Search results for: prospective cohort

Authors: Dima Basma

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The unprecedented expansion in the use of Non-Fungible Tokens (NFTS) has prompted luxury brand owners to file their trademark applications for the use of their marks in the metaverse world. While NFTs provide a favorable tool for product traceability and anti-counterfeiting endeavors, the legal ramifications of such abrupt shift are complex, diverse, and yet to be understood. Practically, a sizable number of NFT creators are minting digital tokens associated with existing trademarks, selling them at strikingly high rates, thus disadvantaging trademark owners who joined and are yet to join the meta-verse world. As a result, multiple luxury brands are filing confusion and dilution lawsuits against alleged artists offering for sale NFTs depicting reputable marks labeling their use as “parody” and “social commentary.” Given the already muddled state of trademark law in relation to both traditional and modern infringement criteria, this paper aims to explore the feasibility of the current system in dealing with the emerging NFT trends. The paper firstly delves into the intersection between trademarks and NFTs. Furthermore, in light of the striking increase in NFT use, the paper sheds critical light on the shortcoming of the current system. Finally, the paper provides recommendations for overcoming current and prospective challenges in this area.

Keywords: trademarks, NFTs, dilution, social commentary

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Authors: K. C. Iyer, Yogita Manan Bindal, Sumit Kumar Bakshi

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The construction industry is plagued with disputes and litigation in India with many stalled projects seeking dispute resolution. This has an adverse effect on the performance and overall project delivery and impacts future investments within the industry. While construction industry is the major driver of growth, there has not been major reforms in the government construction contracts. The study is aimed at identifying the proactive means of dispute avoidance, focusing on reforms required within the construction contracts, by studying 49 arbitration awards of construction disputes. The claims presented in the awards are aggregated to study the causes linked to the contract document and are referred against the prospective recommendation and practices as surveyed from literature review of research papers. Within contract administration, record keeping has been a major concern as they are required by the parties to substantiate the claims or the counterclaims and therefore are essential in any dispute redressal process. The study also observes that the right judgment is inhibited when the record keeping is improper and due to lack of coherence between documents, the dispute resolution period is also prolonged. The finding of the research will be relevant to industry practitioners in contract drafting with a view to avoid disputes.

Keywords: construction contract, contract administration, contract management, dispute avoidance

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Authors: Vandana Singh, Subash Singh

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Introduction: Oral squamous cell carcinoma is the most common malignant tumor of the oral cavity. Normally the death of cell and the growth are active processes and depend not only on external factors but also on the expression of genes like Bcl-2, which activate and inhibit apoptosis. The term Bcl-2 is an acronym for B-cell lymphoma/ leukemia -2 genes. Objectives: An attempt was made to evaluate Bcl-2 oncoprotein expression in patients with oral precancer and cancer and to assess possible correlation between Bcl-2 oncoprotein expression and clinicopathological features of oral precancer and cancer. Material and Methods: This is a selective prospective clinical and immunohistochemical study. Clinicopathological examination is correlated with immunohistochemical findings. The immunolocalization of Bcl-2 protein is performed using the labeled streptavidin biotin (LSAB) method. To visualize the reaction, 3, 3-diaminobenzidine (DAB) is used. Results: Bcl-2 expression was positive in 11 [36.66 %, low Bcl-2 expression 3 (10.00 %), moderate Bcl-2 expression 7 (23.33 %), and high Bcl-2 expression 1 (3.33 %)] oral cancer cases and in 14 [87.50 %, low expression 8 (50 %), moderate expression 6 (37.50 %)] precancer cases. Conclusion: On the basis of the results of our study we conclude that positive Bcl-2 expression may be an indicator of poor prognosis in oral cancer and precancer. Relevance: It has been reported that there is deregulation of Bcl-2 expression during progression from oral epithelial dysplasia to squamous cell carcinoma. It can be used for revealing progression of epithelial dysplasia to malignancy and as a prognostic marker in oral precancer and cancer.

Keywords: BcL-2, immunohistochemistry, oral cancer, oral precancer

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Authors: Yuying Liu

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Despite the increasing popularity of Chinese and the recognition of the growing commodifying ideology of Chinese language in many contexts (Liu and Gao, 2020; Guo, Shin and Shen 2020), the ideological orientations of the Chinese diaspora community towards the Chinese language remain under-researched. This research contributes seeks to bridge this gap by investigating the micro-level language ideologies embedded in the Chinese complementary schools in the Republic of Ireland. Informed by Ruíz’s (1984) metaphorical representations of language, 11 Chinese complementary schools’ websites were analysed as discursive texts that signal the language policy and ideology to prospective learners and parents were analysed. The results of the analysis suggest that a move from a portrayal of Chinese as linked to student heritage identity, to the commodification of linguistic and cultural diversity, is evident. It denotes the growing commodifying ideology among the Chinese complementary schools in the Republic of Ireland. The changing profile of the complementary school, from serving an ethnical community to teaching Chinese as a foreign language for the wider community, indicates the possibility of creating the a positive synergy between the Complementary school and the mainstream education. This study contributes to the wider discussions of language ideology and language planning, with regards to modern language learning and heritage language maintenance.

Keywords: the Chinese language;, Chinese as heritage language, Chinese as foreign language, Chinese community schools

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Authors: Yu Song, Yuefei Jin

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Urban public transportation can be integrated when there is an efficient connection between urban rail lines, however, there are currently no effective or quick solutions being investigated for this connection. This paper analyzes the space-time distribution and travel demand of passenger connection travel based on taxi track data and data from the road network, excavates potential bus connection stations based on potential connection demand data, and introduces the link growth probability model in the complex network to solve the basic connection bus lines in order to ascertain the direction of the bus lines that are the most connected given the demand characteristics. Then, a tree view exhaustive approach based on constraints is suggested based on graph theory, which can hasten the convergence of findings while doing chain calculations. This study uses WEI QU NAN Station, the Xi'an Metro Line 2 terminal station in Shaanxi Province, as an illustration, to evaluate the model's and the solution method's efficacy. According to the findings, 153 prospective stations have been dug up in total, the feeder bus network for the entire line has been laid out, and the best route adjustment strategy has been found.

Keywords: feeder bus, route optimization, link growth probability, the graph theory

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Authors: Adewoyin O. Olusegun, Akinwumi I. Isaac

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In some part of the world where legislations related to site investigations before constructions are not strictly enforced, the expenses and time required for carrying out a comprehensive geotechnical investigation to characterize a site can discourage prospective private residential building developers. Another factor that can discourage a developer is the fact that most of the geotechnical tests procedures utilized during site investigations, to a certain extent, alter the existing environment of the site. This study suggests a quick, non-destructive and non-intrusive method of obtaining key subsoil geotechnical properties necessary for foundation design for proposed engineering facilities. Seismic wave velocities generated from near surface refraction method was used to determine the bulk density of soil, Young’s modulus, bulk modulus, shear modulus and allowable bearing capacity of a competent layer that can bear structural load at the particular study site. Also, regression equations were developed in order to directly obtain the bulk density of soil, Young’s modulus, bulk modulus, shear modulus and allowable bearing capacity from the compressional wave velocities. The results obtained correlated with the results of standard geotechnical investigations carried out.

Keywords: characterize, environment, geophysical, geotechnical, regression

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Authors: Sat Sharma, Antonella Conflitti, Hilary Reiter

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Introduction: The study's purpose was to assess the efficacy of the oral appliance device O2Vent Optima + ExVent as compared to Optima in the treatment of OSA. Methods: A prospective, open-label study conducted at 3 sites included subjects with mild to moderate OSA (AHI ≥ 5 and ≤ 30). Screening Phase: A diagnostic in-lab PSG study was performed to confirm a diagnosis of mild to moderate OSA. Treatment I: Subjects used O2Vent Optima for 6 weeks and underwent an in-lab PSG sleep night while using the O2Vent Optima. Treatment II: Subjects used O2Vent Optima + ExVent for 6 weeks and underwent an in-lab PSG sleep night while using the O2Vent Optima + ExVent Primary Effectiveness Measure: Change in AHI between baseline vs. O2Vent Optima MAD vs. O2Vent Optima + ExVent. Results: Treatment with Optima, Optima + ExVent reduced AHI from 22.5±6.4/hr to 12.6±4.5/hr to 5.9±2.7 (p< 0.005 baseline vs. Optima and Optima + ExVent; p<0.05 Optima MAD vs. Optima + ExVent). The average reduction in AHI with Optima was 43%, and with Optima + ExVent was 72%. The lowest oxygen during sleep increased from 84.6±2.7% to 88.6±2.9% to 91.6±3.2% (p< 0.005 baseline vs. Optima and Optima + ExVent; p<0.05 Optima vs. Optima + ExVent). During the trial, patients on treatment with Optima and Optima + ExVent demonstrated no excessive adverse events or device malfunction. Conclusion: Treatment with O2Vent Optima and O2Vent Optima + ExVent significantly improved OSA compared to the baseline. An even greater benefit was observed with the addition of ExVent to the Optima in mild to moderate OSA.

Keywords: oral appliance, O2Vent, sleep dentistry, sleep apnea

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Authors: R. L. David, E. C. P. Tan, M. A. Ferenczi

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This study aimed to investigate the effect of a 'one-time' optional Information Literacy (IL) workshop to enhance Year 1 medical students' literature search, writing, and citation management skills as directed by a customized five-year IL framework developed for LKC Medicine students. At the end of the IL workshop, the overall rated 'somewhat difficult' when finding, citing, and using information from sources. The study method is experimental using a standardized IL test to study the cohort effect of a 'one-time' optional IL workshop on Year 1 students; experimental group in comparison to Year 2 students; control group. Test scores from both groups were compared and analyzed using mean scores and one-way analysis of variance (ANOVA). Unexpectedly, there were no statistically significant differences between group means as determined by One-Way ANOVA (F₁,₁₉₃ = 3.37, p = 0.068, ηp² = 0.017). Challenges and shortfalls posed by 'one-time' interventions raised a rich discussion to adopt an 'embedded librarianship' approach, which shifts the medial librarians' role into the curriculum and uses Team Based Learning to teach IL skills to medical students. The customized five-year IL framework developed for LKC Medicine students becomes a useful librarian-faculty model for embedding and bringing IL into the classroom.

Keywords: information literacy, 'one-time' interventions, medical students, standardized tests, embedded librarianship, curriculum, medical librarians

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Authors: Nazmul Hussain, Saba Owais

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The paper is an effort to come across the fertility differential by religion and socio-economic characteristic by religion. Religion and Socio-economic characteristic are conceptualised as touching demography in two ways- through its theoretical content, and in terms of the socio-economic ‘characteristics’ of different religious groups. The mean number of children ever born (MCEB) is used to measure fertility. Efficient contrast of Muslims and Non-Muslims shows little difference in their theological positions on demographic issues, with the omission of their position on birth control. The present paper using data from a primary field survey of 2590 households in the Malda district of West Bengal. Older and younger cohorts of women were examined separately for assessing fertility differential. MCEB was found to be high for women with husbands employed as labourers with a low monthly income. This was true for both the cohorts, but fertility levels were much higher among the older cohort. Low MCEB was found with increasing income and for those in regular salaried jobs. The analysis shows that there is a major dissimilarity in the effects of various socio-economic aspects on the number of children-ever-born among the religious groups, suggesting that religious groups may need to be targeted differently by policy-makers in order to influence demographic decision-making.

Keywords: fertility, socio-economic differences, religion, MCEB

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Authors: C. Soh, S. Muktar, C. M. Malata, J. R. Benson

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Introduction Reasons for requesting CPM include prevention of recurrence, peace of mind and moving on after breast cancer. Some women seek CPM as a delayed procedure but factors influencing this are poorly understood. Methods A retrospective analysis examined patients undergoing CPM as either an immediate or delayed procedure with or without breast reconstruction (BR) between January 2009 and December 2019. A cross-sectional survey based on validated questionnaires (5 point Likert scale) explored patients’ decision-making process in terms of timing of CPM and any BR. Results A total of 123 patients with unilateral breast cancer underwent CPM with 39 (32.5%) delayed procedures with or without BR. The response rate amongst patients receiving questionnaires (n=33) was 22/33 (66%). Within this delayed CPM cohort were three reconstructive scenarios 1) unilateral immediate BR with CPM (n=12); 2) delayed CPM with concomitant bilateral BR (n=22); 3) delayed bilateral BR after delayed CPM (n=3). Two patients had delayed CPM without BR. The most common reason for delayed CPM was to complete all cancer treatments (including radiotherapy) before surgery on the unaffected breast (score 2.91). The second reason was unavailability of genetic test results at the time of therapeutic mastectomy (score 2.64) whilst the third most cited reason was a subsequent change in family cancer history. Conclusion Factors for delayed CPM are patient-driven with few women spontaneously changing their mind having initially decided against immediate CPM for reasons also including surgical duration. CPM should be offered as a potentially delayed option with informed discussion of risks and benefits.

Keywords: Breast Cancer, CPM, Prophylactic, Rationale

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Authors: Athira M., Prakasha G. S.

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The rising prevalence of academic entitlement among school and college students necessitates a comprehensive investigation. This study focuses on discovering gender differentials in academic entitlement and their nexus with diverse grade negotiation behaviors within the undergraduate (UG) student cohort. Grade negotiation behaviors, encompassing a range from amicable discussions to more assertive tactics, are influenced by students' perceptions of their academic entitlement. The research delves into the broader significance of academic entitlement, considering its implications for student-teacher conflicts and the dynamics it introduces into the educational field. Employing a quantitative research approach, data from UG students is meticulously analyzed. Mann-Whitney U tests unveil pronounced gender difference in academic entitlement, with females demonstrating higher entitlement levels. Furthermore, the study unearths significant correlations between academic entitlement and specific negotiation styles, notably yielding and forcing strategies, albeit with minimal impact on academic performance. These findings provide a foundational understanding for educators and institutions to foster equitable learning environments and formulate effective conflict resolution strategies, ultimately elevating the quality of the educational experience. Moreover, this study opens avenues for future research, exploring interventions to enhance negotiation skills and diving deeper into the intricate dimensions of academic entitlement within academic life.

Keywords: academic entitlement, grade negotiation, negotiation styles, student-teacher conflict

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Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

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Authors: Daniel Francis, Mo Yassin

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Transverse patella fractures are routinely fixed using tension band wiring (TBW) using Kirschner wires and a wire in the shape of a figure of 8. The idea of the study was to compare the outcomes of the traditional technique against the more recently used cannulated screws and fiber tape in the shape of a figure of 8. We performed a retrospective cohort study of all the surgically fixed patella fractures from the year 2019 to 2022. The patients were divided into two groups TBW group and cannulated screws group. The primary outcome measure was the failure of fixation and the need for the removal of metalwork. Twenty-six patellar fractures were studied. TBW was used in 14 (53.8%), and cannulated screws were used for fixation in 12 (46.2%). There was one incident of metalwork failure in the TBW and one incident in the cannulated screws group. Five (35.7%) of patients in the TBW needed symptomatic metal work removed and One (8.3%) in the cannulated screw group. In both groups, the rate of fixation failure was low. Symptomatic implants, the most common complication observed, were higher in the TBW group in our practice. Although the small numbers in both groups, the hope of this study is to shine the light on the use of cannulated screws for patella fractures as it would reduce the need for a second operation and reduce the load on the already stretched services as well as improving the patient experience by not requiring further surgery. Although this is not a brand-new technique, it is not commonly used as there have not yet been any studies that demonstrate the lower rates of second surgery needed.

Keywords: patella, tension band wiring, randomised, new technique

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Authors: Philip Feig, Klaus Gschwendtner, Julian Schatz, Frank Diermeyer

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Projects of accident research analysis are mostly focused on accidents involving personal damage. Property damage only has a high frequency of occurrence combined with high economic impact. This paper describes main influencing parameters for the extent of damage and presents a repair cost model. For a prospective evaluation method of the monetary effect of advanced driver assistance systems (ADAS), it is necessary to be aware of and quantify all influencing parameters. Furthermore, this method allows the evaluation of vehicle concepts in combination with an ADAS at an early point in time of the product development process. In combination with a property damage database and the introduced repair cost model relevant test scenarios for specific vehicle configurations and their individual property damage risk may be determined. Currently, equipment rates of ADAS are low and a purchase incentive for customers would be beneficial. The next ADAS generation will prevent property damage to a large extent or at least reduce damage severity. Both effects may be a purchasing incentive for the customer and furthermore contribute to increased traffic safety.

Keywords: accident research, accident scenarios, ADAS, effectiveness, property damage analysis

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Authors: Zayed Alsulami, Asma Aldosseri, Ahmed Ezziden, Abdulrahman Alonazi

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Children are more susceptible to medication errors than adults. Medication administration process is the last stage in the medication treatment process and most of the errors detected in this stage. Little research has been undertaken about medication errors in children in the Middle East countries. This study was aimed to evaluate how the paediatric nurses adhere to the medication administration policy and also to identify any medication preparation and administration errors or any risk factors. An observational, prospective study of medication administration process from when the nurses preparing patient medication until administration stage (May to August 2014) was conducted in Saudi Arabia. Twelve paediatric nurses serving 90 paediatric patients were observed. 456 drug administered doses were evaluated. Adherence rate was variable in 7 steps out of 16 steps. Patient allergy information, dose calculation, drug expiry date were the steps in medication administration with lowest adherence rates. 63 medication preparation and administration errors were identified with error rate 13.8% of medication administrations. No potentially life-threating errors were witnessed. Few logistic and administrative factors were reported. The results showed that the medication administration policy and procedure need an urgent revision to be more sensible for nurses in practice. Nurses’ knowledge and skills regarding the medication administration process should be improved.

Keywords: medication sasfety, paediatric, medication errors, paediatric ward

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Authors: N. J. Nawarathna, N. R. Kmarasinghe, D. Chandrasekara, B. M. R. S. Balasooriya, R. A. A. Shaminda, R. J. K. Senevirathne

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Introduction: Thyroid malignancy associated with hyperthyroidism is considered rare. Retrospective studies have shown the incidence of thyroid malignancy in hyperthyroid patients to be low (0.7-8.5%). To assess the clinical relevance of this association, thyroid status in a cohort of patients with thyroid malignancy were analyzed. Method: Thyroid malignancies diagnosed histologically in 56 patients, over a 18 month period beginning from April 2013, in a single surgical unit at Teaching Hospital Kandy were included. Preoperative patient details and progression of thyroid status were asessed with Thyroid Stimulating Hormone, free Thyroxin and free Triiodothyronine levels. Results: Amongst 56 patients Papillary carcinoma was diagnosed in 44(78.6%), follicular carcinomas in 7(12.5%) and 5(8.9%) with medullary and anaplastic carcinomas. 12(21.4%) were males and 44(78.6%) were females. 20(35.7%) were less than 40years, 29(51.8%) were between 40 to 59years and 7(12.5%) were above 59years. Cross tabulation of Type of carcinoma with Gender revealed likelihood ratio of 6.908, Significance p = 0.032. Biochemically 12(21.4%) were hyperthyroid. Out of them 5(41.7%) had primary hyperthyroidism and 7(58.3%) had secondary hyperthyroidism. Mean age of euthyroid patients was 43.77years (SD 10.574) and hyperthyroid patients was 53.25years(SD 16.057). Independent Samples Test t is -2.446, two tailed significance p =0.018. When cross tabulate thyroid status with Age group Likelihood Ratio was 9.640, Significance p = 0.008. Conclusion: Papillary carcinoma is seen more among females. Among the patients with thyroid carcinomas, those with biochemically proven hyperthyroidism were more among the older age group than those who were euthyroid. Hence careful evaluation of elderly hyperthyroid patients to select the most suitable therapeutic approach is justified.

Keywords: age, hyperthyroidism, thyroid malignancy, thyroid status

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Authors: Nikhat Iqbal Tamboli

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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.

Keywords: ocular morbidity, eye trauma, RTA, eye injury

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Authors: Andri Hidayat, Zufialdi Zakaria, Raden Irvan Sophian

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Batam city within next five years are expected to experience water crisis. Sei Gong dam which is located in the Sijantung village, Galang District, Batam City, Riau Islands Province is one of 13 dams that will be built to solve the problems of raw water crisis in the Batam city. The purpose of this study are to determine the condition of engineering geology around Sei Gong Dam area, knowing the value of the soil bearing capacity and recommended pile foundation, and knowing the characteristics of the soil consolidation as one of the factors that affect the incidence of soil subsidence. Based on calculations for shallow foundation in general - soil shear condition and local - soil condition indicates that the highest value in ultimate soil bearing capacity (qu) for each depth was in the square foundations at two meters depth. The zonations of shallow foundation of the research area are divided into five zones, they are bearing capacity zone <10 ton/m2, bearing capacity zone 10-15 ton/m2, bearing capacity zone 15-20 ton/m2, bearing capacity zone 20-25 ton/m2, and bearing capacity zone >25 ton/m2. Based on the parameters of soil engineering analysis, Sei Gong Dam areas at the middle part has a higher value for land subsidence.

Keywords: ultimate bearing capacity, type of foundation, consolidation, land subsidence, Batam

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Authors: Wahyu Purnama Putra, Artono Isharanto

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Thoracic trauma is trauma that hits the thoracic wall or intrathoracic organs, either due to blunt trauma or sharp trauma. Thoracic trauma often causes impaired ventilation-perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of acute respiratory distress syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins, and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. This study aims to predict the incidence of acute respiratory distress syndrome (ARDS) through human neutrophil elastase levels. This study examines the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. Data analysis uses the Pearson correlation test and ROC curve (receiver operating characteristic curve). It can be concluded that there is a significant (p= 0.000, r= -0.988) relationship between elastase levels and BGA-3. If the value of elastase levels is limited to 23.79 ± 3.95, the patient will experience mild ARDS. While if the value of elastase levels is limited to 57.68 ± 18.55, in the future, the patient will experience moderate ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Neutrophil elastase levels correlate with the degree of severity of ARDS incidence.

Keywords: ARDS, human neutrophil elastase, severity, thoracic trauma

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Authors: Sharifah M. Syed Mohsin, Sayid J. Azimi, Abdoullah Namdar

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The present article reports the findings of a study into the behavior of oil palm shell reinforced concrete (OPSRC) beams with the addition of kenaf fibres. The work aim is to examine the potential of using kenaf fibres to improve the strength and ductility of the OPSRC beams and also observe its potential in serving as part of shear reinforcement in the beams. Two different arrangements of the shear links in OPSRC beams with a selection of kenaf fibres (amount of [10kg/m] ^3 and [20kg/m] ^3) content are tested under monotonic loading. In the first arrangement, the kenaf fibres are added to the beam which has full shear reinforcement to study the structural behavior of OPSRC beams with fibres. In the second arrangement, the spacing between the shear links in the OPSRC beams are increased by 50% and experimental work is carried out to study the effect of kenaf fibres without compromising the beams strength and ductility. The results show that the addition of kenaf fibres enhanced the load carrying capacity, ductility and also altered the failure mode of the beams from a brittle shear mode to a flexural ductile one. Furthermore, the study depicts that kenaf fibres are compatible with OPSRC and suggest prospective results.

Keywords: oil palm shell reinforced concrete, kenaf fibres, peak strength, ductility

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Authors: Alireza Javadzadeh

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Background: The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy. Methods: Sixty-one children (age < 16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time. Results: Patients were aged 1–16 years (mean 7.5 ± 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group. Conclusions: Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.

Keywords: children, endoscopy, midazolam, oral, sedation

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Authors: Setareh Shayanfar

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Given the increasing importance of peer relationships during adolescence, the present study aimed to examine peer interactions that facilitate or hinder adolescents’ regulation of negative emotions. Using the Enhanced Critical Incident Technique, 1-hour semi-structured interviews were conducted with 16 junior high school adolescents. Participants were asked to recall situations when they experienced strong negative emotions during the past school year, indicate the peer interactions that helped or hindered their emotion regulation, and identify prospective interactions with the potential to help regulate their emotions. Data analysis extracted 182 critical incidents, including 109 helping incidents, 45 hindering incidents, and 28 wish list items, which generated 10 categories nested within four overarching themes: Positive Personal Support included (a) supportive presence, (b) expressing concern, (c) empathizing, and (d) encouraging and cheering up; while Strategy Transmission included (e) sharing perspective, and (f) giving advice; Activated Support included (g) taking action, and (h) distracting; while Negative Personal Interactions included (i) withdrawing and (j) punishing. Implications for mental health and service providers, as well as recommendations for future research, are presented.

Keywords: adolescence, emotion regulation, enhanced critical incident technique, peers

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Authors: Md. R. Shattique, Md. T. Zaki, Md. G. Kibria

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Fly-ash bricks give a comprehensive solution towards recycling of fly-ash and since there is no requirement of firing to produce them, they are also eco-friendly bricks; little or no carbon-dioxide is emitted during their entire production cycle. As bricks are the most essential and widely utilized building materials in the construction industry, the significance of developing an alternate eco-friendly brick is substantial in modern times. In this paper, manufacturing and potential utilization of Fly-ash made building bricks have been studied and was found to be a prospective substitute for fired clay bricks that contribute greatly to polluting the environment. Also, a comparison between sand made and ceramic dust made Fly-ash bricks have been carried out experimentally. The ceramic dust made bricks seem to show higher compressive strength at lower unit volume weight compared to sand made Fly-ash bricks. Moreover, the water absorption capacity of ceramic dust Fly-ash bricks was lower than sand made bricks. Then finally a statistical comparison between fired clay bricks and fly-ash bricks were carried out. All the requirements for good quality building bricks are matched by the fly-ash bricks. All the facts from this study pointed out that these bricks give a new opportunity for being an alternate building material.

Keywords: coal fly-ash, ceramic dust, burnt clay bricks, sand, gypsum, absorption capacity, unit volume weight, compressive strength

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Authors: J. Punj, R. K. Pandey, V. Darlong, K. Thangavel

Abstract:

Background: Dural puncture epidural (DPE) technique has been introduced recently for labour analgesia however, no study has compared ropivacaine and levobupivacaine for the same. Methods: The primary aim of the study was to compare time to onset of the Numerical Pain Rating Score (NPRS) ≤ 1 in labour analgesia with both drugs. After obtaining ethics and patient consent, ASA I and ASA II parturient with single foetus in vertex presentation and cervical dilatation <5.0 cm were included. DPE was performed with 16/ 26 G combined spinal epidural (CSE) technique, and parturients randomized into two groups. In Group R ( Ropivacaine) 20 ml 0.125% ropivacaine+ fentanyl 2µg/ml was injected to a maximum of 20 ml in 20 minutes and in Group L (Levobupivacaine), 20 ml 0.125% levobupivacaine + fentanyl 2µg/ml was injected. Outcomes were assessed at 0.5,2,4,6,8,10,12,14,16,18,20 and 30 minutes, then every 90 minutes until delivery. Appropriate statistical analysis was done, and p value of <0.05 was considered statistically significant. Results: The median time to onset of NPRS ≤1 in both groups was comparable (group R= 16 minutes vs group L= 18 minutes (p = 0.076). Volume of drug for NPR ≤1 in both groups was also comparable (Group R 15.95± 2.03 ml vs Group L 16.35 ± 1.34 ml (p=0.47). Conclusion: DPE with 16 G epidural needle and 26 gauge spinal needle with both 0.125% ropivacaine and 0.125% levobupivacaine results in similar efficacy of labour analgesia.

Keywords: dural puncture epidural, labour analgesia, obstetric analgesia, hypotension

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Authors: Peri Harish Kumar, Sai Sharan Dwarka, Tajbinder Singh Bains, Suneet John Joseph, Chaitanya Kiran, Sambhu Dutta, Sarah Makram, Mohamed Sayed Zaazouee, Alaa Ahmed Elshanbary

Abstract:

Objective: To identify cancer and non-cancer causes of death in hepatocellular carcinoma (HCC) patients over different time periods after diagnosis and to compare the mortality risk of each cause in HCC patients with the general population. Methods: In this retrospective cohort study, data of 67,637 HCC patients from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the association between different causes of death and the following variables: age, race, tumor stage at diagnosis, and treatment (surgery, chemotherapy, and radiotherapy); each according to the periods of <1 year, 1-5 years, 5-10 years, and >10 years following the diagnosis. Standardized mortality ratios (SMRs) and their 95% confidence intervals (CIs) were calculated for cancer and non-cancer deaths in each of the mentioned periods following diagnosis. Results: Data of 67,637 patients, of whom 50,571 patients died during the follow-up period, were analyzed. Most deaths were due to HCC itself (35,535, 70.3%), followed by other cancers (3,983, 7.9%). Common causes of non-cancer mortality included infectious and parasitic diseases including HIV (2,823 patients, SMR=105.68, 95% CI: 101.82-109.65), chronic liver disease (2,719 patients, SMR=76.56, 95% CI: 73.71,79.5), and heart diseases (1,265 patients, SMR=2.26, 95% CI: 2.14-2.39), with higher mortality risk in HCC patients than in the general population. Conclusion: Cancers stand for most deaths in patients with HCC. Besides, infectious, and parasitic diseases including HIV represent the commonest non-cancer cause of mortality.

Keywords: hepatocellular carcinoma, seer, causes of death, mortality

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Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

Abstract:

Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

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Authors: Vidhu Mitha Goutham, Ruma Mukherjee

Abstract:

The low availability of well-trained, unlimited, dynamic-access models for specific languages makes it hard for corporate users to adopt quick translation techniques and incorporate them into product solutions. As translation tasks increasingly require a dynamic sequence learning curve; stable, cost-free opensource models are scarce. We survey and compare current translation techniques and propose a modified sequence to sequence model repurposed with attention techniques. Sequence learning using an encoder-decoder model is now paving the path for higher precision levels in translation. Using a Convolutional Neural Network (CNN) encoder and a Recurrent Neural Network (RNN) decoder background, we use Fairseq tools to produce an end-to-end bilingually trained Spanish-English machine translation model including source language detection. We acquire competitive results using a duo-lingo-corpus trained model to provide for prospective, ready-made plug-in use for compound sentences and document translations. Our model serves a decent system for large, organizational data translation needs. While acknowledging its shortcomings and future scope, it also identifies itself as a well-optimized deep neural network model and solution.

Keywords: attention, encoder-decoder, Fairseq, Seq2Seq, Spanish, translation

Procedia PDF Downloads 155

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

Abstract:

Introduction: Acute bronchiolitis (AB) is a real public health problem on a global and national scale. Its treatment is most often outpatient. The use of audio-visual supports, such as educational videos, is an innovation in therapeutic education in outpatient treatment. The aim of our study was to evaluate the impact of an educational video on the knowledge, attitudes, and practices of mothers of infants with AB. Methodology: This was a descriptive, analytical, and cross-sectional study with prospective data collection, including mothers of infants with AB. We assessed mothers' knowledge, attitudes, and practices regarding AB, and we created an educational video. We used a questionnaire written in Tunisian Arabic concerning sociodemographic data, mothers' knowledge and attitudes regarding AB, and their opinions on the video, as well as an observation grid to evaluate their practices on the nasopharyngeal unblocking technique. We compared the different parameters before and after watching the video. Results: We noted a statistically significant improvement in mothers' knowledge scores on AB (7.46 in the pre-test versus 14.08 in the post-test; p≤0.05), practices (12.42 in the pre-test versus 18 in the post-test; p≤0.05) and attitudes (5.86 in pre-test versus 9.02 in post-test; p≤0.05). Conclusion: The use of an educational video has a positive impact on the knowledge, practices, and attitudes of mothers towards AB.

Keywords: acute bronchiolitis, therapeutic education, mothers, educational video

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Authors: Sherif Refaat, Hassan Aref

Abstract:

Background: Although asthma is a well-identified presentation to the emergency department, little is known about the frequency and percentage of respiratory and non-respiratory symptoms in patients with acute asthma in the emergency department (ED). Objective: The aim of this study is to identify the relationship between acute asthma exacerbation and different respiratory and non-respiratory symptoms including chest pain encountered by patients visiting the emergency department. Subjects and methods: Prospective study included 169 (97 females and 72 males) asthmatic patients who were admitted to emergency department of two tertiary care facility hospitals for asthma exacerbation from the period of September 2010 to August 2013, an anonyms questionnaire was used to collect symptoms and analysis of symptoms. Results: Females were 97 (57%) of the patients, mean age was 35.6 years; dyspnea on exertion was the commonest symptom accounting for 161 (95.2%) of patients, followed by dyspnea at rest 155 (91.7%), wheezing in 152 (89.9%), chest pain was present in 82 patients (48.5%), the pain was burning in 36 (43.9%) of the total patients with chest pain. Non-respiratory symptoms were seen frequently in acute asthma in ED. Conclusions: Dyspnea was the commonest chest symptoms encountered in patients with acute asthma followed by wheezing. Chest pain in acute asthma is a common symptom and should be fully studied to exclude misdiagnosis as of cardiac origin; there is a need for a better dissemination of knowledge about this disease association with chest pain. It was also noted that other non-respiratory symptoms are frequently encountered with acute asthma in emergency department.

Keywords: asthma, emergency department, respiratory symptoms, non respiratory system

Procedia PDF Downloads 402

Authors: Renee Monchalin

Abstract:

Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

Procedia PDF Downloads 192