Search results for: frequent itemset

Authors: S. Alireza Mirghasemi, Javad Parvizi, Narges R. Gabaran, Shervin Rashidinia, Mahdi M. Bijanabadi, Dariush G. Savadkoohi

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Background: The anterior cruciate ligament is one of the most frequent ligament to be disrupted. Surgical reconstruction of the anterior cruciate ligament is a common practice to treat the disability or chronic instability of the knee. Several factors associated with success or failure of the ACL reconstruction including preoperative laxity of the knee, selection of the graft material, surgical technique, graft tension, and postoperative rehabilitation. We aimed to examine the biomechanical properties of any graft type and initial graft tensioning during ACL reconstruction using 3-dimensional computational finite element simulation. Methods: In this paper, 3-dimensional model of the knee was constructed to investigate the effect of graft tensioning on the knee joint biomechanics. Four different grafts were compared: 1) Bone-patellar tendon-bone graft (BPTB) 2) Hamstring tendon 3) BPTB and a band of gracilis4) Hamstring and a band of gracilis. The initial graft tension was set as “0, 20, 40, or 60N”. The anterior loading was set to 134 N. Findings: The resulting stress pattern and deflection in any of these models were compared to that of the intact knee. The obtained results showed that the combination of a band of gracilis with the former graft (BPTB or Hamstring) increases the structural stiffness of the knee. Conclusion: Required pretension during surgery decreases significantly by adding a band of gracilis to the proper graft.

Keywords: ACL reconstruction, deflection, finite element simulation, stress pattern

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Authors: V. V. Lakshmi, Y. V. S. Annapurna

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Urinary tract infection (UTI) is one of the most common infectious diseases seen in the community. Susceptible individuals experience multiple episodes, and progress to acute pyelonephritis or uro-sepsis or develop asymptomatic bacteriuria (ABU). Ability to cause extraintestinal infections depends on several virulence factors required for survival at extraintestinal sites. Presence of virulence phenotypes enhances the pathogenicity of these otherwise commensal organisms and thus augments its ability to cause extraintestinal infections, the most frequent in urinary tract infections(UTI). The present study focuses on detection of the virulence characters exhibited by the uropathogenic organism and most common factors exhibited in the local pathogens. A total of 700 isolates of E.coli and Klebsiella spp were included in the study.These were isolated from patients from local hospitals reported to be suffering with UTI over a period of three years. Isolation and identification was done based on Gram character and IMVIC reactions. Antibiotic sensitivity profile was carried out by disc diffusion method and multi drug resistant strains with MAR index of 0.7 were further selected. Virulence features examined included their ability to produce exopolysaccharides, protease- gelatinase production, hemolysin production, haemagglutination and hydrophobicity test. Exopolysaccharide production was most predominant virulence feature among the isolates when checked by congo red method. The biofilms production examined by microtitre plates using ELISA reader confirmed that this is the major factor contributing to virulencity of the pathogens followed by hemolysin production.

Keywords: Escherichia coli, Klebsiella spp, Uropathogens, virulence features

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Authors: Mehravar Javid, Rohma Hassan, J. DeSilva

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In this exploratory case study, a 37-year-old male patient who previously terminated treatment after four months of therapy with a different therapist begins anew with a 38-year-old female therapist and undergoes a similar cycle of premature termination, with added discourse caused by erotic transference. Process notes and records of the therapy treatment indicate that during the short course of treatment, the patient explored his difficulties navigating personal relationships, both current and past, and his difficulties coping with hypochondriasis. The therapist becomes tasked with not only navigating the patient’s inner conflict but also how she relates to the patient in the countertransference process while maintaining professional boundaries. This includes empathizing with the patient while also experiencing discomfort in the erotic transference from a professional standpoint. When the patient terminates once more, the therapist reflects on the possible reasons for termination. This includes the patient’s difficulties with tolerating interpretations, which cause him to blame himself for past events. These interpretations were also very frequent, contributing to the emotional burden the patient experienced. The therapist reflected on the use of interpretation versus exploration of the patient’s feelings and how exploring his feelings, including his feelings towards her, would have allowed for an opportunity to explore the emotions that troubled him more deeply. This includes exploring the patient’s anger and fear, which stem from unresolved conflicts from his childhood. Moreover, the erotic transference served as an enactment of previous experiences in which the patient feared losing what he loved, leading him to opt for premature termination instead of losing his ability to control the relationship and experience loss.

Keywords: countertransference, erotic transference, premature termination, therapist-client boundaries, transference

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Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

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Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

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Authors: Walid Abouzeid, Mohamed Shadad, Mostafa Farid, Magdy El Hawary

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The most frequent treatable vascular abnormality of the spinal canal is spinal dural arteriovenous fistulae (SDAVFs), which cause progressive para- or quadriplegia mostly affecting elderly males. SDAVFs are present in the thoracolumbar region. The main goal of treatment must be to obliterate the shunting zone via superselective embolization with the usage of a liquid embolic agent. This study aims to evaluate endovascular technique as a safe and efficient approach for the treatment SDAVFs, especially with long-term follow-up clinical outcomes. Study Design: A retrospective clinical case study. From May 2010 to May 2017, 15 patients who had symptoms attributed to SDAVFs underwent the operation in the Departments of Neurosurgery in Suhag, Tanta, and Al-Azhar Universities and Interventional Radiology, Ain Shams University. All the patients had varying degrees of progressive spastic paraparesis with and without sphincteric disturbances. Endovascular embolization was used in all cases. Fourteen were males, with ages ranging from 45 to 74 years old. After the treatment, good outcome was found in five patients (33.3%), a moderate outcome was delineated in six patients (40 %), and four patients revealed a poor outcome (26.7%). Spinal AVF could be treated safely and effectively by the endovascular approach. Generally, there is no correlation between the disappearance of MRI abnormalities and significant clinical improvement. The preclinical state of the patient is directly proportional to the clinical outcome. Due to unexpected responses, embolization should be attempted even the patient is in a bad clinical condition.

Keywords: spine, arteriovenous, fistula, endovascular, embolization

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Authors: L. M. Al-Harbi, A. M. Shokry, J. S. M. Sabir, A. Chaudhary, J. Manikandan, K. S. Saini

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Breast cancer is the second most common cause of cancer death worldwide and is the most common malignancy among Saudi females. During breast carcinogenesis, a wide-array of cytogenetic changes involving deletions, or amplification, or translocations, of part or whole of chromosome regions have been observed. Because of the limitations of various earlier technologies, newer tools are developed to scan for changes at the genomic level. Recently, Array Comparative Genomic Hybridization (aCGH) technique has been applied for detecting segmental genomic alterations at molecular level. In this study, aCGH was performed on twenty breast cancer tumors and their matching non-tumor (normal) counterparts using the Agilent 2x400K. Several regions were identified to be either amplified or deleted in a tumor-specific manner. Most frequent alterations were amplification of chromosome 1q, chromosome 8q, 20q, and deletions at 16q were also detected. The amplification of genetic events at 1q and 8q were further validated using FISH analysis using probes targeting 1q25 and 8q (MYC gene). The copy number changes at these loci can potentially cause a significant change in the tumor behavior, as deletions in the E-Cadherin (CDH1)-tumor suppressor gene as well as amplification of the oncogenes-Aurora Kinase A. (AURKA) and MYC could make these tumors highly metastatic. This study validates the use of aCGH in Saudi breast cancer patients and sets the foundations necessary for performing larger cohort studies searching for ethnicity-specific biomarkers and gene copy number variations.

Keywords: breast cancer, molecular biology, ecology, environment

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Authors: Shiori Ishida, Hiromi Okuno, Hisato Igarashi, Akemi Yamazaki, Hiroko Takahashi

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The purpose of this study was to clarify the differences and similarities regarding the social support of fathers and mothers towards considering increased assistance for the paternity of children with developmental disabilities. Written questionnaires were completed by fathers (n=85) and mothers (n=101) of children using rehabilitation facilities between infancy and 5 years of age. The survey contained multiple-choice questions on four categories: information support (6 items), emotional support (7 items), evaluation support (3 items), and daily living support (3 items). Regarding information support, fathers answered ‘spouse’ as the provider in over 50% of cases for all 6 items, which was significantly different compared with mothers (all p < 0.001). For emotional support, fathers were significantly more likely to get support from the workplace (p < 0.001) and from spouse (p < 0.001). The ‘evaluation support’ did not have significant differences for fathers in all the items, but the most frequent support providers were ‘spouses’. ‘Daily living support’ was significantly different from fathers in the workplace (p < 0.000) in terms of make allowances for work and duties. Thus, it appeared that fathers had fewer social support sources as compared with mothers and limited non-spouse support. The understanding of developmental disabilities, acquisition of methods of rehabilitation, and sources of support might have been inadequately addressed among fathers, which could be a hindrance to the involvement of fathers in the rearing of children with developmental disabilities. On the other hand, we also observed that some fathers were involved in the care of developmentally troubled children while providing mental support for their spouse, cooperating with housework, and adjusting their work life. However, the results on the external and social backgrounds of fathers indicated a necessity for greater empowerment and peer support to improve the paternal care of children with developmental disabilities in the family survey.

Keywords: children with developmental disabilities, family support, father, social support

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Authors: Eduardo Costa

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Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent, raising concerns in what respects patient safety. In fact, data shows that mortality rates for patients admitted during strikes are up to 30% higher than for patients admitted in other days. This paper analyses the effects of hospital strikes on patients’ outcomes. Specifically, it analyzes the impact of different strikes (physicians, nurses and other health professionals), on in-hospital mortality rates, readmission rates and length of stay. The paper uses patient-level data containing all NHS hospital admissions in mainland Portugal from 2012 to 2017, together with a comprehensive strike dataset comprising over 250 strike days (19 physicians-strike days, 150 nurses-strike days and 50 other health professionals-strike days) from 135 different strikes. The paper uses a linear probability model and controls for hospital and regional characteristics, time trends, and changes in patients’ composition and diagnoses. Preliminary results suggest a 6-7% increase in in-hospital mortality rates for patients exposed to physicians’ strikes. The effect is smaller for patients exposed to nurses’ strikes (2-5%). Patients exposed to nurses strikes during their stay have, on average, higher 30-days urgent readmission rates (4%). Length of stay also seems to increase for patients exposed to any strike. Results – conditional on further testing, namely on non-linear models - suggest that hospital operations and service levels are partially disrupted during strikes.

Keywords: health sector strikes, in-hospital mortality rate, length of stay, readmission rate

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Authors: Wan-Ling Chang, Hsiu-Ju Huang, Jui-Hsiu Chang

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In 2004, the Ministry of Foreign Affairs Taiwan launched ‘An Arrangement on Working Holiday Scheme’ with 15 countries including New Zealand, Japan, Canada, Germany, South Korea, Britain, Australia and others. The aim of the scheme is to allow young people to work and study English or other foreign languages. Each year, there are 30,000 Taiwanese youths applied for participating in the working holiday schemes. However, frequent accidents could cause huge medical expenses and post-delivery fee, which are usually unaffordable for most families. Therefore, this study explored the relationship among perceived risk toward working holiday, insurance product knowledge, brand image and insurance purchase intention for Taiwanese youths who plan to apply for working holiday. A survey questionnaire was distributed for data collection. A total of 316 questionnaires were collected for data analyzed. Data were analyzed using descriptive statistics, independent samples T-test, one-way ANOVA, correlation analysis, regression analysis and hierarchical regression methods of analysis and hypothesis testing. The results of this research indicate that perceived risk has a negative influence on insurance purchase intention. On the opposite, product knowledge has brand image has a positive influence on the insurance purchase intention. According to the mentioned results, practical implications were further addressed for insurance companies when developing a future marketing plan.

Keywords: insurance product knowledges, insurance purchase intention, perceived risk, working holiday

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Authors: Priscila Vitorino, Jeeziane Rezende, Edison Pereira, Adrielly Silva, Weimar Barroso

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Body composition insight during physical activity is relevant to follow up sports income since it can be important and actuate in velocity, resistance, potency, and has an effect on force and agility. The purpose of this study was to identify anthropometric profile, evaluate and correlate body mass index and bioimpedance behavior during the days of Caminhada Ecológica de Goiás - Brasil. A longitudinal study was performed with 25 male participants, with an average age of 45.6±9.1 years. All patients were actives. Body composition was evaluated by body mass index (BMI) measurement and bioimpedance procedures. Both were collected 20 days before walking beginning (A0) and in the four days along the same (A1, A2, A3 e A4). Data were collected in the end of each walking day at athletes accommodations. Final distance during walking route was 308 km in five days, with an average of 62km/day and 7,6 km/hour, and an average temperature of 30°C. Data are represented with mean and standard deviation. ANOVA (Bonferroni pos test) was used to compare frequent measurements between the days. Pearson's correlation test was used to correlate BMI with lean mass, fat mass, and water. BMI decreased from A0 to A1, A2 and A3 (p < 0,01) and increased on A4 (p < 0,01). No changes were observed concerning fat percentage (p=0,60), lean mass (p=0,10) and body water composition (p=0,09). A positive and moderate correlation between BMI and fat percentage was observed; an inverse and moderate correlation between BMI, lean mass and body water composition occurred. Total body mass increased during high intensity and long term walking distance. However, the values of body fat, lean mass and water were maintained.

Keywords: aerobic exercise, body composition, metabolism, sports

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Authors: Chelly Souhir, Harizi Chahida, Hachaichi Aicha, Aissaoui Sihem, Chahed Mohamed Kouni

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Introduction: In Tunisia, few studies have attempted to describe the demand for primary care in a standardized and systematic way. The purpose of this study is to describe the main reasons for demand for care in primary health care, through a survey of the Ariana Governorate PHC and to identify their evolutionary trend compared to last 30 years, reported by studies of the same type. Materials and methods: This is a cross-sectional descriptive study which concerns the study of consultants in the first line of the governorate of Ariana and their use of care recorded during 2 days in the same week during the month of May 2016, in each of these PHC. The same data collection sheet was used in all CSBs. The coding of the information was done according to the International Classification of Primary Care (ICPC). The data was entered and analyzed by the EPI Info 7 software. Results: Our study found that the most common ICPC chapters are respiratory (42%) and digestive (13.2%). In 1996 were the respiratory (43.5%) and circulatory (7.8%). In 2000, we found also the respiratory (39,6%) and circulatory (10,9%). In 2002, respiratory (43%) and digestive (10.1%) motives were the most frequent. According to the ICPC, the pathologies in our study were acute angina (19%), acute bronchitis and bronchiolitis (8%). In 1996, it was tonsillitis ( 21.6%) and acute bronchitis (7.2%). For Ben Abdelaziz in 2000, tonsillitis (14.5%) follow by acute bronchitis (8.3%). In 2002, acute angina (15.7%), acute bronchitis and bronchiolitis (11.2%) were the most common. Conclusion: Acute angina and tonsillitis are the most common in all studies conducted in Tunisia.

Keywords: acute angina, classification of primary care, primary health care, tonsillitis, Tunisia

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Authors: Edgar Mauricio Ruiz Osuna, Claudia Yaneth Herrera Bolivar, Sandra Liliana Gomez Vasquez

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The increasing needs of professionals with skills in software development in industry are incremental, therefore, the relevance of an educational process in line with the strengthening of these competencies, are part of the responsibilities of universities with careers related to the area of Informatics and Systems. In this sense, it is important to consider that in the National Science, Technology and Innovation Plan for the development of the Electronics, Information Technologies and Communications (2013) sectors, it is established as a weakness in the SWOT Analysis of the Software sector and Services, Deficiencies in training and professional training. Accordingly, UNIMINUTO's Computer Technology Program has addressed the analysis of students' performance in software development, identifying various problems such as dropout in programming subjects, academic averages, as well as deficiencies in strategies and competencies developed in the area of programming. As a result of this analysis, it was determined to design a collaborative learning platform in basic programming using heat maps as a tool to support didactic feedback. The pilot phase allows to evaluate in a programming course the ALGORINFO platform as a didactic resource, through an interactive and collaborative environment where students can develop basic programming practices and in turn, are fed back through the analysis of time patterns and difficulties frequent in certain segments or program cycles, by means of heat maps. The result allows the teacher to have tools to reinforce and advise critical points generated on the map, so that students and graduates improve their skills as software developers.

Keywords: collaborative platform, learning, feedback, programming, heat maps

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Authors: Promila Dahiya, Kiran Singh

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Indian agriculture has come a long way from being an era of frequent droughts and vulnerability to food shortages to becoming a significant exporter of agricultural commodities. Polyhouses are essentially microcosms aimed at providing physical environment suitable for the survival and growth of plants with high degree of temperature, humidity and carbon dioxide. The present study was conducted in 21 districts of Haryana State to review Polyhouse farming is an alternative farming in Haryana State to fulfil the needs of population byminimum use of land, water and energy. The information regarding number, area and type of polyhouses and subsidy provided by Govt. of India and Haryana on polyhouse farming was collected from respective district horticulture offices of Haryana State. Four different types of polyhouses were studied during work viz., Hitechnology polyhouse (Hi-tech), Anti-Insect Net Shade House (AINSH), Naturally Ventilated Polyhouse (NVPH) and Walk-In-Tunnel (WIT).In study it was found that in walk-in-tunnel (WIT) and natural ventilated polyhouses (NVPH) the temperature was 69.54% and 52.29% higher and the humidity was 96.37% and 85.19 % higher in comparison to open farming in the months of January and May. No significant different was found in temperature, humidity, dust, solar radiation and CO2 level between open and anti insect net shade house (AINH). In Hi-tech polyhouse, the environment was totally controlled by computer and was not found to much strenuous. Health status of workers was checked by doctor, and it was found that in polyhouse farming workers were more prone to problems of allergy and asthma.

Keywords: polyhouse, unfavorable climate, walk-in-tunnel, psychological aspect

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Authors: Jukka Heinonen

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Higher density reduces distances, private car dependency and thus reduces greenhouse gas emissions (GHGs). As a result, increased density has been given a central role among urban development targets. However, it is not just travel behavior that changes along with density. Rather, the consumption patterns, or overall lifestyles, change along with changing urban structure, particularly with changing housing types and consumption opportunities. Furthermore, elevated consumption of services, more frequent flying and less intra-household sharing have been shown to potentially outweigh the gains from reduced driving in more dense urban settlements. In this study, the geography of carbon footprints (CFs) in California is analyzed paying close attention to the household size differences and the resulting economies-of-scale advantages and disadvantages. A hybrid life cycle assessment (LCA) framework is employed together with consumer expenditure data to assess the CFs. According to the study, small urban households have the highest CFs in California. Their transport related emissions are significantly lower than those of the residents of less urbanized areas, but higher emissions from other consumption categories, together with the low degree of sharing of goods, overweigh the gains. Two functional units, per capita and per household, are used to analyze the CFs and to demonstrate the importance of household size. The lifestyle impacts visible through the consumption data are also discussed. The study suggests that there are still significant gaps in our understanding of the premises of low-carbon human settlements.

Keywords: carbon footprint, life cycle assessment, lifestyle, household size, consumption, economies-of-scale

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Authors: Matthew Fleet, Savannah Elliott

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Background: This study investigates the use of teaching and learning to meet the needs of deaf children in the UK PE curriculum. Research has illustrated that deaf students in mainstream schools do not receive sufficient support from teachers in lessons. This research examines the impact of different types of hearing loss and its implications within Physical Education (PE) in secondary schools. Purpose: The purpose of this study is to highlight challenges PE teachers face and make recommendations for more inclusive learning environments for deaf students. The aims and objectives of this research are: to critically analyse the current situation for deaf students accessing the PE curriculum, by identifying barriers deaf students face; to identify the challenges for PE teachers in providing appropriate support for deaf students; to provide recommendations for deaf awareness training, to enhance PE teachers’ understanding and knowledge. Method: Semi-structured interviews collected data from both PE teachers and deaf students, to examine: the support available and coping mechanisms deaf students use when they do not receive support; strategies PE teachers use to provide support for deaf students; areas for improvement and potential strategies PE teachers can apply to their practice. Results & Conclusion: The findings from the study concluded that PE teachers were inconsistent in providing appropriate support for deaf students in PE lessons. Evidence illustrated that PE teachers had limited exposure to deaf awareness training. This impacted on their ability to support deaf students effectively. Communication was a frequent barrier for deaf students, affecting their ability to retain and learn information. Also, the use of assistive technology was found to be compromised in practical PE lessons.

Keywords: physical education, deaf, inclusion, education

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Authors: V. A. Ritchie

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The loss of life and livelihood experienced after the magnitude 9.3 Sumatra earthquake and tsunami on 26 December 2004 and magnitude 9 earthquake and tsunami in northeastern Japan on 11 March 2011, has raised global awareness and brought tsunami phenomenology, nomenclature, and representation into sharp focus. At the same time, travel and tourism continue to increase, contributing around 1 in 11 jobs worldwide. This increase in tourism is especially true for coastal zones, placing pressure on decision-makers to downplay tsunami risks and at the same time provide adequate tsunami warning so that holidaymakers will feel confident enough to visit places of high tsunami risk. This study investigates how well tsunami preparedness messages are getting through for tourist-based businesses in Hawke’s Bay New Zealand, a region of frequent seismic activity and a high probability of experiencing a nearshore tsunami. The aim of this study is to investigate whether tourists based businesses are well informed about tsunamis, how well they understand that information and to what extent their clients are included in awareness raising and evacuation processes. In high-risk tsunami zones, such as Hawke’s Bay, tourism based businesses face competitive tension between short term business profitability and longer term reputational issues related to preventable loss of life from natural hazards, such as tsunamis. This study will address ways to accommodate culturally and linguistically relevant tourist awareness measures without discouraging tourists or being too costly to implement.

Keywords: tsunami risk and response, travel and tourism, business preparedness, cross cultural knowledge transfer

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Authors: Doaa M. Elghannam, Nashwa Khayrat Abousamra, Doaa A. Shahin, Enas F. Goda, Hanan Azzam, Emad Azmy, Manal Salah El-Din

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Background: The pathogenesis of acute myeloid leukemia (AML) involves the cooperation of mutations promoting proliferation/survival and those impairing differentiation. Point mutations of the NRAS gene are the most frequent somatic mutations causing aberrant signal-transduction in acute myeloid leukemia (AML). Aim: The present work was conducted to study the frequency and prognostic significance of NRAS gene mutations (NRASmut) in de novo Egyptian adult AML. Material and methods: Bone marrow specimens from 150 patients with de novo acute myeloid leukemia and controls were analyzed by genomic PCR-SSCP at codons 12, 13 (exon 1), and 61 (exon 2) for NRAS mutations. Results: NRAS gene mutations was found in 19/150 (12.7%) AML cases, represented more frequently in the FAB subtype M4eo (P = 0.028), and at codon 12, 13 (14of 19; 73.7%). Patients with NRASmut had a significant lower peripheral marrow blasts (P = 0.004, P=0.03) and non significant improved clinical outcome than patients without the mutation. Complete remission rate was (63.2% vs 56.5%; p=0.46), resistant disease (15.8% vs 23.6%; p=0.51), three years overall survival (44% vs 42%; P = 0.85) and disease free survival (42.1% vs 38.9%, P = 0.74). Multivariate analysis showed that age was the strongest unfavorable factor for overall survival (relative risk [RR], 1.9; P = .002), followed by cytogenetics (P = .004). FAB types, NRAS mutation, and leukocytosis were less important. Conclusions: NRAS gene mutation frequency and spectrum differ between biologically distinct subtypes of AML but do not significantly influence prognosis and clinical outcome.

Keywords: NRAS Gene, egyptian adult, acute myeloid leukemia, cytogenetics

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Authors: Yuban Sebastian Cuartas-Agudelo, Sandra Marcela López-Hincapié, Vivianna Alexandra Garrido-Altamar, María de los Ángeles Rodríguez-Gázquez, Camilo Ruiz-Mejía, Lina María Martínez-Sánchez, Gloria Inés Martínez-Domínguez, Luis Eduardo Contreras, Felipe Eduardo Marino-Isaza

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Introduction: Doping is a prohibited practice in competitive sports with potential adverse effects; therefore, it is crucial to describe the attitudes of athletes towards this behavior and to determine which o these increase the susceptibility to carry out this practice. Objective: To determine the attitude of high-performance athletes towards doping in a sports institute in the city of Medellin, Colombia. Methods: We performed a cross-sectional study during 2016, with a sample taken to convenience consisting of athletes over 18 years old enrolled in a sports institute of the city of Medellin (Colombia). The athletes filled by themselves the Petroczi and Aidman questionnaire: Performance Enhancement Attitude Scale (PEAS) adapted to the Spanish language by Morente-Sánchez et al. This scale has 17 items with likert answer options, with a score ranging from 1 to 6, with a higher score indicating a stronger tendency towards doping practices. Results: 112 athletes were included with an average age of 21.6 years old, a 60% of them were male and the most frequent sports were karate 17%, judo 12.5% and athletics 9.8%. The average score of the questionnaire was 35.5 points of a 102 possible points. The lowest score was obtained in the following items: Is Doping necessary 1,4 and Doping isn’t cheating, everyone does it 1,5. Conclusion: In our population, there is a low tendency towards doping practices.

Keywords: sports, doping in sports, athletic performance, attitude

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Authors: Rachna Agarwal, R. Naveen, Darpan Thakre, Rohit Shahi, Maryam Abbasi, Upendra Rathore, Latika Gupta

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Aim: Retinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health. Methods: Adult and juvenile IIM patients visiting a tertiary care centre in 2021 satisfying the International Myositis Classification Criteria were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis. Results: 43 patients with IIM [31 females; age 36 (23-45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6% vs. 4.3%, p <0.001), AV nicking (14% vs. 2.2%, p=0.053), and vascular tortuosity (18.6% vs. 2.2%, p=0.012), besides decreased visual acuity (53.5% vs. 10.9%, p<0.001) and immature cataracts (34.9% vs. 2.2%, p<0.001). Attenuation of vessels [OR 10.9 (1.7-71), p=0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57%) vs. 1 (16%), p=0.068], especially attenuation of vessels [14(38%) vs. 0(0), p=0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI. Conclusion: Retinal microvasculopathy and diminution of vision occur in nearly one-third to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.

Keywords: idiopathic inflammatory myopathies, vascular health, retinal microvasculopathy, arterial attenuation

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Authors: Deependra Prasad Sarraf, Gajendra Prasad Rauniar, Robin Maskey, Rajiv Maharjan, Ashish Shrestha, Ramayan Prasad Kushwaha

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Objectives: To assess the perception of faculties towards online teaching-learning activities conducted during the COVID-19 pandemic and to identify barriers and facilitators to conducting online teaching-learning activities in our context. Methods: A cross-sectional study was conducted among faculties at B. P. Koirala Institute of Health Sciences using a 26-item semi-structured questionnaire. A Google Form was prepared, and its link was sent to the faculties via email. Descriptive statistics were calculated, and findings were presented as tables and graphs. Results: Out of 158 faculties, the majority were male (66.46%), medical faculties (85.44%), and assistant professors (46.84%). Only 16 (10.13%) faculties had received formal training regarding preparing and/or delivering online teaching learning activities. Out of 158, 133 (84.18%) faculties faced technical and internet issues. The most common advantage and disadvantage of online teaching learning activities perceived by the faculties were ‘not limited to time or place’ (94.30%) and ‘lack of interaction with the students’ (82.28%), respectively. Majority (94.3%) of them had a positive perception towards online teaching-learning activities conducted during COVID-19 pandemic. Slow internet connection (91.77%) and frequent electricity interruption (82.91%) were the most common perceived barriers to online teaching-learning. Conclusions: Most of the faculties had a positive perception towards online teaching-learning activities. Academic leaders and stakeholders should provide uninterrupted internet and electricity connectivity, training on online teaching-learning platform, and timely technical support.

Keywords: COVID-19 pandemic, faculties, medical education, perception

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Authors: Ágota Ábrahám, Md Nurul Islam, Karimane Zeghbib, Gábor Kemenesi, Sazeda Akter

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Collecting palm sap as a food source is an everyday practice in some parts of the world. However, the consumption of palm juice has been associated with regular infections and epidemics in parts of Bangladesh. This is attributed to fruit-eating bats and other vertebrates or invertebrates native to the area, contaminating the food with their body secretions during the collection process. The frequent intake of palm juice, whether as a processed food product or in its unprocessed form, is a common phenomenon in large areas. The range of pathogens suitable for human infection resulting from this practice is not yet fully understood. Additionally, the high sugar content of the liquid makes it an ideal culture medium for certain bacteria, which can easily propagate and potentially harm consumers. Rapid diagnostics, especially in remote locations, could mitigate health risks associated with palm juice consumption. The primary objective of this research is the rapid genomic detection and risk assessment of bacteria that may cause infections in humans through the consumption of palm juice. Utilizing state-of-the-art third-generation Nanopore metagenomic sequencing technology based on 16S rRNA, and identified bacteria primarily involved in fermenting processes. The swift metagenomic analysis, coupled with the widespread availability and portability of Nanopore products (including real-time analysis options), proves advantageous for detecting harmful pathogens in food sources without relying on extensive industry resources and testing.

Keywords: raw date palm sap, NGS, metabarcoding, food safety

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Authors: Alireza Abdiardekani, Maryam Salimi, Shirin Sarejloo, Mehdi Bazrafshan, Amir Askarinejad, Amirhossein Salimi, Hanieh Bazrafshan, Salar Javanshir, Armin Attar, Shokoufeh Khanzadeh, Mohsen Esmaeili, Hamed Bazrafshan Drissi

Abstract:

Background: Opium, after tobacco, is the most abused substance in the Middle East. The effects of opium use on coronary artery disease are indeed unclear. This study aimed to assess the association between opium use and angiographic findings in patients with acute coronary syndrome (ACS) diagnosis at Al-Zahra Heart Hospital, Shiraz, Iran. Methods: In this case-control study, 170 patients admitted for coronary angiography were enrolled from 2019 to 2020. They were categorized into two groups based on their history: "non-opium" and "opium." SPSS (Version 26) was used to investigate the correlation between opioid addiction and the severity of coronary artery disease. Results: The results of our study reveal that the mean age of the participants was 61.63±9.07. This study indicated that 49 (28.82%) patients were female, and 121 (71.17%) were male. Our findings revealed that three-vessel disease was more frequent in non-opium (40; 47.05%) and opium (45; 52.94%) groups. There was a significant correlation between the severity of the second diagonal artery(D2) and right coronary artery(RCA) involvement and opium consumption. There was a strong positive correlation between the location of the vascular lesion in the left circumflex artery and opium consumption. Conclusion: Opium, as an independent risk factor for cardiovascular diseases, can have specific effects on angiographic findings in patients with coronary artery disease. Public health officials and politicians should arrange several programs to increase the general population’s consciousness about opioid use and its consequences.

Keywords: acute coronary syndrome, opium, coronary artery disease, angiography

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Authors: Shabadini Sampath, Jinglang Feng

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With huge kinetic energy, space debris poses a major threat to astronauts’ space activities and spacecraft in orbit if a collision happens. The active removal of space debris is required in order to avoid frequent collisions that would occur. In addition, the amount of space debris will increase uncontrollably, posing a threat to the safety of the entire space system. But the safe and reliable removal of large-scale space debris has been a huge challenge to date. While capturing and deorbiting space debris, the space manipulator has to achieve high control precision. However, due to uncertainties and unknown disturbances, there is difficulty in coordinating the control of the space manipulator. To address this challenge, this paper focuses on developing a robust and intelligent control algorithm that controls joint movement and restricts it on the sliding manifold by reducing uncertainties. A neural network adaptive sliding mode controller (NNASMC) is applied with the objective of finding the control law such that the joint motions of the space manipulator follow the given trajectory. A computed torque control (CTC) is an effective motion control strategy that is used in this paper for computing space manipulator arm torque to generate the required motion. Based on the Lyapunov stability theorem, the proposed intelligent controller NNASMC and CTC guarantees the robustness and global asymptotic stability of the closed-loop control system. Finally, the controllers used in the paper are modeled and simulated using MATLAB Simulink. The results are presented to prove the effectiveness of the proposed controller approach.

Keywords: GNC, active removal of space debris, AI controllers, MatLabSimulink

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Authors: Shivani Tiwari, Prathibha Karanth, B. Rajashekhar

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Impairments of syntactic morphology are often considered central in children with Specific Language Impairment (SLI). In English and related languages, deficits of tense-related grammatical morphology could serve as a clinical marker of SLI. Yet, cross-linguistic studies on SLI in the recent past suggest that the nature and severity of morphosyntactic deficits in children with SLI varies with the language being investigated. Therefore, in the present study we investigated the morphosyntactic deficits in a group of children with SLI who speak Kannada, a morphologically complex Dravidian language spoken in Indian subcontinent. A group of 15 children with SLI participated in this study. Two more groups of typical developing children (15 each) matched for language and age to children with SLI, were included as control participants. All participants were assessed for morphosyntactic comprehension and expression using standardized language test and a spontaneous speech task. Results of the study showed that children with SLI differed significantly from age-matched but not language-matched control group, on tasks of both comprehension and expression of morphosyntax. This finding is, however, in contrast with the reports of English-speaking children with SLI who are reported to be poorer than younger MLU-matched children on tasks of morphosyntax. The observed difference in impairments of morphosyntax in Kannada-speaking children with SLI from English-speaking children with SLI is explained based on the morphological richness theory. The theory predicts that children with SLI perform relatively better in morphologically rich language due to occurrence of their frequent and consistent features that mark the morphological markers. The authors, therefore, conclude that language-specific features do influence manifestation of the disorder in children with SLI.

Keywords: specific language impairment, morphosyntax, Kannada, manifestation

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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Authors: Salama A. Ouf, Amera A. El-Adly, Abdelaleam H. Mohamed

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Dermatophytosis is the infection of keratinized tissues such as hair, nail and the stratum corneum of the skin by dermatophytic fungi. Infection is generally cutaneous and restricted to the non-living cornified layers because of the inability of the fungi to penetrate the deeper tissues or organs of immunocompetent hosts. In Saudi Arabia, Onychomycosis is the most frequent infection (40.3%), followed by tinea capitis (21.9%), tinea pedis (16%), tinea cruris (15.1%), and tinea corporis (6.7%). Several azole compounds have been tried to control dermatophytic infection, however, the azole-containing medicines may interfere with the activity of hepatic microsomal enzymes, sex and thyroid hormones, and testosterone biosynthesis. In this research, antibody-conjugated nanoparticles stimulated by cold plasma and laser were evaluated in vitro against some dermatophytes isolated from the common types of tinea. Different types of nanomaterials were tested but silver nanoparticles (AgNPs) were proved to be most effective against the dermatophytes under test. The use of cold plasma coupled with antibody-conjugated nano-particles has severe impact on dermatophytes where the inhibition of growth, spore germination keratinase activity was more than 88% in the case of Trichophyton rubrum, T. violaceum, Microsprum canis and M. gypseum. Complete inhibition of growth for all dermatophytes was brought about by the interaction of conjugated nanoparticles, with cold plasma and laser treatment. The in vivo test with inoculated guinea pigs achieved promising results where the recovery from the infection reached 95% in the case of M. canis –inoculated pigs treated with AgNPs pretreated with cold plasma and laser.

Keywords: cold plasma, dermatophytes, laser, silver nanoparticles

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Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: Firas Al-Mahmoud, Jean-Michel Mechling, Mohamed Shaban

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The long-term durability of fibre reinforced polymer (FRP) composites is often stated as being the main reason for the use of these materials. Indeed, structures externally or Near Surface Mounted (NSM) reinforced with Carbon Fibre Reinforcement Polymer CFRP are often in contact with temperature cycles and salt water immersion and other environmental conditions that reduce the expected durability of the system. Bond degradation is a frequent cause of premature failure of structural elements and environmental conditions are known to relate to such failures. The purpose of this study is to investigate the effect of environmental exposure on the bond for different CFRP strengthening systems. Bending tests were conducted to evaluate the bond with and without environmental exposure. The specimens were strengthened with CFRP sheets, CFRP plates and NSM CFRP rods embedded in two filling materials: epoxy resin and mortar. Then, they were exposed to up to 300 freeze–thaw cycles. One freeze–thaw cycle consisted of four stages according to ASTM or immersed in 3.5% salted tap water. A total of thirty-six specimens were prepared for this purpose. Results showed a decrease in ultimate bond strength for specimens strengthened by CFRP sheets that were immersed in salt water for 120 days, while a reduction was shown for CFRP sheet and plate bonded specimens that were subjected to 300 freeze–thaw cycles. Exposing NSM CFRP rod strengthened specimens, embedded in resin or mortar, to freeze–thaw cycles or to immersion in salt water does not affect the bond strength.

Keywords: durability, strengthening, FRP, bond, freeze–thaw

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Authors: Anca-Diana Bibiri, Mihaela Mocanu, Adrian Turculeț

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In a language the inventory of greetings is dynamic with frequent input and output, although this is hardly noticed by the speakers. In this register, there are a number of constant, conservative elements that survive different language models (among them, the classic formulae: bună ziua! (good afternoon!), bună seara! (good evening!), noapte bună! (good night!), la revedere! (goodbye!) and a number of items that fail to pass the test of time, according to language use at a time (ciao!, pa!, bai!). The source of innovation depends both of internal factors (contraction, conversion, combination of classic formulae of greetings), and of external ones (borrowings and calques). Their use imposes their frequencies at once, namely the elimination of the use of others. This paper presents a sociolinguistic approach of contemporary Romanian greetings, based on prosodic surveys in two research projects: AMPRom, and SoRoEs. Romanian language presents a rich inventory of questions (especially partial interrogatives questions/WH-Q) which are used as greetings, alone or, more commonly accompanying a proper greeting. The representative of the typical formulae is Ce mai faci? (How are you?), which, unlike its English counterpart How do you do?, has not become a stereotype, but retains an obvious emotional impact, while serving as a mark of sociolinguistic group. The analyzed corpus consists of structures containing greetings recorded in the main Romanian cultural (urban) centers. From the methodological point of view, the acoustic analysis of the recorded data is performed using software tools (GoldWave, Praat), identifying intonation patterns related to three sociolinguistics variables: age, sex and level of education. The intonation patterns of the analyzed statements are at the interface between partial questions and typical greetings.

Keywords: acoustic analysis, greetings, Romanian language, sociolinguistics

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Authors: Goutom K. Pall

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At the very heart of the power system, power transmission (PT) acts as an essential link between power generation and distribution. Timely completion of PT infrastructures is therefore crucial to support the development of power system as a whole. Yet despite the importance, studies on PT infrastructure development projects are embryonic and, hence, PT projects undergoing widespread delays worldwide. These delay factors are idiosyncratic and identifying the critical delay factors is essential if the PT industry professionals are to complete their projects efficiently and within the expected timeframes. This study identifies and categorizes 46 causes of PT project delay under ten major groups using six sector expert’s recommendations studied by a preliminary questionnaire survey. Based on the experts’ strong recommendations, two new groups are introduced in the final questionnaire survey: sector specific factors (SSF) and general factors (GF). SSF pertain to delay factors applicable only to the PT projects, while GF represents less biased samples with shared responsibilities of all project parties involved in a project. The study then uses 112 data samples from the contractors to rank the delay factors using relative importance index (RII). The results reveal that SSF, GF and external factors are the most critical groups, while the highest ranked delay factors include the right of way (RoW) problems of transmission lines (TL), delay in payments, frequent changes in TL routes, poor communication and coordination among the project parties and accessibility to TL tower locations. Finally, recommendations are made to minimize the identified delay. The findings are expected to be of substantial benefit to professionals in minimizing time overrun in PT projects implementation, as well as power generation, power distribution, and non-power linear construction projects worldwide.

Keywords: delay, project delay, power transmission projects, time-overruns

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