning tools that promote such interactions would benefit L2 classroom by fostering interaction. This is because the anonymity of clickers allows learners to express their needs without the social risks associated with speaking up in the class. clickers therefore efficiently help learners express their level of understanding during the process of learning itself. This allows for an evaluative feedback loop where both learners and teachers understand the level of progress of the learners, better enabling classrooms to adapt to the learners’ needs. Eventually this tool promotes participation from learners. This, in turn, is believed to be effective in fostering classroom interaction, allowing learning to take place in a more comfortable yet vibrant way. This study is finalized by presenting the result of an experiment conducted to verify the effectiveness of this approach when teaching pragmatic aspect of Korean expressions with similar semantic functions. The learning achievement of learners in the experimental group was found higher than the learners’ in a control group. A survey was distributed to the learners, questioning them regarding the efficacy of clickers, and how it contributed to their learning in areas such as motivation, self-assessment, increasing participation, as well as giving feedback to teachers. Analyzing the data collected from the questionnaire given to the learners, the study presented data suggesting that this approach increased the scope of interactivity in the classroom, thus not only increasing participation but enhancing the type of classroom participation among learners. This participation in turn led to a marked improvement in their communicative abilities.

Keywords: second language acquisition, interaction, clickers, learner response system, output from learners, learner’s cognitive process

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Authors: Neha Singh, Anuj Ranjan, Tanu Jindal

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Over the last decade, the exponential growth of mobile communication has been accompanied by a parallel increase in density of electromagnetic fields (EMF). The continued expansion of mobile phone usage raises important questions as EMF, especially radio frequency (RF), have long been suspected of having biological effects. In the present experiments, we studied the effects of RF-EMF on cell death (apoptosis) and DNA damage of a well- tested biological model, Drosophila melanogaster exposed to 2400 MHz frequency for different time duration i.e. 2 hrs, 4 hrs, 6 hrs,8 hrs, 10 hrs, and 12 hrs each day for five continuous days in ambient temperature and humidity conditions inside an exposure chamber. The flies were grouped into control, sham-exposed, and exposed with 100 flies in each group. In this study, well-known techniques like Comet Assay and TUNEL (Terminal deoxynucleotide transferase dUTP Nick End Labeling) Assay were used to detect DNA damage and for apoptosis studies, respectively. Experiments results showed DNA damage in the brain cells of Drosophila which increases as the duration of exposure increases when observed under the observed when we compared results of control, sham-exposed, and exposed group which indicates that EMF radiation-induced stress in the organism that leads to DNA damage and cell death. The process of apoptosis and mutation follows similar pathway for all eukaryotic cells; therefore, studying apoptosis and genotoxicity in Drosophila makes similar relevance for human beings as well.

Keywords: cell death, apoptosis, Comet Assay, DNA damage, Drosophila, electromagnetic fields, EMF, radio frequency, RF, TUNEL assay

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Authors: Jawaher Bakheet Almudarra

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The Saudi Arabian educational system shared the philosophical principles, in its foundation, which concentrated on the achievement of goals, thereby taking up authoritative styles of leadership. However, organisations are beginning to be more liberal in today’s environment than in the 1940s and 1950s, and appealing to emotional intelligence as a tool and skill are needed for effective leadership. In the Saudi Arabian case, such developments are characterised by changes such as that of the educational supervisor having the role redefined to that of a director. This review tracks several parts: the first section helps western reader to understand the subtleties, complexities, and intricacies of the Saudi Arabia education system and its approach to leadership system of education, history, culture and political contribution. This can lead to the larger extent understand if emotional intelligence is a provocation for better leadership of Saudi Arabian education sector or not. The second part is the growth of educational supervision in Saudi Arabia, focusing on the education system, and evaluates the impact of emotional intelligence as a necessary skill in leadership. The third section looks at emotions and emotional intelligence, gender roles, and contributions by emotional intelligence in the education system. The education system of Saudi Arabia has undergone significant transformation. To fully understand the current climate of Saudi Arabia, it is essential to review this process of transformation in terms of the historical, cultural, political and social positions and transformations. Over the years, the education system in Saudi Arabia has undergone significant metamorphosis. The Saudi government has instituted a wide range of reforms in an attempt to improve education standards and outcomes, facilitate improvements and ensure that high standards of education standards are upheld to keep pace with the global environment and knowledge economy. Leadership itself has become an increasingly prominent aspect of educational reform worldwide. Emotional intelligence is often considered a significant aspect of leadership, but it is in its early stages in Saudi Arabia. Its recognition and adoption may improve leadership practices, particularly among educational supervisors and contribute to national and international understandings of leadership in Saudi Arabia. Studying leadership in the Saudi Arabian context is imperative as the new generation of leaders need to cultivate pertinent skills that will allow them to become fundamentally and positively involved in the regions’ decision making processes in order to impact the progression of the Saudi Arabian education system. Understanding leadership in the education context will allow for suitable inculcation of leadership skills. These skills include goal-setting, sound decision-making as well as problem-solving within the education system of Saudi Arabia.

Keywords: educational supervision, educational administration, emotional intelligence, educational leadership

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Alireza Barari, Saeed Shirali, Ahmad Abdi

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Abstract: Introduction: Physical activity may be related to male reproductive function by affecting on thehypothalamic-pituitary-gonadal(HPG) axis. Our aim was to determine the effects of 6 weeks resistance exercise on reproductive hormones, HPG axis. The hypothalamic-pituitary-gonadal (HPG) axis refers tothe effects of endocrine glands in three-level including (i) the hypothalamic releasing hormone GnRH, which is synthesized in in a small heterogenous neuronal population and released in a pulsatile fashion, (ii) the anterior pituitary hormones, follicle-stimulating hormone(FSH) and luteinizing hormone (LH) and (iii) the gonadal hormones, which include both steroid such as testosterone (T), estradiol and progesterone and peptide hormones (such as inhibin). Hormonal changes that create a more anabolic environment have been suggested to contribute to the adaptation to strength exercise. Physical activity has an extensive impact on male reproductive function depending upon the intensity and duration of the exercise and the fitness level of the individual. However, strenuous exercise represents a physical stress and inflammation changed that challenges homeostasis. Materials and methods: Sixteen male volunteered were included in a 6-week control period followed by 6 weeks of resistance training (leg press, lat pull, chest press, squat, seatedrow, abdominal crunch, shoulder press, biceps curl and triceps press down) four times per week. intensity of training loading was 60%-75% of one maximum repetition. Participants performed 3 sets of 10 repetitions. Rest periods were two min between exercises and sets. Start with warm up exercises include: The muscles relax and stretch the body, which was for 10 minutes. Body composition, VO2max and the circulating level of free testosterone (fT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin (SHBG) and inhibin B measured prior and post 6-week intervention. The hormonal levels of each serum sample were measured using commercially available ELISA kits. Analysis of anthropometrical data and hormonal level were compared using the independent samples t- test in both groups and using SPSS (version 19). P ≤ 0.05 was considered statistically significant. Results: For muscle strength, both lower- and upper-body strength were increased significantly. Aerobic fitness level improved in trained participant from 39.4 ± 5.6 to 41.9 ± 5.3 (P = 0.002). fT concentration rise progressively in the trained group and was significantly greater than those in the control group (P = 0.000). By the end of the 6-week resistance training, serum SHBG significantly increased in the trained group compared with the control group (P = 0.013). In response to resistance training, LH, FSH and inhibin B were not significantly changed. Discussion: According to our finfings, 6 weeks of resistance training induce fat loss without any changes in body weight and BMI. A decline of 25.3% in percentage of body fat with statiscally same weight was due to increase in muscle mass that happened during resistance exercise periods . Six weeks of resistance training resulted in significant improvement in BF%, VO2max and increasing strength and the level of fT and SHBG.

Keywords: resistance, hypothalamic, pituitary, gonadal axis

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Authors: Olaide O. Wahab, Lukman O. Olasunkanmi, Krishna K. Govender, Penny P. Govender

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The economic and environmental challenges associated with azo disperse dyes applications are due to poor aqueous solubility and low degradation tendency which stems from low chemical reactivity. Poor aqueous solubility property of this group of dyes necessitates the use of dispersing agents which increase operational costs and also release toxic chemical components into the environment, while their low degradation tendency is due to the high stability of the azo functional group (-N=N-) in their chemical structures. To address these problems, this study investigated theoretically the effects of some polar substituents on the aqueous solubility and reactivity properties of disperse yellow (DY) 119 dye with a view to theoretically develop new azo disperse dyes with improved solubility in water and higher degradation tendency in the environment using DMol³ computational code. All calculations were carried out using the Becke and Perdew version of Volsko-Wilk-Nusair (VWN-BP) level of density functional theory in conjunction with double numerical basis set containing polarization function (DNP). The aqueous solubility determination was achieved with conductor-like screening model for realistic solvation (COSMO-RS) in conjunction with known empirical solubility model, while the reactivity was predicted using frontier molecular orbital calculations. Most of the new derivatives studied showed evidence of higher aqueous solubility and degradation tendency compared to the parent dye. We conclude that these derivatives are promising alternative dyes for more economic and environmental benign dyeing practice and therefore recommend them for synthesis.

Keywords: aqueous solubility, azo disperse dye, degradation, disperse yellow 119, DMol³, reactivity

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Authors: Savita Tangwongkit, Chittur S Srinivasan, Philip J. Jones

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Thailand has become the world’s fourth largest sugarcane producer and second largest sugar exporter. While there have been a number of drivers of this growth, the primary driver has been wide-ranging government support measures. Recently, the Thai government has emphasized the need for policy reform as part of a broader industry restructuring to bring the sector up-to-date with the current and future developments in the international sugar market. Because of the sectors historical dependence on government support, any such reform is likely to have a very significant impact on the fortunes of Thai cane farmers. This study explores the impact of three policy scenarios, representing a spectrum of policy approaches, on Thai cane producers. These reform scenarios were designed in consultation with policy makers and academics working in the cane sector. Scenario 1 captures the current ‘government proposal’ for policy reform. This scenario removes certain domestic production subsidies but seeks to maintain as much support as is permissible under current WTO rules. The second scenario, ‘protectionism’, maintains the current internal market producer supports, but otherwise complies with international (WTO) commitments. Third, the ‘libertarian scenario’ removes all production support and market interventions, trade and domestic consumption distortions. Most important driver of producer behaviour in all of the scenarios is the producer price of cane. Cane price is obviously highest under the protectionism scenario, followed by government proposal and libertarian scenarios, respectively. Likely producer responses to these three policy scenarios was determined by means of a large-scale survey of cane farmers. The sample was stratified by size group and quotas filled by size group and region. One scenario was presented to each of three sub-samples, consisting of approx.150 farmers. Total sample size was 462 farms. Data was collected by face-to-face interview between June and August 2019. There was a marked difference in farmer response to the three scenarios. Farmers in the ‘Protectionism’ scenario, which maintains the highest cane price and those who farm larger cane areas are more likely to continue cane farming. The libertarian scenario is likely to result in the greatest losses in terms of cane production volume broadly double that of the ‘protectionism’ scenario, primarily due to farmers quitting cane production altogether. Over half of loss cane production volume comes from medium-size farm, i.e. the largest and smallest producers are the most resilient. This result is likely due to the fact that the medium size group are large enough to require hired labour but lack the economies of scale of the largest farms. Over all size groups the farms most heavily specialized in cane production, i.e. those devoting 26-50% of arable land to cane, are also the most vulnerable, with 70% of all farmers quitting cane production coming from this group. This investigation suggests that cane price is the most significant determinant of farmer behaviour. Also, that where scenarios drive significantly lower cane price, policy makers should target support towards mid-sized producers, with policies that encourage efficiency gains and diversification into alternative agricultural crops.

Keywords: farmer intentions, farm survey, policy reform, Thai cane production

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Authors: Wan Liu, Haibo Wang, Cathy Huang, Zhiwu Tan, Zhiwei Chen

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The tremendous diversity of HIV-1 has been a major challenge for an effective AIDS vaccine development. Mosaic approach presents the potential for vaccine design aiming for global protection. The mosaic antigen of HIV-1 Gag allows antigenic breadth for vaccine-elicited immune response against a wider spectrum of viral strains. However, the enhancement of immune response using vaccines is dependent on the strategy used. Heterologous prime/boost regimen has been shown to elicit high levels of immune responses. Here, we investigated whether priming using plasmid DNA with electroporation followed by boosting with the live replication-competent modified vaccinia virus vector TianTan (MVTT) combined with the mosaic antigenic sequence could elicit a greater and broader antigen-specific response against HIV-1 Gag in mice. When compared to DNA or MVTT alone, or MVTT/MVTT group, DNA/MVTT group resulted in coincidentally high frequencies of broadly reactive, Gag-specific, polyfunctional, long-lived, and cytotoxic CD8+ T cells and increased anti-Gag antibody titer. Meanwhile, the vaccination could upregulate PD-1+, and Tim-3+ CD8+ T cell, myeloid-derived suppressive cells and Treg cells to balance the stronger immune response induced. Importantly, the prime/boost vaccination could help control the EcoHIV and mesothelioma AB1-gag challenge. The stronger protective Gag-specific immunity induced by a Mosaic DNA/MVTT vaccine corroborate the promise of the mosaic approach, and the potential of two acceptably safe vectors to enhance anti-HIV immunity and cancer prevention.

Keywords: DNA/MVTT vaccine, EcoHIV, mosaic antigen, mesothelioma AB1-gag

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Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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Authors: Miguel Llorens-Marin, Adolfo Hernandez, Maria Puelles-Gallo

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The increasing influence of Online Travel Agencies (OTAs) on hotel bookings and the electronic word-of-mouth (eWOM) contained in them has been featured by many scientific studies as a major factor in the booking decision. The main reason is that nowadays, in the hotel sector, consumers first come into contact with the offer through the web and the online environment. Due to the nature of the hotel product and the fact that it is booked in advance to actually seeing it, there is a lack of knowledge about its actual features. This makes eWOM a major channel to help consumers to reduce their perception of risk when making their booking decisions. This research studies the relationship between aspects of customer influenceability by reading eWOM communications, at the time of booking a hotel, with the propensity to write a review. In other words, to test relationships between the reading and the writing of eWOM. Also investigates the importance of different underlying motivations for writing eWOM. Online surveys were used to obtain the data from a sample of hotel customers, with 739 valid questionnaires. A measurement model and Path analysis were carried out to analyze the chain of relationships among the independent variable (influenceability from reading reviews) and the dependent variable (propensity to write a review) with the mediating effects of additional variables, which help to explain the relationship. The authors also tested the moderating effects of age and gender in the model. The study considered three different underlying motivations for writing a review on a hotel experience, namely hedonic, altruistic and conflicted. Results indicate that the level of influenceability by reading reviews has a positive effect on the propensity to write reviews; therefore, we manage to link the reading and the writing of reviews. Authors also discover that the main underlying motivation to write a hotel review is the altruistic motivation, being the one with the higher Standard regression coefficient above the hedonic motivation. The authors suggest that the propensity to write reviews is not related to sociodemographic factors (age and gender) but to attitudinal factors such as ‘the most influential factor when reading’ and ‘underlying motivations to write. This gives light on the customer engagement motivations to write reviews. The implications are that managers should encourage their customers to write eWOM reviews on altruistic grounds to help other customers to make a decision. The most important contribution of this work is to link the effect of reading hotel reviews with the propensity to write reviews.

Keywords: hotel reviews, electronic word-of-mouth (eWOM), online consumer reviews, digital marketing, social media

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Authors: Mohammad Saeri, Noor Rizkiyah, Kambang Vetrani Asie, Titin Apung Atikah

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The study aims to assess efficient specific-location soybean farming technology assembly by assisting the farmers in applying the suggested technology. Superimposed trial was conducted to know NPK fertilizer effect toward soybean growth and yield and soybean improved variety test for the dissemination of improved variety. The assessment was conducted at the farmers group of Sumber Rejeki, Kepulungan Village, Gempol Sub-district, Pasuruan Regency as the soybean central at Pasuruan area. The number of farmers involved in the study was 38 people with 25 ha soybean area. This study was held from July to October 2012.  The recommended technology package agreed at the socialization time and used in this research were: using Argomulyo variety seeds of 40 kg/ha, planting by drilling, planting by distance of 40x10 cm, deciding the seeds amount of 2-3 seeds per hole, and giving fertilization based on recommendation of East Java AIAT of 50 kg Urea, 100 kg SP-36 and 50 kg KCl.  Farmers around the research location were used as control group. Assessment on soybean farming system was considered effective because it could increase the production up to 38%. The farming analysis showed that the result collaborator farmers gained were positively higher than non-collaborator farmers with RC ratio of 2.03 and 1.54, respectively. Argomulyo variety has the prospect to be developed due to the high yield of about 2 tons/ha and the larger seeds. The NPK fertilization test at the soybean plants showed that the fertilization had minor effect on the yield.

Keywords: farming system, soybean, variety, location specific

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Authors: Dmitriy V. Chulkov

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Escalation of commitment is defined as continuation of a project after receiving negative information about it. While literature in management and psychology identified various factors contributing to escalation behavior, this phenomenon has received little analysis in economics, potentially due to the apparent irrationality of escalation. In this study, we present an economic model of escalation with asymmetric information in a principal-agent setup where the agents are responsible for a project selection decision and discover the outcome of the project before the principal. Our theoretical model complements the existing literature on several accounts. First, we link the incentive to escalate commitment to a project with the turnover decision by the manager. When a manager learns the outcome of the project and stops it that reveals that a mistake was made. There is an incentive to continue failing projects and avoid admitting the mistake. This incentive is enhanced when the agent may voluntarily resign from the firm before the outcome of the failing project is revealed, and thus not bear the full extent of reputation damage due to project failure. As long as some successful managers leave the firm for extraneous reasons, outside firms find it difficult to link failing projects with certainty to managers that left a firm. Second, we demonstrate that non-CEO managers have reputation concerns separate from those of the CEO, and thus may escalate commitment to projects they oversee, when such escalation can attenuate damage to reputation from impending project failure. Such incentive for escalation will be present for non-CEO managers if the CEO delegates responsibility for a project to a non-CEO executive. If reputation matters for promotion to the CEO, the incentive for a rising executive to escalate in order to protect reputation is distinct from that of a CEO. Third, our theoretical model is supported by empirical analysis of changes in the firm’s operations measured by the presence of discontinued operations at the time of turnover among the top four members of the top management team. Discontinued operations are indicative of termination of failing projects at a firm. The empirical results demonstrate that in a large dataset of over three thousand publicly traded U.S. firms for a period from 1993 to 2014 turnover by top executives significantly increases the likelihood that the firm discontinues operations. Furthermore, the type of turnover matters as this effect is strongest when at least one non-CEO member of the top management team leaves the firm and when the CEO departure is due to a voluntary resignation and not to a retirement or illness. Empirical results are consistent with the predictions of the theoretical model and suggest that escalation of commitment is primarily observed in decisions by non-CEO members of the top management team.

Keywords: discontinued operations, escalation of commitment, executive turnover, top management teams

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Authors: J. Ikome, M. Ndeley

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When a machine breakdown forces a Modified Flow Shop (MFS) out of the prescribed state, the proposed strategy reschedules part of the initial schedule to match up with the preschedule at some point. The objective is to create a new schedule that is consistent with the other production planning decisions like material flow, tooling and purchasing by utilizing the time critical decision making concept. We propose a new rescheduling strategy and a match-up point determination procedure through a feedback mechanism to increase both the schedule quality and stability. The proposed approach is compared with alternative reactive scheduling methods under different experimental settings.

Keywords: advanced critical task methods modified flow shop (MFS), Manufacturing, experiment, determination

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Authors: Jo Rhodes, Peter Lok, Zahra Sadeghinejad

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The aim of this study is to determine the impact of metacognition on top management team members and firm performance based on full team integration. A survey of 1500 small to medium enterprises (SMEs) was initiated and 140 firms were obtained in this study (with response rate of 9%). The result showed that different metacognitive abilities of managers [knowledge and experience] could enhance team decision-making and problem solving, resulting in greater firm performance. This is a significant finding for SMEs because these organisations have small teams with owner leadership and entrepreneurial orientation.

Keywords: metacognition, behavioural integration, top management team (TMT), performance

Procedia PDF Downloads 360

Authors: Mary Therese G. Caluna, Mark Justin B. Campanero, Erlin Maris T. Cantiller, Claudine Mae A. Cantillo, Nerissa L. Caño

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Objective: The study determined the effectiveness of cold tomato paste in relieving pain caused by exacerbation of arthritis in the elderly, specifically on clients 60 years old and above. The study focused on alternative, cost-effective and non-pharmacological techniques in relieving pain experienced by the older people with osteoarthritis and rheumatoid arthritis. Methods: Using purposive non-probability sampling, the researchers gathered a total number of 40 subjects that passed the inclusion criteria provided by the researchers. The subjects were divided into two groups, experimental group (20 subjects) and control groups (20 subjects). The Numeric Rating 11-point Scale (NRS-11) was utilized to assess the pain level of the subject prior the application of the treatment and after the application of the treatment. Key findings: There is a significant difference in the pain levels of the experimental group before and after the application of cold tomato paste. This indicates that that the application of cold tomato paste alleviates the pain experienced by elderly clients with exacerbation of arthritis. Conclusion: The effectiveness of cold tomato paste in relieving pain experienced by elderly clients who are in exacerbation of arthritis was proven to be evidence-based. The cold tomato paste application has significant impact in the field of nursing and therefore, can be used in both clinical trials and practices. The effectiveness of cold tomato application promotes innovation in the field of nursing, thus encouraging further researches regarding other uses of tomato and other herbal interventions to relieve the pain caused by osteoarthritis and rheumatoid arthritis.

Keywords: alternative therapy, arthritis, cold tomato paste, elderly clients, exacerbation

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Authors: Naima Mohammadi

Abstract:

The present paper critically reports on the emergency of Iranian international students in a large public university in Italy. Although the most sizeable diaspora of Iranians dates back to the 1979 revolution, a huge wave of Iranian female students travelled abroad after the Iranian Green Movement (2009) due to the intensification of gender discrimination and Islamization. To explore the experience of Iranian female students at an Italian public university, two complementary methods were adopted: a focus group and individual interviews. Focus groups yield detailed collective conversations and provide researchers with an opportunity to observe the interaction between participants, rather than between participant and researcher, which generates data. Semi-structured interviews allow participants to share their stories in their own words and speak about personal experiences and opinions. Research participants were invited to participate through a public call in a Telegram group of Iranian students. Theoretical and purposive sampling was applied to select participants. All participants were assured that full anonymity would be ensured and they consented to take part in the research. A two-hour focus group was held in English with participants in the presence and some online. They were asked to share their motivations for studying in Italy and talk about their experiences both within and outside the university context. Each of these interviews lasted from 45 to 60 minutes and was mostly carried out online and in Farsi. The focus group consisted of 8 Iranian female post-graduate students. In analyzing the data a blended approach was adopted, with a combination of deductive and inductive coding. According to research findings, although 9/11 was the beginning of the West’s challenges against Muslims, the nuclear threats of Islamic regimes promoted the toughest international sanctions against Iranians as a nation across the world. Accordingly, carrying an Iranian identity contributes to social, political, and economic exclusion. Research findings show that geopolitical factors such as international sanctions and Islamophobia, and a lack of reciprocity in terms of recognition, have created a sense of stigmatization for veiled and unveiled Iranian female students who are the largest groups of ‘non-European Muslim international students’ enrolled in Italian universities. Participants addressed how their nationality has devalued their public image and negatively impacted their self-confidence and self-realization in academia. They highlighted the experience of an unwelcoming atmosphere by different groups of people and institutes, such as receiving marked students’ badges, rejected bank account requests, failed visa processes, secondary security screening selection, and hyper-visibility of veiled students. This study corroborates the need for institutions to pay attention to geopolitical factors and religious diversity in student recruitment and provide support mechanisms and access to basic rights. Accordingly, it is suggested that Higher Education Institutions (HEIs) have a social and moral responsibility towards the discrimination and both social and academic exclusion of Iranian students.

Keywords: Iranian diaspora, female students, recognition theory, inclusive university

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Authors: Nelson Igaba, C. Onaga, S. Hlongwane

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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

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Authors: Karol Konaszewski

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Background: The article is an analysis of the results of the studies conducted among juveniles (boys and girls) in the case of whom the family court applied the educational means of placing them in the youth educational centers. The aim of the study was to find out the correlations between antisocial behaviors, personality traits and the environmental determinants (support factors and risk factors) among juveniles (boys and girls). Methods: The total of 481 juveniles staying in youth educational centers participated in the study. Applied research tools: The Antisocial Behaviors Scale by L. Pytka, NEO-FFI by P. T. Costa and R. R. McCrae was used to diagnose personality traits included in a popular five-factor model (it has been adapted into Polish by B. Zawadzki, J. Strelau, P. Szczepaniak, and M. Śliwińska) and a questionnaire concerning support factors and risk factors was constructed to measure environmental determinants. The data was analysed in a regression model. Findings: The analysis model showed that the significant predictors of antisocial behaviors were neuroticism, extraversion, conscientiousness and negative relations at school. In girls group, the significant predictors of antisocial behaviors were neuroticism, conscientiousness, family support and negative relations at school, while in boys group the significant predictors of antisocial behaviors were neuroticism, extraversion and negative relations at family. Discussion: The results of this study have important implications. They allow for a better understanding of the factors that contribute to antisocial behaviors among juveniles. Future interventions could be based on the creation of personality traits, strengthening of support factors and correction of risk factors.

Keywords: antisocial behaviours, juveniles, personality, youth

Procedia PDF Downloads 244

Authors: Afroze Ibrahim Baqapuri, Ilya Trofimov

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Sponsored search is a multi-billion dollar industry and makes up a major source of revenue for search engines (SE). Click-through-rate (CTR) estimation plays a crucial role for ads selection, and greatly affects the SE revenue, advertiser traffic and user experience. We propose a novel architecture of solving CTR prediction problem by combining artificial neural networks (ANN) with decision trees. First, we compare ANN with respect to other popular machine learning models being used for this task. Then we go on to combine ANN with MatrixNet (proprietary implementation of boosted trees) and evaluate the performance of the system as a whole. The results show that our approach provides a significant improvement over existing models.

Keywords: neural networks, sponsored search, web advertisement, click prediction, click-through rate

Procedia PDF Downloads 558

Authors: Majid Abdolrazzagh-Nezhad, Salwani Abdullah

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The job-shop scheduling problem (JSSP) is an important decision facing those involved in the fields of industry, economics and management. This problem is a class of combinational optimization problem known as the NP-hard problem. JSSPs deal with a set of machines and a set of jobs with various predetermined routes through the machines, where the objective is to assemble a schedule of jobs that minimizes certain criteria such as makespan, maximum lateness, and total weighted tardiness. Over the past several decades, interest in meta-heuristic approaches to address JSSPs has increased due to the ability of these approaches to generate solutions which are better than those generated from heuristics alone. This article provides the classification, constraints and objective functions imposed on JSSPs that are available in the literature.

Keywords: job-shop scheduling, classification, constraints, objective functions

Procedia PDF Downloads 427

Authors: Ae Ra Han, Seoung Eun Huh, Ji Yeon Kim, Joanne Kwak-Kim, Sung Ki Lee

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Objective: Prevalence of osteoporosis, cardiovascular disorders, and Alzheimer's disease rapidly increase after menopause. Immune activation and inflammation are suggested as an important pathogenesis of these serious diseases. Several pro-inflammatory cytokines are increased in women with surgical or natural menopause. However, the little is known about IL-17 producing T cells and Foxp3+ regulatory T (Treg) cells in post-menopause. Methods: A total of 34 postmenopausal women, who had no active cardiovascular, endocrine and infectious disorders were recruited as study group and healthy premenopausal women participated as controls. Peripheral blood mononuclear cells were isolated. Immuno-morphologic (CD3, CD4, CD8, CD19, CD56/CD16), intracellular cytokine (TNF-alpha, IFN-gamma, IL-10, IL-17), and Treg cell (Foxp3) studies were carried out using flow cytometry. The proportion of peripheral lymphocytes, including IL-17 producing and Foxp3+ Treg cells immune cell in each group were statistically analyzed. Results: The proportion of NK cells was significantly increased in menopausal women as compared to that of controls (P=.005). The ratios of TNF-alpha/IL-10 producing CD3+CD4+ T cells were increased in postmenopausal women. CD3+IL-17+ T cell level was higher in postmenopausal women and CD4+ Foxp3+ Treg cells was lower than that of controls. The ratios of CD3+IL-17+ T cell to CD3+Foxp3+ and to CD4+Foxp3+ Treg cells were significantly increased in postmenopausal women (P=.001). Conclusions: We found enhanced innate immunity and Th1- and Th17-mediated adaptive immunity in postmenopausal women. This may explain increasing prevalence of chronic inflammatory diseases after menopause. Further studies are needed to elucidate what factors contribute to this inflammatory shift in the postmenopause.

Keywords: inflammation, immune cell, menopause, Th17, regulatory T cell

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Authors: Arpit K. Shrivastava, Nirmal K. Mohakud, Subrat Kumar, Priyadarshi S. Sahu

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Acute diarrhea is one of the major causes of morbidity and mortality among children less than five years of age. Multiple etiologies have been implicated for infectious gastroenteritis causing acute diarrhea. In our study fecal samples (n=165) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies such as Rotavirus, Adenovirus, Diarrhoeagenic Escherichia coli (EPEC, EHEC, STEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. The overall results from our study showed that 57% of children below 5 years of age with acute diarrhea were positive for at least one infectious etiology. Diarrhoeagenic Escherichia coli was detected to be the major etiological agent (29.09%) followed by Rotavirus (24.24%), Shigella (21.21%), Adenovirus (5.45%), Cryptosporidium (2.42%), and Giardia (0.60%). Among the different DEC strains, EPEC was detected significantly higher in <2 years children in comparison to >2 years age group (p =0.001). Concurrent infections with two or more pathogens were observed in 47 of 160 (28.48%) cases with a predominant incidence particularly in <2-year-old children (66.66%) compared to children of 2 to 5 years age group. Co-infection of Rotavirus with Shigella was the most frequent combination, which was detected in 17.94% cases, followed by Rotavirus with EPEC (15.38%) and Shigella with STEC (12.82%). Detection of multiple infectious etiologies and diagnosis of the right causative agent(s) can immensely help in better management of acute childhood diarrhea. In future more studies focusing on the detection of cases with concurrent infections must be carried out, as we believe that the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea.

Keywords: children, co-infection, infectious diarrhea, Odisha

Procedia PDF Downloads 321