Search results for: local complications

Authors: Kreetha Thumcharoensathit

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The purpose of the analysis of Thai Arts and Culture which concerning the formation of Thai identity letter font designed is to identify The Aumphawa local community identity so as to select the suitable letter font which can applicable to the computer software usage. The populated survey was from the group of local people who live in Aumphawa sub-district. The methodological is cluster sampling from 100 surveyed, those 50 were from people who have household registration done in Aumphawa sub-district and other from people who live outside. In order to analyze and design the Thai identity letter font computer software designed for both Thai and English language version, the analysis had been completed by compiling of document and field survey from local people’s opinion on their Arts and Culture identity. The out-put will be submitted to the experts for evaluation.

Keywords: Thai arts, design, font, identity

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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Authors: Deddi Nordiawan

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Effective public policy creation required a strong budget system, both in terms of design and implementation. Performance-based Budget is an evolutionary approach with two substantial characteristics; first, the strong integration between budgeting and planning, and second, its existence as guidance so that all activities and expenditures refer to measurable performance targets. There are four processes in the government that should be followed in order to make the budget become performance-based. These four processes consist of the preparation of a vision according to the bold aspiration, the formulation of outcome, the determination of output based on the analysis of organizational resources, and the formulation of Value Creation Map that contains a series of programs and activities. This is consistent with the concept of logic model which revealed that the budget performance should be placed within a relational framework of resources, activities, outputs, outcomes and impacts. Through the issuance of Law 17/2003 regarding State Finance, local governments in Indonesia have to implement performance-based budget. Central Government then issued Government Regulation 58/2005 which contains the detail guidelines how to prepare local governments budget. After a decade, implementation of performance budgeting in local government is still not fully meet expectations, though the guidance is completed, socialization routinely performed, and trainings have also been carried out at all levels. Accordingly, this study views the practice of performance-based budget at local governments as a problematic situation. This condition must be approached with a system approach that allows the solutions from many point of views. Based on the fact that the infrastructure of budgeting has already settled, the study then considering the situation as complexity. Therefore, the intervention needs to be done in the area of human activity system. Using Soft Systems Methodology, this research will reconstruct the process of performance-based budget at local governments is area of human activity system. Through conceptual models, this study will invite all actors (central government, local government, and the parliament) for dialogue and formulate interventions in human activity systems that systematically desirable and culturally feasible. The result will direct central government in revise the guidance to local government budgeting process as well as a reference to build the capacity building strategy.

Keywords: soft systems methodology, performance-based budgeting, Indonesia, public policy

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Authors: Nithipattara Balsiri

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The purposes of this research was to develop instructional model by using research-based learning enhancing critical thinking, cognitive skills, and culture and local wisdom knowledge of undergraduate students. The sample consisted of 307 undergraduate students. Critical thinking and cognitive skills test were employed for data collection. Second-order confirmatory factor analysis, t-test, and one-way analysis of variance were employed for data analysis using SPSS and LISREL programs. The major research results were as follows; 1) the instructional model by using research-based learning enhancing critical thinking, cognitive skills, and culture and local wisdom knowledge should be consists of 6 sequential steps, namely (1) the setting research problem (2) the setting research hypothesis (3) the data collection (4) the data analysis (5) the research result conclusion (6) the application for problem solving, and 2) after the treatment undergraduate students possessed a higher scores in critical thinking and cognitive skills than before treatment at the 0.05 level of significance.

Keywords: critical thinking, cognitive skills, culture and local wisdom knowledge

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Authors: Saad Bougrine, Salma Ouchraa, Belaid Ahiod, Abdelhakim Ameur El Imrani

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Ant colony optimization is an ant algorithm framework that took inspiration from foraging behaviour of ant colonies. Indeed, ACO algorithms use a chemical communication, represented by pheromone trails, to build good solutions. However, ants involve different communication channels to interact. Thus, this paper introduces the acoustic communication between ants while they are foraging. This process allows fine and local exploration of search space and permits optimal solution to be improved.

Keywords: acoustic communication, ant colony optimization, local search, traveling salesman problem

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Authors: Joselyne Rugema, Innocent Twagirayezu, Aimable Nkurunziza, Alice Nyirazigama, Vedaste Bagweneza, Belancilla Nikuze

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Introduction: Burn injuries among children are associated with major complications. Early health care seeking and appropriate management are crucial in saving lives and preventing complications. Objective: To assess home-based management practices and health seeking behaviors among caregivers of children admitted with burn injuries at selected hospitals in Rwanda. Methods: A cross-sectional descriptive study was conducted among caregivers of children admitted with burn injuries at three hospitals in Kigali. A semi-structured questionnaire was used to collect the data that were analyzed using SPSS version 25. Statistical software Results: Most of the children with burn injuries had median age of 36 months, and 89.9% had second-degree burns. 92.4% of burns happened at home and 63.3% were scalds. Only 18% of the caregivers seek care immediately after children’s burn injuries. About 2.5% reported not seeking any care after burn injuries and 3.8% sought care from traditional healers. 65.9% of the participants used wrong practices before seeking care such as applying honey, cooking oil and urine to the burn injuries. Transportation difficulties before consulting health facilities were the main reported faced barriers to success health care (86.1%). Conclusion: Immediate health seeking behavior was low. Wrong practices including application of harmful products to burn injuries are common in the community. There is a need for community based interventions to prevent burn injuries at home and to empower the community with appropriate actions to take after injuries.

Keywords: adolescent pregnancy, qualitative design, childbearing, teenage mothers

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Authors: Somayeh Khanjani, Samaneh Nabavi, Shirin Jalili

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Aluminum phosphide (ALP) is an inorganic phosphide used to control insects and is a highly effective insecticide and rodenticide used frequently to protect stored grain. Acute poisoning with this compound is common in some countries including India and Iran, and is a serious health problem. In Iran it was known as "rice tablet", for its use to preserve rice. Two kinds of rice tablets one being herbal while other containing 3g aluminum phosphide (AlP) are available for use in Iranian households to protect stored food grains from pests and rodents. The toxicity of Aluminum phosphide is attributed to the liberation of phosphine gas in contact with water or weak acid and is the major cause of poisoning and deaths. Rice tablet (Aluminum Phosphid) poisoning may be associated with serious and sometimes incurable complications. In 61.3% of patients were shown uniform ingestion. Vomiting was the most common symptoms reported by 96.4% patients. Agitation was reported in 36.9% and felling of thirsty in 27.9 %. Although many complications such as Hypotension, Adult Respiratory Distress Syndrome (ARDS), Acute Renal Failure (ARF) AND Multi Organ Failure (MOF) were the common complications observed in these patients, but the most lethal complication was Cardiac Arrhythmias occurred in 36.9% of cases. Abdominal pain in 31.4% of the patients, nausea in 79.4% of the patients and 41.1% of the patients showed metabolic acidosis. Suicidal intention was the most common cause of poisoning leading to deaths in 18.6% of the patients. Aluminum phosphide can cause either elevation, decrease or no change in electrolytes, bicarbonate and blood glucose level. The possible mechanism for changes in blood glucose levels are complex and depend on the balance of factors which increase its concentration and those which reduce it. AlP poisoning has been postulated to stimulate cortisol which leads to increasing blood level of cortisol, also it may cause stimulation of glucagon, and Adrenaline secretion; in addition, it can inhibit insulin synthesis which may lead to hyperglycemia. Another suggested mechanism of hyperglycemia is rennin activity in some cases, an increase in magnesium level of plasma and that of tissues, and high phosphate level. Although hyperglycemia is most frequent in this poisoning and also is known as a marker of poor prognostic, hypoglycemia in aluminum phosphide poisoning is a rare finding which may be so dangerous. Patients showed sever hypotension and sever acidosis in addition to sever hypoglycemia. The presenting features of AlP intoxication are rapid onset of shock, severe metabolic acidosis, cardiac dysrhythmias and adult respiratory distress syndrome (ARDS).

Keywords: aluminum phosphide (ALP), rice tablet, poisoning, phosphine gas

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Authors: Cheng-Lung Yu, Ying-His Liao

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Some evidence show that public art accelerates local economic growth. Even local governments award the collaboration of public-private partnership to sustain the creation of public art for urban economic development. Through the public-private partnership of public art establishment it is obvious that public construction projects have been led by the governmental policy yet the private developers have played crucial roles to drive the innovative business models such as tourism investment, real estate value up and community participation. This study shows that the types of collaboration have been driven by Taichung city governmental policy from the regulation of public art establishment in the past three years. Through some cases empirical analyzes the authors discover the trends concerning the public art development to support local economic growth in Taiwan.

Keywords: public art, public art establishment regulation, construction management, urban governance

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Authors: Mina Henneb, Rafik Belabbas, Safia Zenia

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The objective of this study was to determine the prevalence and to identify the risk factors of Eimeria spp. and Giardia spp. infection in rabbits from the local population of four localities in northern Algeria. Dung samples were collected from 16 farms, totalling 111 rabbits, and were analysed by the flotation method. Additional, data regarding the farms and management practices were obtained by means of a questionnaire used in the surveys and interviews. The results revealed that the prevalence of Eimerias pp. contamination was 68.75% (11/16) for farms and 58.56% (65/111) for rabbits, respectively. The prevalence of Giardia spp. was respectively 56.25% (9/16) for farms and 11.7% (13/111) for rabbits. The analyses showed that the prevalence of Eimeria spp. was significantly higher in the farms that did not comply with hygiene and non-conventional feeding and watering. However, the prevalence of Giardia spp. was significant in rabbits kept in poor conditions of rearing. In conclusion, this study showed that the prevalence of these two parasites in rabbits from the local population is relevant and may have important implications for the rabbit industry and public health, especially in rural areas.

Keywords: Algeria, digestive parasites, prevalence, rabbits, risk factors

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Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

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Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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Authors: Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O Saleh, Manal Badawi

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Background: Diabetes is a metabolic disease that affects a wide range of people worldwide and results in serious complications. Streptozotocin (STZ) causes selective cytotoxicity in the pancreatic β-cell, and it has been extensively used to induce diabetes mellitus in rats. The present study investigated the effects of diosmin and chrysin alone or in combination with each other on glucose level and on liver in STZ diabetic rats. Methods: In this study, rats were divided into six experimental groups (normal, untreated STZ-diabetic (60 mg/kg B.W., IP), treated STZ-diabetic with glycazide (10 mg/kg B.W, oral), treated STZ-diabetic with diosmin (100 mg/kg B. W., oral), treated STZ-diabetic with chrysin (80 mg/kg B.W., oral), treated STZ-diabetic with diosmin (50 mg/kg B.W, oral) + chrysin (40 mg/kg B.W., oral). After 2 weeks blood samples were withdrawn and glucose was measured. Animals were anaesthetized with an intraperitoneal injection of sodium pentobarbital (60 mg/kg), and sacrificed for dissecting liver. Results: Throughout the experimental period, all treatments significantly (P<0.05) lowered serum glucose, AST, ALT, triglyceride, cholesterol, IL-6, TNF-α and IL-1β. Moreover, the treated diabetic rats showed higher levels of reduced glutathione (P<0.05) in the liver compared to the diabetic control rats and inhibited diabetes-induced elevation in the levels of malondialdehyde in liver. The results of this study clearly demonstrated that diosmin and chrysin possess several treatment-oriented properties, including the control of hyperglycemia, antioxidant effects and anti-inflammatory effects. Conclusion: Considering these observations, it appears that diosmin and chrysin may be a useful supplement to delay the developmentof diabetes and its complications.

Keywords: diabetes, streptozocin, chrysin, rat, diosmin, cytokines

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Bing-Shun Huang, Hung-Ju Chiu, Wen-Kai Hsieh, Hsiu-Chuan Lin, Ming-Lung Hung

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Taiwan's solar photovoltaic target in 2025 is 20 GW, of which the fish-electricity symbiosis target is 4 GW. In the future, many solar photovoltaic installations may cause local environmental or social impacts. Therefore, the Taiwan government inspects the fish-electricity symbiosis to reduce the impact of solar photovoltaics on the local environment or society. This stuy takes the symbiosis of fishery and electricity in Kaohsiung City as an example to explore Taiwan's environmental and social inspection practices. It mainly analyzes the two aspects of environmental ecology and social economy. The results show that the environmental inspection is mainly through site surveys, ecological information mapping, on-site interviews, and public consultation meetings. Social inspection mainly includes document analysis, on-site interviews, site surveys, expert discussions, and public consultations to identify possible local problems. Although the government had recognized the local issues, the future status may also change. It is recommended that future photoelectric companies should reconfirm the current situation of development sites when applying for the installation and propose countermeasures to solve the problem.

Keywords: taiwan, fish-electricity symbiosis, environment, society, inspection

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Authors: Pornnapat Berndt

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The purpose of this research is to study the tourism routes in Bangnoi Floating Market, Bangkhontee District, Samut Songkhram province, Thailand in order to create type and form of interpretation to promote cultural tourism based on local community and visitor requirement. To accomplish the goals and objectives, qualitative research will be applied. The research instruments used are observation, questionnaires, basic interviews, in-depth interviews, focus group, interviewed of key local informants including site visitors. The study also uses both primary data and secondary data. A Statistical Package for Social Sciences (SPSS) was used to analyze the data. Descriptive and inferential statistics such as tables, percentage, mean and standard deviation were used for data analysis and summary. From research result, it is revealed that the local community requirement on types of interpretation conforms to visitors require which need guide post, guide book, etc. with up to date and informally content to present Bangnoi Floating Market which got the most demand score (3.78) considered as most wanted demand.

Keywords: interpretation, cultural tourism, tourism route, local community, stakeholders participated

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Authors: Nemat Mohammadi, Yuki Nakayama

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After occurring Great East Japan earthquake and as a consequence the invasion of an extremely large Tsunami to the city, obligated many local governments to take into account certainly these kinds of issues. Poor preparation of local governments to deal with such kinds of disasters at that time and consequently lack of assistance delivery for local residents caused thousands of civilian casualties as well as billion dollars of economic damages. Those local governments who are responsible for governing such coastal areas, have to consider some countermeasures to deal with these natural disasters, prepare a comprehensive evacuation plan and contrive some feasible emergency plans for the purpose of victims’ reduction as much as possible. Under this evacuation plan, the local government should contemplate more about the traffic congestion during wide-area evacuation operation and estimate the minimum essential time to evacuate the whole city completely. This challenge will become more complicated for the government when the people who are affected by disasters are not only limited to the normal informed citizens but also some pregnant women, physically handicapped persons, old age citizens and foreigners or tourists who are not familiar with that conditions as well as local language are involved. The important issue to deal with this challenge is that how to inform these people to take a proper action right away noticing the Tsunami is coming. After overcoming this problem, next significant challenge is even more considerable. Next challenge is to evacuate the whole residents in a short period of time from the threated area to the safer shelters. In fact, most of the citizens will use their own vehicles to evacuate to the designed shelters and some of them will use the shuttle buses which are provided by local governments. The problem will arise when all residents want to escape from the threated area simultaneously and consequently creating a traffic jam on evacuation routes which will cause to prolong the evacuation time. Hence, this research mostly aims to calculate the minimum essential time to evacuate each region inside the threated area and find the evacuation start point for each region separately. This result will help the local government to visualize the situations and conditions during disasters and assist them to reduce the possible traffic jam on evacuation routes and consequently suggesting a comprehensive wide-area evacuation plan during natural disasters.

Keywords: BPR formula, disaster scenarios, evacuation completion time, wide-area evacuation

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Authors: A. N. Roslen, S. A. Syed-Sahil, A. Musavir

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In Malaysia, there are only few fashion designers who are inspired by the work of artists when creating their collections. The researchers confirmed this statement by interviewing fashion experts in Malaysia. The objectives of this study are to: 1. Investigate the acceptance of fashion inspired by the work of art among consumers. 2. Encourage more designers to use work of art as their inspirations. 3. Promote Malaysian Artists through fashion. Thus, the researchers interviewed Malaysian fashion designers, image consultants, and one famous Malaysian Artist (Awang Damit). All of them had agreed that the fashion inspired by the work of art in Malaysia has a long way to go. Therefore, the researchers’ aim is to attract more fashion designers to use the work of local artists in their creations. The researchers had used interview, survey and experimentation as methods of this study. In the experimentation procedure, paintings of local artist, Awang Damit was used as a source of inspiration in creating a design Line. The result of this study had shown that fashion inspired by work of art is acknowledged and accepted by the designers and consumers.

Keywords: art, fashion, inspiration, local artist

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Authors: Jason Hoellwarth, Atiya Oomatia, Anuj Chavan, Kevin Tetsworth, Munjed Al Muderis

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Introduction: Percutaneous EndoProsthetic Osseointegration for Limbs (PEPOL) facilitates improved quality of life (QOL) and objective mobility for most amputees discontent with their traditional socket prosthesis (TSP) experience. Some amputees desiring PEPOL have residual bone much shorter than the currently marketed press-fit implant lengths of 14-16 cm, potentially a risk for failure to integrate. We report on the techniques used, complications experienced, the management of those complications, and the overall mobility outcomes of seven patients who had femur distraction osteogenesis (DO) with a Freedom nail followed by PEPOL. Method: Retrospective evaluation of a prospectively maintained database identified nine patients (5 females) who had transfemoral DO in preparation for PEPOL with two years of follow-up after PEPOL. Six patients had traumatic causes of amputation, one had perinatal complications, one was performed to manage necrotizing fasciitis and one was performed as a result of osteosarcoma. Result: The average age at which DO commenced was 39.4±15.9 years, and seven patients had their amputation more than ten years prior (average 25.5±18.8 years). The residual femurs, on average, started at 102.2±39.7 mm and were lengthened 58.1±20.7 mm, 98±45% of the goal (99±161% of the original bone length). Five patients (56%) had a complication requiring additional surgery: four events of inadequate regeneration were managed with continued lengthening to the desired goal followed by autograft placement harvested from contralateral femur reaming; one patient had the cerclage wires break, which required operative replacement. All patients had osseointegration performed at 355±123 days after the initial lengthening nail surgery. One patient had K-level >2 before DO, at a mean of 3.4±0.6 (2.6-4.4) years following osseointegration. Six patients had K-level >2. The 6-Minute Walk Test remained unchanged (267±56 vs. 308 ± 117 meters). Patient self-rating of prosthesis function, problems, and amputee situation did not significantly change from before DO to after osseointegration. Six patients required additional surgery following osseointegration: six to remove fixation plates placed to maintain distraction osteogenesis length at osseointegration; two required irritation and debridement for infection. Conclusion: Extremely short residual femurs, which make TSP use troublesome, can be lengthened with externally controlled telescoping nails and successfully achieve osseointegration. However, it is imperative to counsel patients that additional surgery to address inadequate regeneration or to remove painful hardware used to maintain fixation may be necessary. This may improve the amputee’s expectations before beginning a potentially arduous process.

Keywords: osseointegration, limb lengthening, quality of life, amputation

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Authors: Levente Varga, Dávid Deritei, Mária Ercsey-Ravasz, Răzvan Florian, Zsolt I. Lázár, István Papp, Ferenc Járai-Szabó

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One of the major shortcomings of widely used scientometric indicators is that different disciplines cannot be compared with each other. The issue of cross-disciplinary normalization has been long discussed, but even the classification of publications into scientific domains poses problems. Structural properties of citation networks offer new possibilities, however, the large size and constant growth of these networks asks for precaution. Here we present a new tool that in order to perform cross-field normalization of scientometric indicators of individual publications relays on the structural properties of citation networks. Due to the large size of the networks, a systematic procedure for identifying scientific domains based on a local community detection algorithm is proposed. The algorithm is tested with different benchmark and real-world networks. Then, by the use of this algorithm, the mechanism of the scientometric indicator normalization process is shown for a few indicators like the citation number, P-index and a local version of the PageRank indicator. The fat-tail trend of the article indicator distribution enables us to successfully perform the indicator normalization process.

Keywords: citation networks, cross-field normalization, local cluster detection, scientometric indicators

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Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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Authors: Lilian Kishimbo

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This study aims to examine Corporate Social Responsibility (CSR) practices of local large firms of East Africa region. In this study CSR is defined as all actions that go beyond obeying minimum legal requirements as espoused by other authors. Despite the increase of CSR literature empirical evidence clearly demonstrate an imbalance of CSR studies in the developing countries . Moreover, it is evident that most of the research on CSR in developing economies emerges from large fast-growing economies or BRICS members (i.e. Brazil, India, China and South Africa), and Indonesia and Malaysia and a further call for more research in Africa is particularly advocated. Taking Africa as an example, there are scanty researches on CSR practices, and the few available studies are mainly from Nigeria and South Africa leaving other parts of Africa for example East Africa underrepresented. Furthermore, in the face of globalization, experience shows that literature has focused mostly on multinational companies (MNCs) operating in either North-North or North-South and less on South-South indigenous local firms. Thus the existing literature in Africa shows more studies of MNCs and little is known about CSR of local indigenous firms operating in the South particularly in the East Africa region. Accordingly, this paper explores CSR practices of indigenous local large firms of East Africa region particularly Kenya and Tanzania with the aim of testing the hypothesis that do local firms of East Africa region engage in similar CSR practices as firms in other parts of the world?. To answer this question only listed local large firms were considered based on the assumption that they are large enough to engage. Newspapers were the main source of data and information collected was supplemented by business Annual Reports for the period 2010-2012. The research finding revealed that local firms of East Africa engage in CSR practices. However, there are some differences in the set of activities these firms prefers to engage in compared to findings from previous studies. As such some CSR that were given priority by firms in East Africa were less prioritized in the other part of the world including Indonesia. This paper will add knowledge to the body of CSR and experience of CSR practices of South-South indigenous firms where is evidenced to have a relative dearth of literature on CSR. Finally, the paper concludes that local firms of East Africa region engage in similar activities like other firms globally. But firms give more priority to some activities such education and health related activities. Finally, the study intends to assist policy makers at firm’s levels to plan for long lasting projects related to CSR for their stakeholders.

Keywords: Africa, corporate social responsibility, developing countries, indigenous firms, Kenya, Tanzania

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Authors: Kingkan Chumjamras

Abstract:

There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Luedech Girdwichai, Witthaya Mekhum

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This research analyses the factors affecting the success and develops a guideline for self- reliance planning of the entrepreneurs for effective implementation. Samples in this study included 42 awarded winners from the 2nd Sufficiency Economics Philosophy (SEP) National Contest arranged by Office of the Royal Development Projects Board. The results revealed 4 main factors affecting the success as follows: 1) there is a need to encourage unity and cooperation in the enterprise in conducting development plan. 2) The entrepreneur must be a knowledge seeker and lead by example on SEP life. 3) The entrepreneur must be able to apply traditional local wisdom with his present experience and knowledge in defining product identity. 4) The entrepreneur should provide career training for the staffs to develop their competencies. The guideline for self-reliance planning consisted of 4 aspects: 1) Human resource development: the enterprise should develop its staffs especially on integrity, honesty, and public minded. 2) Local community development: there should be a clear target for the local community development. 3) Local community economic development: by encouraging additional incomes through experience sharing. 4) Enterprise development planning: by arranging monthly meeting to conduct the development plan including analysing problems and synthesizing data.

Keywords: potential development, SME entrepreneurs, sufficiency economics philosophy, finance, management

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Authors: Beulah Rani Inbanathan

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In the present era, it is vivid from the numerous outcomes that data privacy is being compromised in various ways. Machine learning is one technology that uses the centralized server, and then data is given as input which is being analyzed by the algorithms present on this mentioned server, and hence outputs are predicted. However, each time the data must be sent by the user as the algorithm will analyze the input data in order to predict the output, which is prone to threats. The solution to overcome this issue is federated learning, where the models alone get updated while the data resides on the local machine and does not get exchanged with the other local models. Nevertheless, even on these local models, there are chances of data poisoning, and it is crystal clear from various experiments done by many people. This paper delves into many ways where data poisoning occurs and the many methods through which it is prevalent that data poisoning still exists. It includes the poisoning attacks on IoT devices, Edge devices, Autoregressive model, and also, on Industrial IoT systems and also, few points on how these could be evadible in order to protect our data which is personal, or sensitive, or harmful when exposed.

Keywords: data poisoning, federated learning, Internet of Things, edge computing

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Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

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Authors: Alexandru Achim, Tamás Szűcsborus, Viktor Sasi, Ferenc Nagy, Zoltán Jambrik, Attila Nemes, Albert Varga, Călin Homorodean, Olivier F. Bertrand, Zoltán Ruzsa

Abstract:

Aim: Our study aimed to establish the safety and the technical success of distal radial access for balloon aortic valvuloplasty (DR-BAV). The secondary objective was to determine the effectiveness and appropriate role of DR-BAV within half year follow-up. Methods: Clinical and angiographic data from 32 consecutive patients with symptomatic aortic stenosis were evaluated in a prospective pilot single-center study. Between 2020 and 2021, the patients were treated utilizing dual distal radial access with 6-10F compatible balloons. The efficacy endpoint was divided into technical success (successful valvuloplasty balloon inflation at the aortic valve and absence of intra- or periprocedural major complications), hemodynamic success (a reduction of the mean invasive gradient >30%), and clinical success (an improvement of at least one clinical category in the NYHA classification). The safety endpoints were vascular complications (major and minor Valve Academic Research Consortium (VARC)-2 bleeding, diminished or lost arterial pulse or the presence of any pseudo-aneurysm or arteriovenous fistula during the clinical follow-up) and major adverse events, MAEs (the composite of death, stroke, myocardial infarction, and urgent major aortic valve replacement or implantation during the hospital stay and or at one-month follow-up). Results: 32 patients (40 % male, mean age 80 ± 8,5) with severe aortic valve stenosis were included in the study and 4 patients were excluded. Technical success was achieved in all patients (100%). Hemodynamic success was achieved in 30 patients (93,75%). Invasive max and mean gradients were reduced from 73±22 mm Hg and 49±22 mm Hg to 49±19 mm Hg and 20±13 mm Hg, respectively (p = <.001). Clinical success was achieved in 29 patients (90,6%). In total, no major adverse cardiac or cerebrovascular event nor vascular complications (according to VARC 2 criteria) occurred during the intervention. All-cause death at 6 months was 12%. Conclusion: According to our study, dual distal radial artery access is a safe and effective option for balloon aortic valvuloplasty in patients with severe aortic valve stenosis and can be performed in all patients with sufficient lumen diameter. Future randomized studies are warranted to investigate whether this technique is superior to other approaches.

Keywords: mean invasive gradient, distal radial access for balloon aortic valvuloplasty (DR-BAV), aortic valve stenosis, pseudo-aneurysm, arteriovenous fistula, valve academic research consortium (VARC)-2

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Authors: Hussin K. Ragb, Vijayan K. Asari

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In this paper, we present a pedestrian detection descriptor called Fused Structure and Texture (FST) features based on the combination of the local phase information with the texture features. Since the phase of the signal conveys more structural information than the magnitude, the phase congruency concept is used to capture the structural features. On the other hand, the Center-Symmetric Local Binary Pattern (CSLBP) approach is used to capture the texture information of the image. The dimension less quantity of the phase congruency and the robustness of the CSLBP operator on the flat images, as well as the blur and illumination changes, lead the proposed descriptor to be more robust and less sensitive to the light variations. The proposed descriptor can be formed by extracting the phase congruency and the CSLBP values of each pixel of the image with respect to its neighborhood. The histogram of the oriented phase and the histogram of the CSLBP values for the local regions in the image are computed and concatenated to construct the FST descriptor. Several experiments were conducted on INRIA and the low resolution DaimlerChrysler datasets to evaluate the detection performance of the pedestrian detection system that is based on the FST descriptor. A linear Support Vector Machine (SVM) is used to train the pedestrian classifier. These experiments showed that the proposed FST descriptor has better detection performance over a set of state of the art feature extraction methodologies.

Keywords: pedestrian detection, phase congruency, local phase, LBP features, CSLBP features, FST descriptor

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Authors: Kedar Nath Nepal, Tek Bahadur Thapa, David Guerena;

Abstract:

The community participation is central to the in-situ project objectives, as farming communities are key stakeholders in the on-farm conservation of agricultural bio- diversity. Besides technical means to adding benefits, the complimentary strategy includes creating market-based value adding measures by increasing users’ awareness of the value of traditional foods and nutritional values; exhibitions and improved processing; and policy incentives. This paper presents various participatory activities carried out in Nepal as options for enhancing benefits to local communities by increased utilization of local crop diversity on -the farm through non-breeding discussed, and outcomes are documented using farmers’ perception data and secondary information. The paper focuses on three major areas of public awareness, market incentives and non-market incentives that may enhance on -farm conservation and use of biodiversity.

Keywords: biodiversity, in-situ, market-based, non-market

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Authors: Constanza Monterrubio-Solis, Jose Tomas Ibarra

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The fertile interdependence of social-ecological systems reveals itself in the interactions between native forests and seeds, home gardens, kitchens, foraging activities, local knowledge, and food practices, creating particular flavors and food meanings as part of cultural identities within territories. Resilience in local-food systems, from a relational perspective, can be understood as the balance between persistence and adaptability to change. Food growing, preparation, and consumption are constantly changing and adapting as expressions of agency of female and male indigenous peoples and peasants. This paper explores local food systems’ expressions of resilience in the la Araucanía region of Chile, namely: diversity, redundancy, buffer capacity, modularity, self-organization, governance, learning, equity, and decision-making. Applying ethnographic research methods (participant observation, focus groups, and semi-structured interviews), this work reflects on the experience developed through work with Mapuche women cultivating home gardens in the region since 2012; it looks to material and symbolic elements of resilience in the local indigenous food systems. Local food systems show indeed indicators of social-ecological resilience. The biocultural memory is expressed in affection to particular flavors and recipes, the cultural importance of seeds and reciprocity networks, as well as an accurate knowledge about the indicators of the seasons and weather, which have allowed local food systems to thrive with a strong cultural foundation. Furthermore, these elements turn into biocultural resistance in the face of the current institutional pressures for rural specialization, processes of cultural assimilation such as agroecosystems and diet homogenization, as well as structural threats towards the diversity and freedom of native seeds. Thus, the resilience-resistance dynamic shown by the social-ecological systems of the southern Andes is daily expressed in the local food systems and flavors and is key for diverse and culturally sound social-ecological health.

Keywords: biocultural heritage, indigenous food systems, social-ecological resilience, southern Andes

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Authors: Arun C. Gulani, Aaishwariya A. Gulani, Amanda Southall

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Background: Laser Corneoplastique™ as a least interventional, visually promising technique for patients with vision disability from corneal scars of varied causes has been retrospectively reviewed and proves to cause a paradigm shift in mindset and approach towards corneal scars as a Refractive surgery aiming for emmetropic, unaided vision of 20;/20 in most cases. Three decades of work on this technique has been compiled in this 15-year study. Subject and Methods: The objective of this study was to determine the success of Laser Corneoplastique™ surgery as a treatment of corneal scar cases. A survey of corneal scar cases caused by various medical histories that had undergone Laser Corneoplastique™ surgery over the past twenty years by a single surgeon Arun C. Gulani, M.D. were retrospectively reviewed. The details of each of the cases were retrieved from their medical records and analyzed. Each patient had been examined thoroughly at their preoperative appointments for stability of refraction and vision, depth of scar, pachymetry, topography, pattern of the scar and uncorrected and best corrected vision potential, which were all taken into account in the patients' treatment plans. Results: 64 eyes of 53 patients were investigated for scar etiology, keratometry, visual acuity, and complications. There were 25 different etiologies seen, with the most common being a Herpetic scar. The average visual acuity post-op was, on average, 20/23.55 (±7.05). Laser parameters used were depth and pulses. Overall, the mean Laser ablation depth was 30.67 (±19.05), ranging from 2 to 73 µm. Number of Laser pulses averaged 191.85 (±112.02). Conclusion: Refractive Laser Corneoplastique™ surgery, when practiced as an art, can address all levels of ametropia while reversing complex corneas and scars from refractive surgery complications back to 20/20 vision.

Keywords: corneal scar, refractive surgery, corneal transplant, laser corneoplastique

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Authors: Jaan Lellep, Shahid Mubasshar

Abstract:

A numerical solution is developed for simply supported nanoarches based on the non-local theory of elasticity. The nanoarch under consideration has a step-wise variable cross-section and is weakened by crack-like defects. It is assumed that the cracks are stationary and the mechanical behaviour of the nanoarch can be modeled by Eringen’s non-local theory of elasticity. The physical and thermal properties are sensitive with respect to changes of dimensions in the nano level. The classical theory of elasticity is unable to describe such changes in material properties. This is because, during the development of the classical theory of elasticity, the speculation of molecular objects was avoided. Therefore, the non-local theory of elasticity is applied to study the vibration of nanostructures and it has been accepted by many researchers. In the non-local theory of elasticity, it is assumed that the stress state of the body at a given point depends on the stress state of each point of the structure. However, within the classical theory of elasticity, the stress state of the body depends only on the given point. The system of main equations consists of equilibrium equations, geometrical relations and constitutive equations with boundary and intermediate conditions. The system of equations is solved by using the method of separation of variables. Consequently, the governing differential equations are converted into a system of algebraic equations whose solution exists if the determinant of the coefficients of the matrix vanishes. The influence of cracks and steps on the natural vibration of the nanoarches is prescribed with the aid of additional local compliance at the weakened cross-section. An algorithm to determine the eigenfrequencies of the nanoarches is developed with the help of computer software. The effects of various physical and geometrical parameters are recorded and drawn graphically.

Keywords: crack, nanoarches, natural frequency, step

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