Search results for: preoperative geriatric scores

Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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Authors: Gianella Franco, Karen Suarez, María Quijano, Patricia Manzano

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Agro-industries generate large amounts of waste, which are mostly untapped. This research was carried out to use cocoa, coffee and orange industrial by-products to develop a dairy drink. The product was prepared by making a 10% aqueous extract of the mixture of cocoa and coffee beans shells and orange peel. Extreme Vertices Mixture Design was applied to vary the proportions of the ingredients of the aqueous extract, getting 13 formulations. Each formulation was mixed with skim milk and pasteurized. The attributes of taste, smell, color and appearance were evaluated by a semi-trained panel by multiple comparisons test, comparing the formulations against a standard marked as "R", which consisted of a coffee commercial drink. The formulations with the highest scores were selected to maximize the Total Polyphenol Content (TPC) through a process of linear optimization resulting in the formulation 80.5%: 18.37%: 1.13% of cocoa bean shell, coffee bean shell and orange peel, respectively. The Total Polyphenol Content was 4.99 ± 0.34 mg GAE/g of drink, DPPH radical scavenging activity (%) was 80.14 ± 0.05 and caffeine concentration of 114.78 mg / L, while the coffee commercial drink presented 3.93 ± 0.84 mg GAE / g drink, 55.54 ± 0.03 % and 47.44 mg / L of TPC, DPPH radical scavenging activity and caffeine content, respectively. The results show that it is possible to prepare an antioxidant - rich drink with good sensorial attributes made of industrial by-products.

Keywords: DPPH, polyphenols, waste, food science

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Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

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Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

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Authors: A. Ashraff

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The increasing importance of the web as a medium for electronic and business transactions has served as a catalyst or rather a driving force for the introduction and implementation of recommender systems. Recommender Systems play a major role in processing and analyzing thousands of data rows or reviews and help humans make a purchase decision of a product or service. It also has the ability to predict whether a particular user would rate a product or service based on the user’s profile behavioral pattern. At present, Recommender Systems are being used extensively in every domain known to us. They are said to be ubiquitous. However, in the field of recruitment, it’s not being utilized exclusively. Recent statistics show an increase in staff turnover, which has negatively impacted the organization as well as the employee. The reasons being company culture, working flexibility (work from home opportunity), no learning advancements, and pay scale. Further investigations revealed that there are lacking guidance or support, which helps a job seeker find the company that will suit him best, and though there’s information available about companies, job seekers can’t read all the reviews by themselves and get an analytical decision. In this paper, we propose an approach to study the available review data on IT companies (score their reviews based on user review sentiments) and gather information on job seekers, which includes their Psychometric evaluations. Then presents the job seeker with useful information or rather outputs on which company is most suitable for the job seeker. The theoretical approach, Algorithmic approach and the importance of such a system will be discussed in this paper.

Keywords: psychometric tests, recommender systems, sentiment analysis, hybrid recommender systems

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Authors: Raymond Li

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In this project a web-based classroom response system (CRS) was used in the teaching an intermediate level economics course. This system allows the instructor to post a question on the screen and students to answer questions using their own electronic mobile devices. The questions and the results summarizing student responses can be shown to students simultaneously and the instructor can make timely feedback to students in class. CRS gives students a chance to respond to the instructor’s question privately, encouraging students who might not typically speak up in class to express their thoughts and opinions. There is a vast literature on the advantages and challenges of using CRS. However, empirical evidence on the student attributes that increase the effectiveness of CRS in improving student learning outcomes is sparse. The purpose of this project is to (1) find out if the use of CRS is beneficial to students taking economics, and (2) discover key student attributes that will likely make CRS more effective. Students’ performance in examinations and an end-of-semester questionnaire were used to assess the effectiveness of CRS in this project. Comparing the examination scores of the CRS treatment group and control group, the treatment group performed considerably better and statistically significant differences were found basing on paired t-tests on the differences. According to the questionnaire results, around 75% of the students in the treatment group generally agreed that CRS allowed them to express their views more freely. We also observed that students who prefer to use instant messaging rather than making conversations are generally more positive towards CRS. The use of CRS also benefits the instructor – students’ rating of the instructor in the teaching evaluation was significantly higher for the CRS treatment group.

Keywords: education technology, classroom response system, student attributes, economics education

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Authors: Claudia Patricia Beltran Miranda, Mónica López Anaya, Mónica Navarro Meza, Maria Leonor Valderrama Chairez

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Background: Mexico occupies the second world-wide place of morbid obese people (10- 12 million). Factors that predispose the development of MO are genetic, environmental, physiological, psycho-social and behavioral (nourishing habits). Objective: Associate Gln223Arg polymorphism of gene LEPR, levels of leptina and nourishing habits with the presence of morbid obesity in adolescents of the south of Jalisco (México). Methods: In 41 adolescents (18 normal weight and 23 morbid obesity) of 12 to 19 years of age, both sexes that were measure size and weight with tanita scale and stadimeter to determine IMC. Morbid obesity was determined by tables of the WHO and was established with a standard deviation >3. The Gln223Arg polymorphism have been identify by PCR and leptina levels by ELISA. Nourishing habits were evaluate by the questionnaire the Adolescent Food Habits Checklist. The statistical analysis was performed to compare mean scores obtained from the questionnaire when we compare morbid obesity vs. normal weight adolescents with p=0.03 and a significance of 95%. Results: frequencies alellics and genics were not stadistics significatives p= 0,011 and p=0,279 respectly when were compared between normal weight adolescents and morbib obesity Leptin levels and nourishing habits were associated with morbid obesity. The polymorphism not shown significance with morbid obesity. Conclusions: Dietary habits and leptin levels in adolescents are important factor that predisposes the development of obesity in adolescents. The presence of the polymorphism are not associated with morbid obesity in these subjects.

Keywords: leptin, nourishing habits, morbid obesity, polymorphism

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Authors: Rukminingsih Rukmi

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This paper addresses the issue of L2 teaching speaking to ESL students by fostering their active learning through project-based learning. Project-based learning was employed in classrooms where teachers support students by giving sufficient guidance and feedback. The students drive the inquiry, engage in research and discovery, and collaborate effectively with teammates to deliver the final work product. The teacher provides the initial direction and acts as a facilitator along the way. This learning approach is considered helpful for fostering students’ active learning. that the steps in implementing of project-based learning that fosters students’ critical thinking in TEFL class are in the following: (1) Discussing the materials about Speaking Class, (2) Working with the group to construct scenario of ways on speaking practice, (3) Practicing the scenario, (4) Recording the speaking practice into video, and (5) Evaluating the video product. This research is aimed to develop a strategy of teaching speaking by implementing project-based learning to improve speaking skill in the second Semester of English Department of STKIP PGRI Jombang. To achieve the purpose, the researcher conducted action research. The data of the study were gathered through the following instruments: test, observation checklists, and questionnaires. The result was indicated by the increase of students’ average speaking scores from 65 in the preliminary study, 73 in the first cycle, and 82 in the second cycle. Besides, the results of the study showed that project-based learning considered to be appropriate strategy to give students the same amount of chance in practicing their speaking skill and to pay attention in creating a learning situation.

Keywords: active learning, project-based learning, speaking ability, L2 teaching speaking

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Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background & Objectives: Audio-visual aids and computer-assisted language instruction (CALI) effects are strong in teaching language components (sound system, grammatical structures and vocabulary) to students of special needs. To explore the effects of the audio-visual aids and CALI in teaching sound system to this class of students by speech language therapists (SLTs), an experiment has been undertaken to evaluate their performance during their study of the sound system course. Methods: Forty students (males and females) of special needs at al-Malādh school for teaching students of special needs in Dhamar (Yemen) range between 8 and 18 years old underwent this experimental study while they were studying language sound system course. Pre-and-posttests have been administered at the begging and end of the semester. Students' treatment was compared to a similar group (control group) of the same number under the same environment. Whereas the first group was taught using audio-visual aids and CALI, the second was not. Students' performances were linguistically and statistically evaluated. Results & conclusions: Compared with the control group, the treatment group showed significantly higher scores in the posttest (72.32% vs. 31%). Compared with females, males scored higher marks (1421 vs. 1472). Thus, we should take the audio-visual aids and CALI into consideration in teaching sound system to students of special needs.

Keywords: language components, sound system, audio-visual aids, CALI, students, special needs, SLTs

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Authors: Tannistha Dasgupta

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This study explores the aspects of second language (L2) spoken fluency that are related to L2 linguistic knowledge and processing skill. It draws on Levelt’s ‘blueprint’ of the L2 speaker which discusses the cognitive issues underlying the act of speaking. However, L2 speaking assessments have largely neglected the underlying mechanism involved in language production; emphasis is given on the relationship between subjective ratings of L2 speech sample and objectively measured aspects of fluency. Hence, in this study, the relation between L2 linguistic knowledge and processing skill i.e. Cognitive Fluency (CF), and objectively measurable aspects of L2 spoken fluency i.e. Utterance Fluency (UF) is examined. The participants of the study are L2 learners of English, studying at high school level in Hyderabad, India. 50 participants with intermediate level of proficiency in English performed several lexical retrieval tasks and attention-shifting tasks to measure CF, and 8 oral tasks to measure UF. Each aspect of UF (speed, pause, and repair) were measured against the scores of CF to find out those aspects of UF which are reliable indicators of CF. Quantitative analysis of the data shows that among the three aspects of UF; speed is the best predictor of CF, and pause is weakly related to CF. The study suggests that including the speed aspect of UF could make L2 fluency assessment more reliable, valid, and objective. Thus, incorporating the assessment of psycholinguistic mechanisms into L2 spoken fluency testing, could result in fairer evaluation.

Keywords: attention-shifting, cognitive fluency, lexical retrieval, utterance fluency

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Authors: Ainolnaim Azizol, Valerie Ross

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Music is as old as mankind and rituals using music such as Kavadi have been associated with social, cultural, and spiritual practices in many traditional and modern societies. Recent literature has provided scientific evidence that music affects psychological and physical changes through stimulation of brainwave. Despite such advances, the scientific study of the sonic qualities peculiar to traditional instruments and how it impacts on ritualistic activities is still lacking. This study addresses one such phenomenon. Devotees in Kavadi rituals are known to be in a state of trance state and do not experience pain nor suffer injury despite the hundreds of needles pierced through their skins. Although scientists have sought to understand how this is possible, lesser is known about the music that is used to prepare devotees to enter into the trance state. This study fills this gap of knowledge by providing scientific evidence through the identification and mapping of the sonic spectrum or sound fingerprint of the instruments and the repertoire used in these ritualistic forms in their ethnographic environment and in audio-controlled situations. The objectives are to identify and categorize the different types of traditional music used in Kavadi rituals; to record, transcribe and digitally score the musical repertoire used in the oral tradition of Kavadi rituals; to map the sonic spectrum of ritual music using spectromography and advanced music analytical software a mixed methodology will be used. This comprises ethnographic field studies using interviews, participant observation, audio-video recordings and audio-methodology using spectromography and advanced audio-technology for sonic mapping and the transcription of audio recordings into digital scores.

Keywords: sonic, traditional, ritual, Kavadi, music

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Authors: Keivan Jmahidi, Afshin Zahedi

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To evaluate neurotoxic effects of ACR on hypothalamus of rat, amino-cupric silver staining technique of de Olmos and electron microscopic examination were conducted. For this purpose 60 adult male Wistar rats (± 250 g) were selected. Randomly assigned groups of rats (10 rats per exposure group, as A, B, C, D, E) were exposed to 0.5, 5, 50, 100 and 500 mg/kg per day×11days i.p. respectively. The remaining 10 rats were housed in group F as control group. Control rats received daily i.p. injections of 0.9% saline (3ml/kg). As indices of developing neurotoxicity, daily weight gain, gait scores and landing hindlimb foot splay (LHF) were determined. After 11 days, two rats for silver stain, and two rats for EM, were randomly selected, dissected and proper samples were collected from hypothalamus. Rats in groups D and E died within 1-2 hours due to sever toxemia. In histopathological studies no argyrophilic neurons or processes were observed in stained sections obtained from hypothalamus of rats belong to groups A, B and F, while moderate to severe argyrophilic changes were observed in different nuclei and regions of stained sections obtained from hypothalamus of rats belong to group C. In ultrastructural studies some variations in the myelin sheet of injured axons including decompactation, interlaminar space formation, disruption of the laminar sheet, accumulation of neurofilaments, vacculation and clumping inside the axolem, and finaly complete disappearance of laminar sheet were observed.

Keywords: acrylamide (ACR), amino-cupric silver staining technique of de Olmos, argyrophilia, hypothalamic neuropathy

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Authors: Qaisara Parveen, M. Imran Yousuf

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The purpose of this study was to find the effectiveness of the use of advance organizer model for enhancing meta-cognition of students in the subject of science. It was hypothesized that the students of experimental group taught through advance organizer model would show the better cognition than the students of control group taught through traditional teaching. The population of the study consisted of all secondary school students studying in government high school located in Rawalpindi. The sample of the study consisted of 50 students of 9th class of humanities group. The sample was selected on the basis of their pretest scores through matching, and the groups were randomly assigned for the treatment. The experimental group was taught through advance organizer model while the control group was taught through traditional teaching. The self-developed achievement test was used for the purpose of pretest and posttest. After collecting the pre-test score and post-test score, the data was analyzed and interpreted by use of descriptive statistics as mean and standard deviation and inferential statistics t-test. The findings indicate that students taught using advance organizers had a higher level of meta-cognition as compared to control group. Further, meta cognition level of boys was found higher than that of girls students. This study also revealed the fact that though the students at different meta-cognition level approached learning situations in a different manner, Advance organizer model is far superior to Traditional method of teaching.

Keywords: descriptive, experimental, humanities, meta-cognition, statistics, science

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Authors: Leila Habibi, Hadi Hakimi, Maryam Jafari Mehrabadi, Hadi Sadeghian

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Nowadays, the importance of information technology and web- based information in tourism is very obvious. Increasing of sales and promotion of brands, the rise of information about tourist attractions and tourist areas, Entrepreneurship and making money, introducing of hotels and side information to tourists via web are some Examples of website effects on tourism. The hotels using web-based information can succeed in attracting tourists and improve the quality of services to the tourists so; the study of hotel websites has become one of the most important issues in tourism. Therefore, this research aims to analyze the status of hotel websites in Yazd City as one of the most tourist visited counties in Iran. The quality of hotel website in a city such as this city can be very vital for tourism. Hence, this research compares the status of hotel websites in Yazd City with standard indexes and items that extracted from Literature and theoretical framework. It is used content analysis for analyzing of hotel websites with indexes and items in methodology. In the other words, all of the items is compared with the content of hotel-websites in Yazd one by one. Finally, every hotel archived final score and it represents the position of the hotel among the others. All of scores and status of hotels is displayed in their own Figures. The result of this research shows that many hotels do not offer standard web -based services and information. So, the existing situation is not very suitable for the attraction of web users or improving the tourism. The result of this research may help the managers and authorities of tourism to offer and improve the web- based services and information.

Keywords: e-tourism, hotel websites, tourism, web-tourism

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Authors: Haleh Dadgostar, Faramarz Akbari, Hosien Vahid Tari, Masoud Solaymani-Dodaran, Mohammad Razi

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Introduction: There are a number of exercises-protocols have been applied to improve low back pain. We compared the effect of supervised exercise therapy and home-based exercise therapy among patients with nonspecific chronic low back pain. Methods: 70 patients with nonspecific chronic low back pain were randomly (using a random number generator, excel) divided into two groups to compare the effects of two types of exercise therapy. After a common educational session to learn how to live with low back pain as well as to use core training protocols to strengthen the muscles, the subjects were randomly assigned to follow supervised exercise therapy (n = 31) or home-based exercise therapy (n = 34) for 20 weeks. Results: Although both types of exercise programs resulted in reduced pain, this factor decreased more significantly in supervised exercise program. All scores of fitness improved significantly in supervised exercise group. But only knee extensor strength score was increased in the home base exercise group. Conclusion: Comparing between two types of exercise, supervised group exercise showed more effective than the other one. Reduction in low back pain severity and improvement in muscle flexibility and strength can be more achieved by using a 20-week supervised exercise program compared to the home-based exercise program in patients with nonspecific chronic low back pain.

Keywords: low back pain, anthropometric parameters, supervised exercise therapy, home-based exercise therapy

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Authors: Jareeluk Ratanaphan

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The purposed of this research were; 1. To survey the teacher’s needs on knowledge about special education management for special needs student 2. Development of distance training packages for teacher on special education management for special needs student 3. to study the effects of using the packages on trainee’s achievement 4. to study the effects of using the packages on trainee’s opinion on the distance training packages. The design of the experiment was research and development. The research sample for survey were 86 teachers, and 22 teachers for study the effects of using the packages on achievement and opinion. The research instrument comprised: 1) training packages on special education management for special needs student 2) achievement test 3) questionnaire. Mean, percentage, standard deviation, t-test and content analysis were used for data analysis. The findings of the research were as follows: 1. The teacher’s needs on knowledge about teaching for a learner with learning disability, mental retardation, autism, physical and health impairment and research in special education. 2. The package composed of special education management for special needs student document and manual of distance training packages. The document consisted by the name of packages, the explanation for the educator, content’s structure, concept, objectives, content and activities. Manual of distance training packages consisted by the explanation about a document, objectives, explanation about using the package, training schedule, and evaluation. The efficiency of packages was established at 79.50/81.35. 3. The results of using the packages were the posttest average scores of trainee’s achievement were higher than the pretest. 4. The trainee’s opinion on the package was at the highest level.

Keywords: distance training package, teacher, learner with special needs

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Authors: Narin Charoenphun, Praopen Rattanadee, Chaiporn Phaephiromrat

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One of the most important intricacies of cooking is seasoning which is the process of adding salt, herbs, or spices to food to enhance the flavor. Sodium chloride (NaCl) was added in seasoning powder for taste-improving and shelf life of products. However, the raised blood pressure caused by eating too much NaCl may damage the arteries leading to the heart. Interestingly, NaCl replacement with other substance is essential for consumer. The objective of this study was to investigate the effects of NaCl replacement with potassium chloride (KCl) on the sensory characteristics and physiochemical properties of longan seasoning powder. Five longan seasoning Powder were replaced sodium chloride with KCl at 0, 25, 50 75 and 100%. Mixture design with 2 replications was performed. Sensory characteristics on overall flavor, saltiness, sweetness, bitterness and overall liking were investigated using 12 descriptive trained panelists. Results revealed that NaCl and KCl had effects on saltiness, bitterness and overall liking. As the level of KCl substituted increased, the overall flavor and sweetness of powdered seasoning from longan were not significantly (p < 0.05). This resulted in the decrease of overall liking of the products. In addition, increasing the level of KCl substituted resulted in the drop of saltiness but out of bitterness of the products. Saltiness of powdered seasoning from longan with replacement levels of 50, 75 and 100% KCl different when compared to that of 0% KCl. Bitterness of powdered seasoning from longan with replacement levels of 50, 75 and 100% KCl different when compared to that of 0% KCl. Moreover, consumer acceptance test was conducted (n=100). In conclusion, the optimum formulation contained of 32.0% longan powder, 28.0% sugar, 15.0% NaCl, 5% KCl, 16.0% pork powder, 3.0% pepper powder, and 3.0% garlic powder that would meet acceptability scores of at least 7 or like moderately.

Keywords: longan, seasoning, NaCl, KCl

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Authors: Golson Mohamed, Yasmine Gamasy, Khaled EL-Khatib, Anas Al-Natour, Shady Fadel, Haytham Rashwan, Haytham Badawy, Nadia Farghaly

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Introduction: Wilm's tumor is the most common malignant renal tumor in children. Much progress has been made in the management of patients with this malignancy over the last 3 decades. Today treatments are based on several trials and studies conducted by the International Society of Pediatric Oncology (SIOP) in Europe and National Wilm's Tumor Study Group (NWTS) in the USA. It is necessary for us to understand why do we follow either of the protocols, NWTS which follows the upfront surgery principle or the SIOP which follows the upfront chemotherapy principle in all stages of the disease. Objective: The aim of is to assess outcome in patients treated with preoperative chemotherapy and patients treated with upfront surgery to compare their effect on overall survival. Study design: to decide which protocol to follow, study was carried out on records for patients aged 1 day to 18 years old suffering from Wilm's tumor who were admitted to Alexandria University Hospital, pediatric oncology, pediatric urology and pediatric surgery departments, with a retrospective survey records from 2010 to 2015, Design and editing of the transfer sheet with a (PRISMA flow study) Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. (11) Qualitative data were described using number and percent. Quantitative data were described using Range (minimum and maximum), mean, standard deviation and median. Comparison between different groups regarding categorical variables was tested using Chi-square test. When more than 20% of the cells have expected count less than 5, correction for chi-square was conducted using Fisher’s Exact test or Monte Carlo correction. The distributions of quantitative variables were tested for normality using Kolmogorov-Smirnov test, Shapiro-Wilk test, and D'Agstino test, if it reveals normal data distribution, parametric tests were applied. If the data were abnormally distributed, non-parametric tests were used. For normally distributed data, a comparison between two independent populations was done using independent t-test. For abnormally distributed data, comparison between two independent populations was done using Mann-Whitney test. Significance of the obtained results was judged at the 5% level. Results: A significantly statistical difference was observed for survival between the two studied groups favoring the upfront chemotherapy(86.4%)as compared to the upfront surgery group (59.3%) where P=0.009. As regard complication, 20 cases (74.1%) out of 27 were complicated in the group of patients treated with upfront surgery. Meanwhile, 30 cases (68.2%) out of 44 had complications in patients treated with upfront chemotherapy. Also, the incidence of intraoperative complication (rupture) was less in upfront chemotherapy group as compared to upfront surgery group. Conclusion: Upfront chemotherapy has superiority over upfront surgery.As the patient who started with upfront chemotherapy shown, higher survival rate, less percent in complication, less percent needed for radiotherapy, and less rate in recurrence.

Keywords: Wilm's tumor, renal tumor, chemotherapy, surgery

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Authors: In Hee Shim, Dong Sik Bae

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Introduction: Obesity and unfavorable lipid profile may be linked to depressive disorders. This study compared the levels of obesity, lipid profiles and depression severity of patients with depressive disorders. Methods: This study included 156 patients diagnosed with a depressive disorder who were hospitalized between March 2012 and February 2016. The patients were categorized into mild to moderate and severe depressive groups, based on Hamilton Depression Rating Scale scores (Mild to moderate depression 8-23 vs. severe depression ≥ 24). The charts of the patients were reviewed to evaluate body mass index and lipid profiles, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TG), confounding factors, such as other general medical disorders (hypertension, diabetes mellitus, and dyslipidemia), except smoking status (insufficient data). Demographic and clinical characteristics, such as age, sex, comorbidities, family history of mood disorders, psychotic features, and prescription patterns were also assessed. Results: Compared to the mild to the moderate depressive group, patients with severe depression had significantly lower rate of male and comorbidity. The patients with severe depression had a significantly lower TG than patients in the mild to moderate depressive group. After adjustment for the sex and comorbidity, there were no significant differences between the two groups in terms of the obesity and lipid profiles, including TG. Conclusion: These results did not show a significant difference in the association between obesity, lipid profiles and the depression severity. The role of obesity and lipid profiles in the pathophysiology of depression remains to be clarified.

Keywords: depression, HAM-D, lipid profiles, obesity

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Authors: Noor A. Hakim

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Several studies in the developed countries investigated the prevalence of diabetes and obesity among individuals from different socioeconomic levels and suggested lower rates among the higher socioeconomic groups. However, studies evaluating diabetes risk and prevalence of obesity among the population of middle- to high-income status in developing countries are limited. The aim of this study is to evaluate the risk of developing type-2 diabetes mellitus (T2DM) and the weight status of female students in private universities in Jeddah City, Saudi Arabia. This is a cross-sectional study of 121 female students aged ≤ 25 years old was conducted; participants were recruited from two private universities. Diabetes risk was evaluated using the Finnish Diabetes Risk Score. Anthropometric measurements were assessed, and body-mass-index (BMI) was calculated. Diabetes risk scores indicated that 35.5% of the female students had a slightly elevated risk, and 10.8% had a moderate to high risk to develop T2DM. One-third of the females (29.7%) were overweight or obese. The majority of the normal weight and underweight groups were classified to have a low risk of diabetes, 22.2% of the overweight participants were classified to have moderate to high risk, and over half of the obese participants (55.5%) were classified to be at the moderate to high-risk category. Conclusions: Given that diabetes risk is alarming among the population in Saudi Arabia, healthcare providers should utilize a simple screening tool to identify high-risk individuals and initiate diabetes preventive strategies to prevent, or delay, the onset of T2DM and improve the quality of life.

Keywords: risk of type 2 diabetes, weight status, college students, socioeconomic status

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Authors: Kenji Gwee

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In Singapore, the death penalty remains in active use for murder and drug trafficking of controlled drugs such as heroin. As such, the psychological assessment of defendants can often be of high stakes. The Test of Memory Malingering (TOMM) is employed by government psychologists to determine the degree of effort invested by defendants, which in turn inform on the veracity of overall psychological findings that can invariably determine the life and death of defendants. The purpose of this study was to find out if defendants facing the death penalty were more likely to invest less effort during psychological assessment (to fake bad in hopes of escaping the death sentence) compared to defendants facing lesser penalties. An archival search of all forensic cases assessed in 2012-2013 by Singapore’s designated forensic psychiatric facility yielded 186 defendants’ TOMM scores. Offence severity, coded into 6 rank-ordered categories, was analyzed in a one-way ANOVA with TOMM score as the dependent variable. There was a statistically significant difference (F(5,87) = 2.473, p = 0.038). A Tukey post-hoc test with Bonferroni correction revealed that defendants facing lower charges (Theft, shoplifting, criminal breach of trust) invested less test-taking effort (TOMM = 37.4±12.3, p = 0.033) compared to those facing the death penalty (TOMM = 46.2±8.1). The surprising finding that those facing death penalties actually invested more test taking effort than those facing relatively minor charges could be due to higher levels of cooperation when faced with death. Alternatively, other legal avenues to escape the death sentence may have been preferred over the mitigatory chance of a psychiatric defence.

Keywords: capital sentencing, offence severity, Singapore, Test of Memory Malingering

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Authors: Fatima Zehra Allahverdi, Nukhet Bayer

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Objective: Three questions were formulated to examine stressful working units (intensive care units, emergency unit nurses) utilizing the self-perception theory and social support theory. This study provides a distinctive input by inspecting the combination of variables regarding stressful working environments. Method: The descriptive research was conducted with the participation of 400 nurses working at Ankara City Hospital. The study used Multivariate Analysis of Variance (MANOVA), regression analysis, and a mediation model. Hypothesis one used MANOVA followed by a Scheffe post hoc test. Hypothesis two utilized regression analysis using a hierarchical linear regression model. Hypothesis three used a mediation model. Result: The study utilized mediation analyses. Findings supported the hypotheses that intensive care units have significantly high scores in virtual communication and virtual tolerance. The number of years on the job, virtual communication, virtual tolerance, and phubbing significantly predicted 51% of the variance of perception of addiction. Interestingly, the number of years on the job, while significant, was negatively related to perception of addiction. Conclusion: The reasoning behind these findings and the lack of significance in the emergency unit is discussed. Around 7% of the variance of phubbing was accounted for through working in intensive care units. The model accounted for 26.80 % of the differences in the perception of addiction.

Keywords: phubbing, social media, working units, years on the job, stress

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Authors: Nunyong Fuengkajornfung, Pattama Hirunyophat, Tidarat Sanphom

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The objectives of this research were: To study of the recipe standard of Thai steamed dumpling, to study the ratio of modified starch in Thai steamed dumpling, to study chemical elements analyzing and Escherichia coli in Thai steamed dumpling. The experimental processes were designed in two stages as follows: To study the recipe standard of Thai steamed dumpling and to study the ratio of rice flour: modify starch by three levels 90:10, 73:30, and 50:50. The evaluation test used 9 Points Hedonic Scale method by the sensory evaluation test such as color, smell, taste, texture and overall liking. An experimental by Randomized Complete Block Design (RCBD). The statistics used in data analyses were means, standard deviation, one-way ANOVA and Duncan’s New Multiple Range Test. Regression equation, at a statistically significant level of .05. The results showed that the recipe standard was studied from three recipes by the sensory evaluation test such as color, odor, taste, spicy, texture and total acceptance. The result showed that the recipe standard of second was suitably to development. The ratio of rice flour: modified starch had 3 levels 90:10, 73:30, and 50:50 which the process condition of 50:50 had well scores (like moderately to like very much; used 9 Points Hedonic Scale method for the sensory test). Chemical elements analyzing, it showed that moisture 58.63%, fat 5.45%, protein 4.35%, carbohydrate 30.45%, and Ash 1.12%. The Escherichia coli is not found in lab testing.

Keywords: Thai snack in Rattanakosin era, Thai steamed dumpling, modify starch, recipe standard

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: N. R. P Withana, E. Auch

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The purpose of this study was to investigate perceptions of climate change risk to forest ecosystems and forest-based communities as well as perceived effectiveness of adaptation strategies for climate change as well as challenges for adaptation. Data was gathered using a pre-tested semi-structured questionnaire. Simple random selection technique was applied. For the majority of issues, the responses were obtained on multi-point Likert scales, and the scores provided were, in turn, used to estimate the means and other useful estimates. A composite knowledge index developed using correct responses to a set of self-rated statements were used to evaluate the issues. The mean of the knowledge index was 0.64. Also all respondents recorded values of the knowledge index above 0.25. Increase forest fire was perceived by respondents as the greatest risk to forest eco-system. Decrease access to water supplies was perceived as the greatest risk to livelihoods of forest based communities. The most effective adaptation strategy relevant to climate change risks to forest eco-systems and forest based communities livelihoods in Kathmandu valley in Nepal as perceived by the respondents was reforestation and afforestation. As well, lack of public awareness was perceived as the major limitation for climate change adaptation. However, perceived risks as well as effective adaptation strategies showed an inconsistent association with knowledge indicators and social-cultural variables. The results provide useful information to any party who involve with climate change issues in Nepal, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.

Keywords: climate change, risk perceptions, forest ecosystems, forest-based communities

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Authors: Yagmur Kocaoglu, Nurtekin Erkmen

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The aim of this study was to determine effects of elastic resistance band training on body composition and postural control in sedentary women. Thirty-four sedentary females participated voluntarily for this study. Subjects' age was 21.88 ± 1.63 years, height was 161.50 ± 4.45 cm, and weight was 59.47 ± 7.03 kg. Participants were randomly placed into one of two groups (Experimental = 17, Control = 17). The elastic resistance training program lasted 8 weeks with 3 sessions per week. Experimental Group performed elastic resistance band training with red color for first 3 weeks, blue color for second 3 weeks and for last 2 weeks. The subjects carried out exercises 3 set, 10-15 repetitions with 15 seconds rest between exercises. The rest between sets was 30 seconds. The subjects underwent a standard warm-up for 10 minutes in every session. The elastic resistance training lasted 40 minutes for each session. After the training, all subjects performed a standard cool down for 10 minutes in each session. After and before 8 weeks training period, all subjects in experimental group and control group participated body composition and postural control measurements. Independent t-Test and Mann Whitney U Test were conducted to compare differences between experimental and control groups. Paired t-Test and Wilcoxon Z Test were used to compare differences between pre and posttests. There is no significant difference between pre and posttests in BMI (p>0.05). After the elastic resistance training, postural control scores and body fat significantly decreased in experimental group (p<0.05). In conclusion, it can be concluded that elastic resistance training improves postural control and body composition in sedentary women.

Keywords: body composition, elastic resistance band, postural control, sedentary women

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Authors: Ran An, Dang Wang

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Background: Mechanical ventilation has been confirmed to increase the incidence of postoperative pulmonary complications (PPCs), and several studies have shown that low tidal volumes combined with positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RM) reduce the incidence of PPCs. However, the optimal lung-protective ventilatory strategy remains unclear. Methods: Multiple databases were searched for randomized controlled trials (RCTs) published prior to October 2023. The association between individual PEEP (iPEEP) or other forms of lung-protective ventilation and the incidence of PPCs was evaluated by Bayesian network meta-analysis. Results: We included 58 studies (11610 patients) in this meta-analysis. The network meta-analysis showed that low ventilation (LVt) combined with iPEEP and RM was associated with significantly lower incidences of PPCs [HVt: OR=0.38 95CrI (0.19, 0.75), LVt: OR=0.33, 95% CrI (0.12, 0.82)], postoperative atelectasis, and pneumonia than was HVt or LVt. In abdominal surgery, LVT combined with iPEEP or medium-to-high PEEP and RM were associated with significantly lower incidences of PPCs, postoperative atelectasis, and pneumonia. LVt combined with iPEEP and RM was ranked the highest, which was based on SUCRA scores. Conclusion: LVt combined with iPEEP and RM decreased the incidences of PPCs, postoperative atelectasis, and pneumonia in noncardiac surgery patients. iPEEP-guided ventilation was the optimal lung protection ventilation strategy. The quality of evidence was moderate.

Keywords: protection ventilation strategies, postoperative pulmonary complications, network meta-analysis, noncardiac surgery

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Payal Maheshwari, Bansari Shah

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The research aimed to study the level of emotional intelligence (EI) and organizational role stress (ORS) of fire-fighters and the relationship between the two variables. Hundred and twenty fire-fighters were selected from different fire stations of Mumbai by purposive sampling. The firefighters who had the basic training, a minimum experience of 2 years and had been on the field during a crisis situation were selected for the study. The firefighters selected ranged from 23-58 years of age, and the number of years of experience ranged from 2 to 33 years. The findings of the study revealed that majority of the firefighters perceived themselves to be at an above average (57) and high (58) level of EI (M=429.35, SD=38.712). Domain-wise analysis disclosed that compared to self-awareness (92) and relationship management (93), more number of participants perceived themselves in the high category in the domains of self-management (108) and social management (106). Further, examination of the subdomain scores conveyed that a large number of participants rated themselves in the average level of these skills of accurate self-assessment (50), emotional self-control (50), adaptability (56) initiative (41), influence (66), change catalyst (53), and conflict management (50). With relation to the stress variable, it was found that almost half the number of the participants (59) rated themselves as having an average level of stress (M=137.44, SD=28.800). In most of the domains, majority of the participants perceived themselves as having an average level of stress, while in the domain of role isolation, self-role distance, and role ambiguity, majority of the firefighters rated themselves as having a low level of stress. A strong negative correlation (r=-.360**, p=.000) was found between EI and ORS. This study is a contribution to the literature and has implications for fire-fighters at the personal level, for the policymakers, and the fire department.

Keywords: emotional intelligence, organizational role stress, firefighters, relationship

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Authors: Joy Johnbest Egbo

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The study was designed to investigate the relative effectiveness of inquiry role approach and expository instructional methods in fostering students’ retention in chemistry. Two research questions were answered and three null hypotheses were formulated and tested at 0.05 level of significance. A quasi-experimental (the non-equivalent pretest, posttest control group) design was adopted for the study. The population for the study comprised all senior secondary school class two (SS II) students who were offering Chemistry in single sex schools in Enugu Education Zone. The instrument for data collection was a self-developed Chemistry Retention Test (CRT). Relevant data were collected from a sample of one hundred and forty–one (141) students drawn from two secondary schools (1 male and 1 female schools) using simple random sampling technique. A reliability co-efficient of 0.82 was obtained for the instrument using Kuder Richardson formular20 (K-R20). Mean and Standard deviation scores were used to answer the research questions while two–way analysis of covariance (ANCOVA) was used to test the hypotheses. The findings showed that the students taught with Inquiry role approach retained the chemistry concept significantly higher than their counterparts taught with expository method. Female students retained slightly higher than their male counterparts. There is significant interaction between instructional packages and gender on Chemistry students’ retention. It was recommended, among others, that teachers should be encouraged to employ the use of Inquiry-role approach more in the teaching of chemistry and other subjects in general. By so doing, students’ retention of the subject could be increased.

Keywords: inquiry role approach, retention, exposition method, chemistry

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Authors: Miriam Palomo-Nieto, Adrian Agricola, Rudolf Psotta, Reza Abdollahipour, Ludvik Valtr

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The importance of vision and the visual control of movement have been labeled in the literature related to motor control and many studies have demonstrated that children with low motor competence may rely more heavily on vision to perform movements than their typically developing peers. The aim of the study was to highlight the effects of different visual conditions on motor performance during walking in children with different levels of motor coordination. Participants (n = 32, mean age = 8.5 years sd. ± 0.5) were divided into two groups: typical development (TD) and low motor coordination (LMC) based on the scores of the Movement Assessment Battery for Children (MABC-2). They were asked to walk along a 10 meters walkway where the Optojump-Next instrument was installed in a portable laboratory (15 x 3 m), which allows that all participants had the same visual information. They walked in self-selected speed under four visual conditions: full vision (FV), limited vision 100 ms (LV-100), limited vision 150 ms (LV-150) and non-vision (NV). For visual occlusion participants were equipped with Plato Goggles that shut for 100 and 150 ms, respectively, within each 2 sec. Data were analyzed in a two-way mixed-effect ANOVA including 2 (TD vs. LMC) x 4 (FV, LV-100, LV-150 & NV) with repeated-measures on the last factor (p ≤.05). Results indicated that TD children walked faster and with longer normalized steps length and strides than LMC children. For TD children the percentage of the single support and swing time were higher than for low motor competence children. However, the percentage of load response and pre swing was higher in the low motor competence children rather than the TD children. These findings indicated that through walking we could be able to identify different levels of motor coordination in children. Likewise, LMC children showed shorter percentages in those parameters regarding only one leg support, supporting the idea of balance problems.

Keywords: visual information, motor performance, walking pattern, optojump

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