Search results for: physical therapy

Authors: Li-Yu Lee, Yu-Shuan Chen, Jun Sheng Wang, I-Ming Chu

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Microneedle patch is a painless transdermal drug delivery method, It could solve some problems in traditional drug delivery such as digestive system causing drug metabolism and subcutaneous injection causing some side effects. Coating drug on or loading drug in microneedle can carry active ingredient through stratum corneum, also can control dose well when microneedle patch apply on localized topical area. We used hyaluronic acid to fabricate dissolvable microneedle patch and encapsulated minoxidil into microneedles. Minoxdil is a drug for exterior use that can be used to treat Androgenetic alopecia, but related commercial products have some shortcomings, for example, propylene glycol which is used to soften stratum corneum cause skin allergic reaction, comparing chemical promotion, microneedle patch provide physical way to make drugs through nature barrier of skin. In this research, we designed a two-step process to fabricate microneedle patch, that can effectively reduce drug waste, and gentle production process could maintain drug activity well. We also do in vitro test on cadaver to make sure patch has enough mechanical strength to penetrate stratum corneum. In the release test and animal test, we found microneedle patch has higher delivery efficiency than tradition way. In this study, we may determine that germinal MNs patch is a potential commodity.

Keywords: dissolving microneedles, androgenetic alopecia, minoxidil, transdermal drug delivery

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Authors: Khader A. Almhdawi, Hassan Alrabbaie

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Background: Musculoskeletal disorders (MSDs) represent a significant challenge for registered nurses. To our best knowledge, there is no published study that investigated the prevalence of MSDs among nurses and their associated factors comprehensively in Jordan. This study aimed to find the prevalence of MSDs, their possible predictors among registered nurses in Jordanian hospitals. Methods: A cross-sectional design was used. Outcome measures included Nordic Musculoskeletal Questioner (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), IPAQ, and sociodemographic data. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were conducted to identify predictors of MSDs. Results: 597 nurses from different hospitals in Jordan participated in this study. Reported MSDs prevalence was the highest at neck (61.1%), followed by upper back (47.2%), shoulder (46.7%), wrist and hands (27.3%), and elbow (13.9%). Significant predictors of MSDs among Jordanian nurses included: being a female, poor sleep quality, high physical activity levels, poor ergonomics, increased workload, and mental stress. Conclusion: This study showed a high prevalence of MSDs among Jordanian nurses and identified their significant predictors. Future studies are needed to investigate the progressive nature of MSDs and their effective treatment strategies.

Keywords: musculoskeletal disorders, nursing, ergonomic, occupational stress

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Authors: Kafuko M. Maria, Namisango Fatuma, Byomire Gorretti

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Mobile learning (m-learning) is steadily growing and has undoubtedly derived benefits to learners and tutors in different learning environments. This paper investigates the variation in benefits derived from enhanced classroom learning through use of m-learning platforms in the context of a developing country owing to the fact that it is still in its initial stages. The study focused on how basic technology-enhanced pedagogic innovation like cell phone-based learning is enhancing classroom learning from the learners’ perspective. The paper explicitly indicates the opportunities presented by enhanced learning to a conventional learning environment like a physical classroom. The findings were obtained through a survey of two universities in Uganda in which data was quantitatively collected, analyzed and presented in a three banded diagram depicting the variation in the obtainable benefits. Learners indicated that a smartphone is the most commonly used device. Learners also indicate that straight lectures, student to student plus student to lecturer communication, accessing learning material and assignments are core activities. In a TEL environment support by smartphones, learners indicated that they conveniently achieve the prior activities plus discussions and group work. Learners seemed not attracted to the possibility of using TEL environment to take lectures, as well as make class presentations. The less attractiveness of these two factors may be due to the teacher centered approach commonly applied in the country’s education system.

Keywords: technology enhanced learning, m-learning, classroom learning, perceived benefits

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Authors: Christi Jackson, Chuka Onaga

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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

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Authors: Shanshan Guo, Xiaoying Zhu, Dominik Jańczewski, Koon Gee Neoh

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Surface charge and wettability are two prominent physical factors governing cell adhesion and have been extensively studied in the literature. However, a comparison between the two driving forces in terms of their independent and cooperative effects in affecting cell adhesion is rarely explored on a systematic and quantitative level. Herein, we formulate a protocol which allows two-dimensional and independent control over both surface charge and wettability. This protocol enables the unambiguous comparison of the effects of these two properties on cell adhesion. This strategy is implemented by controlling both the relative thickness of polyion layers in the layer-by-layer assembly and the polyion side chain chemical structures. The 2D property matrix spans surface isoelectric point ranging from 5 to 9 and water contact angle from 35º to 70º, with other interferential factors (e.g. roughness) eliminated. The interplay between these two surface variables influences 3T3 fibroblast cell adhesion. The results show that both surface charge and wettability have an effect on its adhesion. The combined effects of positive charge and hydrophilicity led to the highest cell adhesion whereas negative charge and hydrophobicity led to the lowest cell adhesion. Our design strategy can potentially form the basis for studying the distinct behaviors of electrostatic force or wettability driven interfacial phenomena and serving as a reference in future studies assessing cell adhesion to surfaces with known charge and wettability within the property range studied here.

Keywords: cell adhesion, layer-by-layer, surface charge, surface wettability

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Authors: Gourav Jain, Sameer Dixit, Surjeet Kumar Arya, Praveen C. Verma

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Plant cell wall plays a major role in defence mechanism against biotic and abiotic stress as it constitutes the physical barrier between the microenvironment and internal component of the cell. It is a complex structure composed of mostly carbohydrates among which cellulose and hemicelluloses are most abundant that is embedded in a matrix of pectins and proteins. Multiple enzymes have been reported which plays a vital role in cell wall modification, Pectin Methylesterase (PME) is one of them which catalyses the demethylesterification of homogalacturonans component of pectin which releases acidic pectin and methanol. As emitted methanol is toxic to the insect pest, we use PME gene for the better methanol production. In the current study we showed overexpression of PME gene isolated from Withania somnifera under the insect inducible promoter causes enhancement of methanol production at the time of insect feeds to plants, and that provides better insect resistance property. We found that the 85-90% mortality causes by transgenic tobacco in both chewing (Spodoptera litura larvae and Helicoverpa armigera) and sap-sucking (Aphid, mealybug, and whitefly) pest. The methanol content and emission level were also enhanced by 10-15 folds at different inducible time point interval (15min, 30min, 45min, 60min) which would be analysed by Purpald/Alcohol Oxidase method.

Keywords: methanol, Pectin methylesterase, inducible promoters, Purpald/Alcohol oxidase

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Authors: Lu Lin

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Urbanization has reshaped physical environment, energy consumption and carbon emission of the urban area. China is a typical developing country under a rapid urbanization process and is the world largest carbon emission country. This study aims to explore the correlation between urban form and carbon emission caused by urban energy consumption in China. 287 provincial-level and prefecture-level cities are studied in 2000, 2005, and 2010. Compact ratio index, shape index, and fractal dimension index are used to quantify urban form. Geographically weighted regression (GWR) model is employed to explore the relationship between urban form, energy consumption, and related carbon emission. The results show the average compact ratio index decreased from 2000 to 2010 which indicates urban in China sprawled. The average fractal dimension index increases by 3%, indicating the spatial layouts of China's cities were more complicated. The results by the GWR model show that shape index and fractal dimension index had a non-significant relationship with carbon emission by urban energy consumption. However, compact urban form reduced carbon emission. The findings of this study will help policy-makers make sustainable urban planning and reduce urban carbon emission.

Keywords: carbon emission, GWR model, urban energy consumption, urban form

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Authors: Julian B. García, Virginie Q. R. Pinto, André P. Assis

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This paper presents numerical flow and slope stability simulations in three typical sections of earth dams built in tropical regions, two homogeneous with different slope inclinations, and the other one heterogeneous with impermeable core. The geotechnical material parameters used in this work were obtained from a lab testing of physical characterization, compaction, consolidation, variable load permeability and saturated triaxial type CD for compacted soil samples with standard proctor energy at optimum moisture content (23%), optimum moisture content + 2% and optimum moisture content +5%. The objective is to analyze the general behavior of earth dams built in rainy regions where optimum moisture is exceeded. The factor of safety is satisfactory for the three sections compacted in all moisture content during the stages of operation and end of construction. On The other hand, the rapid drawdown condition is the critical phase for homogeneus dams configuration, the factor of safety obtained were unsatisfactory. In general, the heterogeneous dam behavior is more efficient due to the fact that the slopes are made up of gravel, which favors the dissipation of pore pressures during the rapid drawdown. For the critical phase, the slopes should have lower inclinations of the upstream and downstream slopes to guarantee stability, although it increases the costs.

Keywords: earth dams, flow, moisture content, slope stability

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Authors: Roop Kiran, Muhammad Shoaib Zafar, Nazish Idrees Chaudhary

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Depression is known to be the second most frequently occurring comorbid mental illness among patients suffering from chronic physical conditions. Around the world, depression is associated with chronic liver diseases as one of the dominant symptoms. This evidence brings attention to the research about various predictors for short life expectancy and poor quality of life in patients suffering from comorbid depression and CLD. Following are the objectives of this study i) measure the occurrence rate of comorbid depression among patients with CLD and ii) find the frequency of risk factors between patients with and without depression comorbid with CLD. This is a quantitative study with a cross-sectional design. The research data was collected through a measure called Hamilton Depression Rating Scale (HDRS) with a demographic Performa from 100 patients who visited the Department of Psychiatry for consultation at Mayo Hospital Lahore with a diagnosed CLD from the last four years. There were (42%) patients with CLD who had comorbid depression. Among depressed and non-depressed patients, significant differences were found (p<0.05) for unemployment in 25 (59.5%) males and 20 (34.5%) female patients, for co-morbidity in 25 (59.5%) males and 18 (31.0%) female patients, for illiteracy in 18 (42.9%) males and 13 (22.4%) female patients, for the history of CLD for more than the last 2years in 41 (97.6%) males and 47 (81.0%) female patients, for severity of CLD in 26 (61.9%) males and 20 (34.5%) female patients. This concludes that depression frequently occurs among patients with CLD. This study recommends considerable attention to plan preventative measures in the future and develop such intervention protocols that consider the management of risk factors that significantly influence comorbid depression with CLD.

Keywords: psychiatry, comorbid, health, quality of life

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Authors: Ikram Kamal, Mohamed Blaghen

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Biosurfactants are amphiphilic biological compounds consisting of hydrophobic and hydrophilic domains produced extracellularly or as part of the cell membrane by a variety of yeast, bacteria and filamentous fungi. Biosurfactant applications in the environmental industries are promising due to their biodegradability, low toxicity, and effectiveness in enhancing biodegradation and solubilization of low solubility compounds. Currently, the main application is for enhancement of oil recovery and hydrocarbon bioremediation due to their biodegradability and low critical micelle concentration (CMC). The use of biosurfactants has also been proposed for various industrial applications, such as in food additives, cosmetics, detergent formulations and in combinations with enzymes for wastewater treatment. In this study, we have investigated the potential of bacterial strains: Mannheimia haemolytica, Burkholderia cepacia and Serratia ficaria were collected aseptically from the lagoon Marchika (water and soil) in Nador, Morocco; for the production of biosurfactants. This study also aimed to optimize the biosurfactant production process by changing the variables that influence the type and amount of biosurfactant produced by these microorganisms such as: carbon sources and also other physical and chemical parameters such as temperature and pH. Emulsification index, methylene blue test, and thin layer chromatography (TLC) revealed the ability of strains used in this study to produce compounds that could emulsify gasoline. In addition, a GC/MS was used to separate and identify different biosurfactants purified.

Keywords: biosurfactants, Mannheimia haemolytica, biodegradability, Burkholderia cepacia, Serratia ficaria

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Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

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Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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Authors: Aicha Bouhlala, Sabah Chettibi

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A systematic investigation on structural, electronic, and magnetic properties of Ce₀.₇₅A₀.₂₅O₂ (A = W, Mo) is performed using first-principles calculations within the framework Full-Potential Linear Augmented Plane Wave (FP-LAPW) method based on the Density Functional Theory (DFT). The exchange-correlation potential has been treated using the generalized gradient approximation (WC-GGA) developed by Wu-Cohen. The host compound CeO2 was doped with transition metal atoms W and Mo in the doping concentration of 25% to replace the Ce atom. In structural properties, the equilibrium lattice constant is observed for the W-doped CeO₂ compound which exists within the value of 5.314 A° and the value of 5.317 A° for Mo-doped CeO2. The present results show that Ce₀.₇₅A₀.₂₅O₂ (A=W, Mo) systems exhibit semiconducting behavior in both spin channels. Although undoped CeO₂ is a non-magnetic semiconductor. The band structure of these doped compounds was plotted and they exhibit direct band gap at the Fermi level (EF) in the majority and minority spin channels. In the magnetic properties, the doped atoms W and Mo play a vital role in increasing the magnetic moments of the supercell and the values of the total magnetic moment are found to be 1.998 μB for Ce₀.₇₅W₀.₂₅O₂ and to be 2.002 μB for Ce₀.₇₅Mo₀.₂₅O₂ compounds. Calculated results indicate that the magneto-electronic properties of the Ce₁₋ₓAₓO₂(A= W, Mo) oxides supply a new way to the experimentalist for the potential applications in spintronics devices.

Keywords: FP-LAPW, DFT, CeO₂, properties

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Authors: M. E. Silva, I. Brás

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To study the influence of different organic amendments on the quality of poultry manure compost, three pilot composting trials were carried out with different mixes: poultry manure/carcasse meal/ashes/grape pomace (Pile 1), poultry manure/ cellulosic sludge (Pile 2) and poultry manure (Pile 3). For all piles, wood chips were applied as bulking agent. The process was monitored, over time, by evaluating standard physical and chemical parameters, such as, pH, electric conductivity, moisture, organic matter and ash content, total carbon and total nitrogen content, carbon/nitrogen ratio (C/N) and content in mineral elements. Piles 1 and 2 reached a thermophilic phase, however having different trends. Pile 1 reached this phase earlier than Pile 2. For both, the pH showed a slight alkaline character and the electric conductivity was lower than 2 mS/cm. Also, the initial C/N value was 22 and reached values lower than 15 at the end of composting process. The total N content of the Pile 1 increased slightly during composting, in contrast with the others piles. At the end of composting process, the phosphorus content ranged between 54 and 236 mg/kg dry matter, for Pile 2 and 3, respectively. Generally, the Piles 1 and 3 exhibited similar heavy metals content. This study showed that organic amendments can be used as carbon source, given that the final composts presented parameters within the range of those recommended in the 2^nd Draft of EU regulation proposal (DG Env.A.2 2001) for compost quality.

Keywords: co-composting, compost quality, organic ammendment, poultry manure

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Authors: Ching-Feng Chen, Ching-Chih Tsai

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With the size of the transistor gradually approaching the physical limit, it challenges the persistence of Moore’s Law due to the development of the high numerical aperture (high-NA) lithography equipment and other issues such as short channel effects. In the context of the ever-increasing technical requirements of portable devices and high-performance computing, relying on the law continuation to enhance the chip density will no longer support the prospects of the electronics industry. Weighing the chip’s power consumption-performance-area-cost-cycle time to market (PPACC) is an updated benchmark to drive the evolution of the advanced wafer nanometer (nm). The advent of two and half- and three-dimensional (2.5 and 3D)- Very-Large-Scale Integration (VLSI) packaging based on Through Silicon Via (TSV) technology has updated the traditional die assembly methods and provided the solution. This overview investigates the up-to-date and cutting-edge packaging technologies for 2.5D and 3D integrated circuits (ICs) based on the updated transistor structure and technology nodes. The author concludes that multi-chip solutions for 2.5D and 3D IC packagings are feasible to prolong Moore’s Law.

Keywords: moore’s law, high numerical aperture, power consumption-performance-area-cost-cycle time to market, 2.5 and 3D- very-large-scale integration, packaging, through silicon via

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Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

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Authors: Husni Mohd Radzi, Lilie Zahara Ramly, Sapora Sipon, Salhah Abdullah

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Malaysia have been experiencing series of huge floods all around the country for the past decades despide planned development done by local authorities. The floods incurred due to factors like natural climate change or man-made disaster. Floods have caused a lot of damages, destructions and losses in term of infrastructure, financial implications and physical health. However, other damaging aspect was not being given much attention are the psychological need of the flood victim. The traumatic impact from the natural disaster like floods may cause serious psychological and spiritual deterioration. Many flood relief shelters in the past did not provide counseling services for flood victims to consult, and as a result, it contributes to added stress among the flood victims, as the issue were not being addressed. Some studies indicates that flood victims did not look for counseling service being offered. A total of 257 flood victim was involved in this study. Main area of the study was Kg Bukit Changgang, Kg. Rancangan Tanah Belia, Kg. Labohan Dagang and Kg.Olak Lempit in Kuala Langat, Selangor. The flood victims have responded to the survey given and the data was analyze using SPSS for descriptive information and other measures. At least 13 victims were reported to have experienced moderate to severe level of stress and anxiety over the flood disaster incidents and a total of 88 respondents admitted to have at least thought and consider getting counseling service.

Keywords: perception, acceptance towards counseling, counseling service for flood victim, disaster

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Authors: David Ross Cameron

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In an attempt to alleviate the educational planning problem, double-shift schools have been created throughout various regions in Jordan, namely communities closer to the Syrian border, where a large portion of the refugee population settled, allowing Jordanians to attend the morning-shift and Syrians to attend the afternoon-shift. Subsequently, overcrowded classrooms have added a significant amount of stress on school facilities and teacher capacities. Established national policies and the implementation of inclusive educational practices have been jeopardized. In particular, teachers’ and student’s attitudes of the importance of inclusive education provisions in the classroom have deteriorated. To have a more comprehensive understanding of the current situation and possible plan for intervention, a focus study was carried out at a double-shift Jordanian/Syrian girls’ public school in Irbid, Jordan. Interviews and surveys of 29 students with physical, learning, emotional and behavioral disabilities, 33 students without any special needs and nine teachers were included with a mixed-method social research approach to highlight the current attitudes that students and teachers held and factors that contributed to shaping their inclinations and beliefs of inclusive education.

Keywords: capacity building, development, double-shift, Irbid, inclusive education, Jordan, pedagogy, planning, policy, refugee, special education, special needs, vulnerable population

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Authors: M. S. Said, J. A. Ghani, Izzati Osman, Z. A. Latiff, S. A .F. Syed Mohd

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Metal matrix composites have demand for light-weight structural and functional materials. MMCs have been shown to offer improvements in strength, rigidity, temperature stability, wear resistance, reliability and control of physical properties such as density and coefficient of thermal expansion, thereby providing improved engineering performance in comparison to the un-reinforced matrix. Experiment were conducted at various cutting speed, feed rate and difference cutting tools according to Taguchi method using a standard orthogonal array L9. The volume of AlN reinforced particle was 10% in MMC. The milling process was carried out under dry cutting condition using uncoated carbide, TiN and TiCN tool insert. The parameters used were the cutting speed of (230,300,370 m/min) the federate used were (0.4, 0.6, 0.8 mm/tooth) while the depth of cut is constant (0.3 mm). The tool diameter is 20mm. From the project, the surface roughness mechanism was investigated in detail using Mitutoyo portable surface roughness measurements surftest SJ-310. This machining will be fabricated on MMC with 150mm length, 100mm width and 30mm thick. The results showed using S/N ratio, concluded that a combination of low cutting speed, medium feed rate and uncoated insert give a remarkable surface finish. From the ANOVA result showed the feed rate was major contributing factor (43.76%) following type of insert (40.89%).

Keywords: MMC, milling operation and surface roughness, Taguchi method

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Authors: Tabiti S. Tabiti, A. M. Jinadu, Daramola Japheth

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Urban insecurity is among the challenges militating against sustainable urban governance; in the first place it distorts the peace of urban areas making them unsafe. On the other hand it hinders the effective performance of urban functions. Urban security challenges manifest in different forms such as, street violence, theft and robbery, accidents of different types kidnapping, killings etc.. Efforts to address urban security challenges in Nigeria have been concentrated in legislative, law enforcement and the use of community vigilante groups. However in this study, the place of physical planning strategy through effective neighbourhood renewal as practiced in Mokola is presented as an effective complementary approach for addressing urban insecurity. On this backdrop, the paper recommends the need for gradual rehabilitation of urban slum neighborhoods by the state government in collaboration with World Bank and other development financiers. The local governments should be made autonomy in Nigeria so as to make them more responsible to the people. Other recommendations suggested in the paper include creating enabling environment that will promote economic empowerment and public enlightment on personal and community sanitation. It is certain that if these recommendations are adopted the challenge of urban insecurity will reduce significantly in Nigerian cities.

Keywords: neighbourhood renewal, pilot project, slum upgrading, urban security

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Authors: Abdul Salam Turkmani

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The Lower Cretaceous rocks are exposed only in the mountains regions of Syria, such as the Anti- Lebanon mountain on the western side of Damascus. The lower cretaceous sequences are made up of different rocks. The upper and middle parts of the section are composed mainly of carbonate sediments and, less frequently, gypsum and anhydrite. The lower beds are mainly composed of sandstone, conglomerate and clay. Clay samples were collected from the study area, which is located about 45 km west of the city of Damascus, near the border village of Kfer Yabous and to the left of the Damascus -Beirut International Road, within the lower Cretaceous upper Aptian deposits. The properties of clay were carried out by X-ray diffraction (XRD) and, X-ray fluorescence (XRF) and Thermal Analysis (DTA-TG-DSC) techniques. The studied samples of clay were mainly composed of kaolinite, quartz, illite. Chemical analysis shows the content of SiO₂ varied between 46.06 to 73 % Al₂O₃ 14.55-26.56%, about the staining oxides (Fe₂O₃ + TiO₂), the total content is about 4.3 to 12.5%. The physical properties were determined by studying the behavior of the body before and after firing, showed low bending strength values (22.5 kg/cm²) after drying, and (about 247 kg/cm²) after firing at 1180°C, water absorption value was about 10%. The cubic thermal expansion coefficient at 1140°C is 213.77 x 10-7 /°C. All of the presented results confirm the suitability of this clay for the ceramic industry.

Keywords: anti-Lebanon, Damascus, ceramic, clay, thermal analysis, thermal expansion coefficient

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Authors: Hamed Sadeghi, Pouya A. Panahi, Hamed Nasiri, Mohammad Sadeghi

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Collapsible soils like loess comprise an important category of problematic soils for construction purposes and sustainable development. As a result, research on both geological and geotechnical aspects of this type of soil have been in progress for decades. However, considerable natural variability in physical properties of in-situ loess strata even in a single block sample challenges the fundamental laboratory investigations. The reason behind this is that it is somehow impossible to remove the effect of a specific factor like void ratio from fair comparisons to come with a reliable conclusion. In order to cope with this limitation, two types of artificially made dispersive and calcareous loess are introduced which can be easily reproduced in any soil mechanics laboratory provided that all its compositions are known and controlled. The collapse potential is explored for a variety of soil water salinity and lime content and comparisons are made against the natural soil behavior. Trends are reported for the influence of pore water salinity on collapse potential under different osmotic flow conditions. The most important advantage of artificial loess is the ease of controlling cementing agent content like calcite or dispersive potential for studying their influence on mechanical soil behavior.

Keywords: artificial loess, unsaturated soils, collapse potential, dispersive clays, laboratory tests

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Authors: Radhika Jain

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The nursing community in India face unique challenges ranging from lack of adequate career progression, low social status attached to the profession, poor nurse-to-patient ratio leading to heavy workload resulting in stress and burnout, lack of general recognition and the responsibility of often having to deal with the ire of the patients and their families. This study explores how a combination of Playback Theatre and Expressive Arts could be used as a very powerful tool to understand the concerns, and consequently as a self-care tool to bring about the sense of well-being and emotional awareness for the nurses. For the purpose of this study, Playback Theatre was used as an entry tool to understand the thoughts, feelings and concerns. Playback theatre is a unique improvisational form of theatre developed by Jonathan Fox and Jo Salas in 1975, in which audience share their own stories from their lives and the performers play them back through a range of improv techniques such as metaphor, poetry, music and movement. Playback Theatre helped in first warming them up to the idea of sharing and then gave them the confidence of a safe space to collectively go deeper into their emotional experiences. As the next step, structured sessions of Expressive Arts were conducted with the same set of nurses, for them to work on the issues and concerns they have (and which they shared during the Playback performance). These sessions were to enable longer engagements as many of the concerns expressed were related to perceptions and beliefs that have been ingrained over a period of time and hence it needs a longer engagement to be worked on in detail. The Expressive Art sessions helped in this regard. Expressive arts therapy combines psychology and the creative process to promote emotional growth and healing. The study was conducted at two places: one a geriatric centre and the other, a palliative care centre. The study revealed that concerns and challenges would not be identical across the nursing community or across similar types of health care organizations but would be specific to each organization or centre as the circumstances and set-up at each place would be different. At the geriatric centre, stress and burnout emerged as the main concerns while at the palliative care centre, the main concern that came up was around the difficulty the nurses faced in expressing emotions and in communicating their feelings. The objective analysis of the results of the study indicated how longer-term engagements using Expressive Arts as the modality helped the nurses have better awareness of their emotions and helped them develop tools of self-care tools while also tapping into their emotions to express and experience. The process of eliciting the main concerns from the nurses using a Playback Theatre performance and then following that with subsequent sessions of expressive arts helped the nurses in the way nurses approached their job and the reduced level of overwhelm that they felt.

Keywords: palliative care, nurses, self-care, expressive arts, playback theatre

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Authors: Dganit Sharon, Raghda Alnabilsy

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The goal of this qualitative research was to sound the voices of Jewish and Arab women in Israel who had experienced obstetric violence, to learn the consequences of the violence to them on different levels and over time, and to present their coping strategies from their perspective. Another goal was to expand the research knowledge on an issue that has not been studied among Arab and Jewish women in Israel. The premise of this study is the feminist approach that aims to promote human rights, and to eradicate phenomena related to cultural, structural, gender and patriarchal structures of women, their bodies, and their health. The research was based on the qualitative-constructivist methodology, by means of thematic analysis of 20 in-depth semi-structured interviews. Two main themes emerged from the analysis. First, the physical and emotional consequences of obstetric violence, consequences to spousal relationships, and mistrust of the health system and service providers. Second, women’s coping strategies with obstetric violence that included repression and avoidance as a way of coping with the pain and trauma of the abuse; garnering inner strengths, resilience, knowledge and awareness of the delivery process; recruiting and relying on external help; sharing on social media, and discussions with other women who had similar experiences; or reaching out to therapists / legal aid / public complaints.

Keywords: obstetric violence, Jewish and arab women in israel, consequences, coping strategies, gender-related perspective

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Authors: Yoel Agustheo Rinding

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Globalization has made physical borders between countries become more obscure. Due to the free flow of information between countries, issue for instance, environment has become global concern. The concern has grown as the result of endless campaign made by most of the non-governmental organizations (NGOs). By means of this situation, international voluntary initiatives on environmental issues have appeared to be popular among world’s society today especially for youth. AIESEC as international non-governmental organization (INGO) through IGreen Project has initiated environmental international voluntary initiatives concerning in environmental awareness of Bandung’s citizen. Bandung itself is still struggling on solving flood as one of its major problems regardless the fact that Bandung is one of the most developed cities in Indonesia. This paper would like to discuss on how globalization affects AIESEC as an INGO in order to spread its influence and also on how it could build international voluntary initiatives networks. Afterwards, author would like to elaborate how both AIESEC and youth perceive the importance of international voluntary initiatives by using cosmopolitanism approach. In order to get a deep understanding of how this activity works, this paper also would like to explain regarding the management, expected outcomes, and the real impacts of IGreen project towards Bandung. In the end of this paper, author would like to propose solutions on how to utilize international voluntary initiatives as a solution for environmental issues nowadays.

Keywords: AIESEC, cosmopolitanism, environmental issues, globalization, IGreen project, international environmental voluntary initiatives, INGO, youth

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Authors: Shiva Shakori Poshteh

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Lung cancer is a highly prevalent and devastating disease, representing a significant global health concern with profound implications for healthcare systems and society. Its high incidence, mortality rates, and late-stage diagnosis contribute to its formidable nature. To address these challenges, nanoparticle-based drug delivery has emerged as a promising therapeutic strategy. Curcumin (CUR), a natural compound derived from turmeric, has garnered attention as a potential nanomedicine for lung cancer treatment. Nanoparticle formulations of CUR offer several advantages, including improved drug delivery efficiency, enhanced stability, controlled release kinetics, and targeted delivery to lung cancer cells. CUR exhibits a diverse array of effects on cancer cells. It induces apoptosis by upregulating pro-apoptotic proteins, such as Bax and Bak, and downregulating anti-apoptotic proteins, such as Bcl-2. Additionally, CUR inhibits cell proliferation by modulating key signaling pathways involved in cancer progression. It suppresses the PI3K/Akt pathway, crucial for cell survival and growth, and attenuates the mTOR pathway, which regulates protein synthesis and cell proliferation. CUR also interferes with the MAPK pathway, which controls cell proliferation and survival, and modulates the Wnt/β-catenin pathway, which plays a role in cell proliferation and tumor development. Moreover, CUR exhibits potent antioxidant activity, reducing oxidative stress and protecting cells from DNA damage. Utilizing CUR as a standalone treatment is limited by poor bioavailability, lack of targeting, and degradation susceptibility. Nanoparticle-based delivery systems can overcome these challenges. They enhance CUR’s bioavailability, protect it from degradation, and improve absorption. Further, Nanoparticles enable targeted delivery to lung cancer cells through surface modifications or ligand-based targeting, ensuring sustained release of CUR to prolong therapeutic effects, reduce administration frequency, and facilitate penetration through the tumor microenvironment, thereby enhancing CUR’s access to cancer cells. Thus, nanoparticle-based CUR delivery systems promise to improve lung cancer treatment outcomes. This article provides an overview of lung cancer, explores CUR nanoparticles as a treatment approach, discusses the benefits and challenges of nanoparticle-based drug delivery, and highlights prospects for CUR nanoparticles in lung cancer treatment. Future research aims to optimize these delivery systems for improved efficacy and patient prognosis in lung cancer.

Keywords: lung cancer, curcumin, nanomedicine, nanoparticle-based drug delivery

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Authors: Wahab Ali Shah, Junjia He

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In this work, we performed a large-scale investigation into leader development in a 10 m rod-plane gap under a long front positive impulse. To describe the leader propagation under slow front impulse voltages, we recorded the leader propagation with a high-speed charge coupled device (CCD) camera. It is important to figure out this phenomenon to deepen our understanding of leader discharge. The observation results showed that the leader mechanism is a very complex physical phenomenon; it could be categorized into two types of leader process, namely, continuous and the discontinuous leader streamer-leader propagation. Furthermore, we studied the continuous leader development parameters, including two-dimensional (2-D) leader length, injected charge, and final jump stage, as well as leader velocity for rod–plane configuration. We observed that the discontinuous leader makes an important contribution to the appearance of channel re-illuminations of the positive leader. The comparative study shows better results in terms of standard switch impulse and long front positive impulse. Finally, the results are presented with a view toward improving our understanding of propagation mechanisms related to restrike phenomena, which are rarely reported. To clarify the above doubts under long front cases, we carried out extensive experiments in this study.

Keywords: continuous and discontinuous leader, high-speed photographs, long air gap, positive long front impulse, restrike phenomena

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Authors: Sanober Khanum, Barerah Siddiqui, Asim Qidwai

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Objective: To determine the risk factors and frequency of depressive trends in children and adolescents suffering from Beta-Thalassemia. Background: Thalassemia is a chronic disease affecting 10,000 people in 60 countries. Many studies show that prolonged medical conditions cause depression. Due to the invasive procedures and suffering, Beta-Thalassemia cause great psychological distress to both children and their caregivers. The study shows 14-24% prevalence of psychiatric problems in Thalassemic patients. Method: Sample consisted of 195 registered patients of A.M.T.F (Female=95 and Male=100). Based on age range the sample was divided into two groups, Group A = children (4-9 years) and Group B = adolescent (10-16 years). A detailed interview with a self-made screening measure was administered on parents to find out the level of depression in patients. Statistics: Chi-square and t-test was applied in order to analyze the data. Results show high prevalence of depression, depression n= 131(66.83%), no depression n=65(33.16%). Analyses reflect that age influences the level of depression Adolescent (71.05%) and Children (64.16%). The analysis also shows a difference in level of depression between both genders. (t=2.975, p < .05). Conclusion: There is a high possibility of developing depressive trend in children affected with Beta Thalassemia; especially females. Therefore, there is a dire need for psychological screening and appropriate treatment in order to improve physical; as well as mental health.

Keywords: childhood depression, chronic illness, psychopathology, Thalassemia

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Both obesity and intimate partner violence (IPV) are growing health threats. This study aimed to assess the prevalence and risk factors of both IPV and obesity and their association. In this cross-sectional study, 530 women aged 16-65 years attending Mazandaran primary health centers were recruited through the stratified random sampling method (2019-2020). Data were collected using the modified World Health Organization Domestic Violence questionnaire, Perceived Stress Scale, and socio-demographic, obstetric, and anthropometric questionnaires. The data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression. The prevalence of overweight, obesity and psychological, physical, and sexual IPV were 47.6%, 26.7%, 70.4%, 17.9%, and 6.4%, respectively. Increasing women’s educational level and exposure to violence during their lifespan increased the odds of any type of IPV while living in a nuclear family reduced it. In groups of women who were subjected to any type of IPV and only psychological IPV, experiencing violence during the lifespan was significant in predicting obesity. The alarming prevalence of IPV and obesity-overweight in this study points to the need for collaborative socio-political and health intervention. The link between experiencing violence during lifespan and obesity in some subgroups of women highlights the detrimental consequences of chronic violence and the urgent need for effective preventive programs.

Keywords: intimate partner violence, body mass index, obesity, risk factor, women

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Authors: Pramod Ghadge, Swadesh Srivastava

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Revenue generation of a logistics company depends on how the logistics cost of a shipment is calculated. Logistics cost of a shipment is a function of distance & speed of the shipment travel in a particular network, its volumetric size and dead weight. Logistics billing is based mainly on the consumption of the scarce resource (space or weight carrying capacity of a carrier). Shipment’s size or deadweight is a function of product and packaging weight, dimensions and flexibility. Hence, to arrive at a standard methodology to compute accurate cost to bill the customer, the interplay among above mentioned physical attributes along with their measurement plays a key role. This becomes even more complex for an ecommerce company, like Flipkart, which caters to shipments from both warehouse and marketplace in an unorganized non-standard market like India. In this paper, we will explore various methodologies to define a standard way of billing the non-standard shipments across a wide range of size, shape and deadweight. Those will be, usage of historical volumetric/dead weight data to arrive at a factor which can be used to compute the logistics cost of a shipment, also calculating the real/contour volume of a shipment to address the problem of irregular shipment shapes which cannot be solved by conventional bounding box volume measurements. We will also discuss certain key business practices and operational quality considerations needed to bring standardization and drive appropriate ownership in the ecosystem.

Keywords: contour volume, logistics, real volume, volumetric weight

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