Search results for: health- care

Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

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Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

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Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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Authors: Stephanie Elizabeth Talder

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Art therapy is a field that is growing exponentially with new groundbreaking discoveries that allow for embodying trauma and mental healing. Applied theatre and performance is a continuously growing and developing field that can help people who are struggling to work through traumatic experiences plaguing their life. By using performance, there is an ability to target sensitive topics in a manner that does not lead to re-traumatization. The use of theatre as a healing agent has been going on for centuries, with clear applications beginning in Greek theatre and tragedy. When working with complex mental illness, issues such as PTSD, anxiety, and depression can be managed and worked through. A central component of drama therapy is the connection to community and self. The ability to connect mind-body to stories as well as to other people allows for healing to occur. There is the opportunity for healing through emotional catharsis and community building. Applied theatre in connection to the medical field can allow for there to be a meaningful impact made on mental health. Though there is still a significant amount of progress to be made within the stigmatization of mental health problems, bringing in a varying option that allows for there to be movement and community building possesses a strong ability to impact people in a positive way.

Keywords: applied theatre, drama therapy, art therapy, performance, theatre

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Authors: Caglayan Pinar Demirtas, Mustafa Koc

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Objective: This study was carried out in order to find out; the methods which are used by primary school teachers to cope with stress, their psychological health, and the direction of controlling focus. The study was carried out by using the ‘school survey’ and ‘society survey’ methods. Method: The study included primary school teachers. The study group was made up of 1066 people; 511 women and 555 men who accepted volunteerly to complete; ‘the inventory for collecting data, ‘the Scale for Attitude of Overcoming Stress’ (SBTE / SAOS), ‘Rotter’s Scale for the Focus of Inner- Outer Control’ (RİDKOÖ / RSFIOC), and ‘the Symptom Checking List’ (SCL- 90). The data was collected by using ‘the Scale for Attitude of Overcoming Stress’, ‘the Scale for the Focus of Inner- Outer Control’, ‘the Symptom Checking List’, and a personal information form developed by the researcher. SPSS for Windows packet programme was used. Result: The age variable is a factor in interpersonal sensitivity, depression, anxciety, hostality symptoms but it is not a factor in the other symptoms. The variable, gender, is a factor in emotional practical escaping overcoming method but it is not a factor in the other overcoming methods. Namely, it has been found out that, women use emotional practical escaping overcoming method more than men. Marital status is a factor in methods of overcoming stress such as trusting in religion, emotional practical escaping and biochemical escaping while it is not a factor in the other methods. Namely, it has been found out that married teachers use trusting in religion method, and emotional practical escaping method more than single ones. Single teachers generally use biochemical escaping method. In primary school teachers’ direction of controlling focus, gender variable is a factor. It has been found out that women are more inner controlled while the men are more outer controlled. The variable, time of service, is a factor in the direction of controlling focus; that is, teachers with 1-5 years of service time are more inner controlled compared with teachers with 16-20 years of service time. The variable, age, is a factor in the direction of controlling focus; that is, teachers in 26-30 age groups are more outer controlled compared with the other age groups and again teachers in 26-30 age group are more inner controlled when compared with the other age groups. Direction of controlling focus is a factor in the primary school teachers’ psychological health. Namely, being outer controlled is a factor but being inner controlled is not. The methods; trusting in religion, active plannıng and biochemical escaping used by primary school teachers to cope with stress act as factors in the direction of controlling focus but not in the others. Namely, it has been found out that outer controlled teachers prefer the methods of trusting in religion and active planning while the inner controlled ones prefer biochemical escaping.

Keywords: coping with, controlling focus, psychological health, stress

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Authors: Ana Fouto

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Background: Continuing Personal Development (CPD) enables professionals to keep up to date with the professional requirements, broadening their knowledge and expertise. However, much of the research explores the registered professionals’ experiences and the factors that influence their choice of engaging, despite the unregistered staff providing the majority of the direct patient care. Aim: To explore the Nursing/Midwifery Assistants’ (NAs) perception of the concept of CPD, as well as explore the factors that influence the NAs to engage (or not) with CPD experiences. Methodology: This pilot study used a qualitative approach through a case study, where a semi-structured interview was applied to three NAs to explore the factors that influence the decision-making of process of CPD engagement. Thematic analysis was used to analyse their answers and interpret patterns and associations. Findings: All the participants agreed that CPD is important and relevant to their practice and personal lives. Five main categories were identified: NAs’ scope of practice, the impact of CPD; decision-making process; challenges; changes required. Although similar findings to the registered nurses were identified, the lack of CPD regulation for NAs and the rapid evolution of their role make the CPD engagement more problematic. Conclusion: Engagement with CPD is influenced by a wide range of professional (organisational and national) and personal factors. NAs perceive lack of management support at different stages of the CPD activities as a main influence. Organisations should be more flexible in the recruitment, offer of CPD choices, content, delivery, and contractual arrangements of NAs, which may increase engagement.

Keywords: nursing assistants, engagement, factors, pilot, continuing professional development (CPD)

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Authors: Mukesh A. Modi

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High-nitrate concentration in groundwater of unconfined aquifers has been a serious issue for public health risk at a global scale. Various anthropogenic activities in agricultural land and urban land of alluvial soil have been observed to be responsible for the increment of nitrate in groundwater. The present study was designed to identify suitable denitrification strategies to minimize the effects of high nitrate in groundwater near the Mahi River of Vadodara block, Gujarat. There were 11 wells of Jal Jeevan Mission, Ministry of Jal Shakti, along with 3 observation wells of Gujarat Water Resources Development Corporation have been used for the duration of 21 years. MODFLOW and MT3DMS codes have been used to simulate solute transport phenomena along with attempted effectively for optimization. Current research is one step ahead by optimizing various denitrification strategies with the simulation of the model. The in-situ and ex-situ denitrification strategies viz. NAS (No Action Scenario), CAS (Crop Alternation Scenario), PS (Phytoremediation Scenario), and CAS + PS (Crop Alternation Scenario + Phytoremediation Scenario) have been selected for the optimization. The groundwater model simulates the most suitable denitrification strategy considering the hydrogeological characteristics at the targeted well.

Keywords: groundwater, high nitrate, MODFLOW, MT3DMS, optimization, denitrification strategy

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Authors: André Luis Messias Dos Santos Duque, Daniela Polessa Paula, Rosane Harter Griep

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The intensity of physical activity (PA) over time is essential for health promotion. However, there are few studies that have analyzed the practice of different intensities of PA longitudinally. The objective was to identify PA intensity trajectories in men and women from a Brazilian multicentric cohort and their associated factors. Data from 10,367 participants (5,777 women and 4,590 men) aged 35 to 74 years from the baseline and two follow-up visits (2012-2014 and 2017-2019) of the Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. PA intensity (low, moderate, or high) was assessed using the leisure-time PA module of the International Physical Activity Questionnaire (IPAQ), and sociodemographic, behavioral, and clinical variables were included. Chi-square and T-student tests were used, considering a significant level of 5%. Four intensity trajectories were identified: low, moderate, high, and no pattern. Most participants (82.5% of women and 75.7% of men) had low PA intensity trajectories, and only 2% of women and 4.8% of men had high PA intensity trajectories. For both sexes, a significant difference (p<0.05) was found for age group, education level, income, smoking, type 2 diabetes, obesity, hypertriglyceridemia, and hypertension. Actions that promote the practice of high-intensity PA over time and consider sociodemographic, clinical, and behavioral factors are necessary.

Keywords: lifestyle, longterm effects, physical activity, socioeconomic factors

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Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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Authors: Yohtahe Woldegerima Berhe, Tadesse Belayneh Melkie, Girmay Fitiwi Lema, Marye Getnet, Wubie Birlie Chekol

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Introduction: Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology: Hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by the State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. The strength of association was described in adjusted odds ratio (AOR) and a p-value < 0.05 at a 95% confidence interval which was considered statistically significant. Results: A total of 400 patients were included in this study, with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40 – 56.7). age ≥ 60 years (AOR: 5.7, CI: 1.6 – 20.4, P: 0.007), emergency surgery (AOR: 2.5, CI: 1.3 – 4.7, P: 0.005), preoperative pain (AOR: 2.6, CI: 1.2 – 5.4, P: 0.005), and rural residency (AOR: 1.8, CI: 1.1 – 2.9, P: 0.031) were found significantly associated with preoperative anxiety. Conclusions: The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found to be significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.

Keywords: preoperative anxiety, anxiety, anxiety of anesthesia and surgery, state-trait anxiety inventory, preoperative care

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Authors: Tamar Trop, Ido Izhaki

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Small natural freshwater bodies (SNFWBs), which are vital for many waterbird species, are considered endangered habitats due to their progressive loss and extensive degradation. While SNFWBs are becoming extinct, studies have indicated that many waterbird species may greatly benefit from various types of small artificial waterbodies (SAWBs), such as floodwater and treated water reservoirs. If designed and managed with care, SAWBs hold significant potential to serve as alternative or complementary habitats for birds, and thus mitigate the adverse effects of SNFWBs loss. Currently, most reservoirs are built as infrastructural facilities and designed according to engineering best practices and site-specific considerations, which do not include catering for waterbirds' needs. Furthermore, as things stand, there is still a lack of clear and comprehensive knowledge regarding the additional factors that should be considered in tackling the challenge of attracting waterbirds' to reservoirs, without compromising on the reservoirs' original functions. This study attempts to narrow this knowledge gap by performing a systematic review of the various factors (e.g., bird attributes; physical, structural, spatial, climatic, chemical, and biological characteristics of the waterbody; and anthropogenic activities) affecting the occurrence, abundance, richness, and diversity of waterbirds in SNFWBs. The methodical review provides a concise and relatively unbiased synthesis of the knowledge in the field, which can inform decision-making and practice regarding the planning, design, and management of reservoirs with birds in mind. Such knowledge is especially beneficial for arid and semiarid areas, where natural water sources are deteriorating and becoming extinct even faster due to climate change.

Keywords: artificial waterbodies, reservoirs, small waterbodies, waterbirds

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Authors: Adekunle Taiwo Adenike, I. K. Ogundoyin

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Lassa fever is a neglected tropical virus that has become a significant public health issue in Nigeria, with the country having the greatest burden in Africa. This paper presents a Geo-Computational Model for Analysis and Prediction of Lassa Fever Dynamics and Outbreaks in Nigeria. The model investigates the dynamics of the virus with respect to environmental factors and human populations. It confirms the role of the rodent host in virus transmission and identifies how climate and human population are affected. The proposed methodology is carried out on a Linux operating system using the OSGeoLive virtual machine for geographical computing, which serves as a base for spatial ecology computing. The model design uses Unified Modeling Language (UML), and the performance evaluation uses machine learning algorithms such as random forest, fuzzy logic, and neural networks. The study aims to contribute to the control of Lassa fever, which is achievable through the combined efforts of public health professionals and geocomputational and machine learning tools. The research findings will potentially be more readily accepted and utilized by decision-makers for the attainment of Lassa fever elimination.

Keywords: geo-computational model, lassa fever dynamics, lassa fever, outbreak prediction, nigeria

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Authors: Salahaeddine Sbai

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Air quality analysis using machine learning models is a method employed to assess and predict air pollution levels. This approach leverages the capabilities of machine learning algorithms to analyze vast amounts of air quality data and extract valuable insights. By training these models on historical air quality data, they can learn patterns and relationships between various factors such as weather conditions, pollutant emissions, and geographical features. The trained models can then be used to predict air quality levels in real-time or forecast future pollution levels. This application of machine learning in air quality analysis enables policymakers, environmental agencies, and the general public to make informed decisions regarding health, environmental impact, and mitigation strategies. By understanding the factors influencing air quality, interventions can be implemented to reduce pollution levels, mitigate health risks, and enhance overall air quality management. Climate change is having significant impacts on Morocco, affecting various aspects of the country's environment, economy, and society. In this study, we use some machine learning models under python environment to predict and analysis air quality change over North of Morocco to evaluate the climate change impact on agriculture.

Keywords: air quality, machine learning models, pollution, pollutant emissions

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Authors: Dibakar Chakrabarty, Mebada Suiting

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Rapid urbanization coupled with changes in land use pattern results in increasing peak discharge and shortening of catchment time of concentration. The consequence is floods, which often inundate roads and inhabited areas of cities and towns. Management of storm water resulting from rainfall has, therefore, become an important issue for the municipal bodies. Proper management of storm water obviously includes adequate design of storm water drainage networks. The design of storm water network is a costly exercise. Least cost design of storm water networks assumes significance, particularly when the fund available is limited. Optimal design of a storm water system is a difficult task as it involves the design of various components, like, open or closed conduits, storage units, pumps etc. In this paper, a methodology for least cost design of storm water drainage systems is proposed. The methodology proposed in this study consists of coupling a storm water simulator with an optimization method. The simulator used in this study is EPA’s storm water management model (SWMM), which is linked with Genetic Algorithm (GA) optimization method. The model proposed here is a mixed integer nonlinear optimization formulation, which takes care of minimizing the sectional areas of the open conduits of storm water networks, while satisfactorily conveying the runoff resulting from rainfall to the network outlet. Performance evaluations of the developed model show that the proposed method can be used for cost effective design of open conduit based storm water networks.

Keywords: genetic algorithm (GA), optimal design, simulation-optimization, storm water network, SWMM

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Authors: Gali Pesin, Yuliya Lipshits-Braziler, Sima Amram-Vaknin, Moshe Tatar

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The present study introduces four different patterns of seeking and providing help online among adolescents: (I) ‘Transceivers’ - adolescents who both seek as well as provide help online; (II) ‘Receivers’ - adolescents who seek help online, yet don’t provide it; (III) ‘Transmitters’ - adolescents who provide help online, yet don’t seek it; and (IV) ‘Idles’ - adolescents who refrain from seeking and providing help online. The study examined differences in seeking and providing help online between possible combinations of the four patterns, as well as gender differences within each pattern. Data was collected from 528 adolescents in Israel (59% were girls). Findings revealed that Transceivers are the largest group (45%) in this study, with higher representation of girls (65%). These adolescents seek help mainly around social difficulties, and they turn to peers who are both known and unknown to them. In addition, their preferred way to seek and provide help is through social network sites. Moreover, they often accept and give others emotional support. Receivers are the smallest group (5%) in this study. They turn to both known and unknown professionals more often than to friends and family. In addition, they seek help mostly around health and nutrition issues, and they usually receive instrumental support. For Receivers, the most important factor for seeking help online is anonymity, and the least important factor is familiarity with the help giver. Transmitters represent 16% of the adolescents in this study, with a greater representation of boys (52%). Their main reason to refrain from seeking help online is self-reliance. Nevertheless, these adolescents provide help to others online, mainly to those known to them through posting or responding to posts on social network sites. Idles represent 34% of the adolescents in this study. They refrain from seeking help online mainly due to their preference to seek help face to face, and due to their lack of trust in the internet or those using it. Idles and Transmitters are willing to seek help online mostly from friends and family. In addition, they are willing seek help online mainly regarding questions concerning military or civil service. They consider the most important facilitators for seeking help online as confidentiality and reliability. The present study’s main contribution is exploring the role of providing online help in understanding the adolescent behavior of seeking help online. In addition, the results of the present study have practical implications for the work of mental health providers, such as counseling psychologists and online mental health support.

Keywords: adolescents, counseling, online help-seeking, online help-providing

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Authors: Adrian Kong, William Chang, Rolando Valdes, Alec Rodriguez, Roberto Miki

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The Pneumask consists of a custom snorkel-specific adapter that attaches a snorkel-port of the mask to a 3D-printed filter. This full-face snorkel mask was designed for use as personal protective equipment (PPE) during the COVID-19 pandemic when there was a widespread shortage of PPE for medical personnel. Various clinical validation tests have been conducted, including the sealing capability of the mask, filter performance, CO2 buildup, and clinical usability. However, data regarding the filter efficiencies of Pneumask and multiple filter types have not been determined. Using an experimental system, we evaluated the filtration efficiency across various masks and filters during inhalation. Eighteen combinations of respirator models (5 P100 FFRs, 4 Dolfino Masks) and filters (2091, 7093, 7093CN, BB50T) were evaluated for their exposure to airborne particles sized 0.3 - 10.0 microns using an electronic airborne particle counter. All respirator model combinations provided similar performance levels for 1.0-micron, 3.0-micron, 5.0-micron, 10.0-microns, with the greatest differences in the 0.3-micron and 0.5-micron range. All models provided expected performances against all particle sizes, with Class P100 respirators providing the highest performance levels across all particle size ranges. In conclusion, the modified snorkel mask has the potential to protect providers who care for patients with COVID-19 from increased airborne particle exposure.

Keywords: COVID-19, PPE, mask, filtration, efficiency

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Authors: D. Bheenick, M. Young, M.Elmussareh, A.Ali

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Objective: Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. Patient and methods: Retrospective data of patients presenting acutely to the urology department was collected between 13th January to 22nd March 2020 (pre-lockdown period) and 23rd March to 31st May 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Results: 1092 patients were included in the study. An overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. Conclusion: The admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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Authors: Zoe Lynch, Kirsty Zieschank

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There are several factors that compromise the utility and wide-spread use of existing emotional and behavioural distress screening instruments. Some of these factors include lengthy administration times, high costs, feasibility issues, and a lack of self-report options for children under 12 years of age. This animation-based resource was developed to overcome as many of these factors as possible. Developed for educators and medical and mental health professionals, this resource offers children a self-guided mechanism for reporting any current emotional and behavioural distress. An avatar assistant, selected by the child, accompanies them through each stage of the screening process, offering further instruction if prompted. Children enter their age and gender before viewing comparative animations conveying common childhood emotional and behavioural difficulties. The child then selects the most relatable animations, along with the frequency with which they experience the depicted emotions. From a perspective of intellectual development, an engaging, animated format means that outcomes will not be constrained by children’s reading, writing, cognitive, or verbal expression abilities. Having been user-tested with children aged 6 to 12, this resource shows promising results as a self-guided screening instrument.

Keywords: animation-based screening instrument, mental health, primary-aged children, self-guided

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Authors: Siddhant Yadav, Rylea Ranum, Hannah Alberts, Abdul Kalaiger, Brent Bauer, Ryan Hurt, Ann Vincent, Loren Toussaint, Sanjeev Nanda

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Background and significance: Fibromyalgia (FM) is a chronic pain disorder also characterized by chronic fatigue, morning stiffness, sleep, and cognitive symptoms, psychological disturbances (anxiety, depression), and is comorbid with multiple medical and psychiatric conditions. It has an incidence of 2-4% in the general population and is reported more commonly in women. Oxidative stress and inflammation are thought to contribute to pain in patients with FM, and the adoption of an antioxidant/anti-inflammatory diet has been suggested as a modality to alleviate symptoms. The aim of this systematic review was to evaluate the efficacy of specialized diets (ketogenic, gluten free, Mediterranean, and low carbohydrate) in improving FM symptoms. Methodology: A comprehensive search of the following databases from inception to July 15th, 2021, was conducted: Ovid MEDLINE and Epub ahead of print, in-process and other non-indexed citations and daily, Ovid Embase, Ovid EBM reviews, Cochrane central register of controlled trials, EBSCO host CINAHL with full text, Elsevier Scopus, website and citation index, web of science emerging sources citation and clinicaltrials.gov. We included randomized controlled trials, non-randomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports in adults with fibromyalgia. The risk of bias was assessed with the Agency for Health Care Research and Quality designed, specific recommended criteria (AHRQ). Results: Thirteen studies were eligible for inclusion. This included a total of 761 participants. Twelve out of the 13 studies reported improvement in widespread body pain, joint stiffness, sleeping pattern, mood, and gastrointestinal symptoms, and one study reported no changes in symptomatology in patients with FM on specialized diets. None of the studies showed the worsening of symptoms associated with a specific diet. Most of the patient population was female, with the mean age at which fibromyalgia was diagnosed being 48.12 years. Improvement in symptoms was reported by the patient's adhering to a gluten-free diet, raw vegan diet, tryptophan- and magnesium-enriched Mediterranean diet, aspartame- and msg- elimination diet, and specifically a Khorasan wheat diet. Risk of bias assessment noted that 6 studies had a low risk of bias (5 clinical trials and 1 case series), four studies had a moderate risk of bias, and 3 had a high risk of bias. In many of the studies, the allocation of treatment (diets) was not adequately concealed, and the researchers did not rule out any potential impact from a concurrent intervention or an unintended exposure that might have biased the results. On the other hand, there was a low risk of attrition bias in all the trials; all were conducted with an intention-to-treat, and the inclusion/exclusion criteria, exposures/interventions, and primary outcomes were valid, reliable, and implemented consistently across all study participants. Concluding statement: Patients with fibromyalgia who followed specialized diets experienced a variable degree of improvement in their widespread body pain. Improvement was also seen in stiffness, fatigue, moods, sleeping patterns, and gastrointestinal symptoms. Additionally, the majority of the patients also reported improvement in overall quality of life.

Keywords: fibromyalgia, specialized diet, vegan, gluten free, Mediterranean, systematic review

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Authors: Pierre van Tonder, Dinesh Muthoo, Kim twiname

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Many existing and newly built structures are constructed on the design basis of the engineer and the workmanship of the construction company. However, when considering larger structures where more people are exposed to the building, its structural integrity is of great importance considering the safety of its occupants (Raghu, 2013). But how can the structural integrity of a building be monitored efficiently and effectively. This is where the fourth industrial revolution step in, and with minimal human interaction, data can be collected, analysed, and stored, which could also give an indication of any inconsistencies found in the data collected, this is where the Fibre Bragg Grating (FBG) monitoring system is introduced. This paper illustrates how data can be collected and converted to develop stress – strain behaviour and to produce bending moment diagrams for the utilisation and prediction of the structure’s integrity. Embedded fibre optic sensors were used in this study– fibre Bragg grating sensors in particular. The procedure entailed making use of the shift in wavelength demodulation technique and an inscription process of the phase mask technique. The fibre optic sensors considered in this report were photosensitive and embedded in the slab and beams for data collection and analysis. Two sets of fibre cables have been inserted, one purposely to collect temperature recordings and the other to collect strain and temperature. The data was collected over a time period and analysed used to produce bending moment diagrams to make predictions of the structure’s integrity. The data indicated the fibre Bragg grating sensing system proved to be useful and can be used for structural health monitoring in any environment. From the experimental data for the slab and beams, the moments were found to be64.33 kN.m, 64.35 kN.m and 45.20 kN.m (from the experimental bending moment diagram), and as per the idealistic (Ultimate Limit State), the data of 133 kN.m and 226.2 kN.m were obtained. The difference in values gave room for an early warning system, in other words, a reserve capacity of approximately 50% to failure.

Keywords: fibre bragg grating, structural health monitoring, fibre optic sensors, beams

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Authors: N. Sena, C. Vasconcelos

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Portugal has a lower rate of people who exercise. Fitness centers are a widely recognized context for the performance of an exercise. Thus, the objective of this study is to analyze the motivational factors for the practice of exercise in a sample of Portuguese fitness center users. The sample consists of 34 users (23 men and 11 women), aged between 16 and 60 years old (24.7 ± 11,5 years old). The instrument used for data collection was the Motivation Questionnaire for Exercise (version translated and validated into Portuguese), consisting of forty-nine items grouped into ten motivational factors. Responses to the Exercise Motivation Questionnaire are given on a 6-point Likert scale (0="not at all true for me" to 5="completely true for me"). With regard to the results, it is possible to verify that the motivational factors considered most relevant by the sample of our study were “Well-being” (4.44 ± 0.28), followed by “Health” (4.29 ± 0.57) and “Stress Management” (4.06 ± 0.54). The factors “Affiliation” (3.11 ± 0.49) “Personal Appreciation” (2.26 ± 0.59) and “Medical History” (1.71 ± 0.74) were considered by the respondents to be the least important factors for performing the exercise. The conclusion of this study is that in the sample of this study, the factors that most motivated the practice of exercise were “Well-being”, “Health” and “Stress Management”. In the opposite direction, the factors that least motivated the individuals in this sample to practice exercise were “Affiliation”, “Personal Appreciation” and “Medical History”.

Keywords: exercise, fitness center users, motivational factors, Portugal

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Authors: Mohd Bahroddin Badri, Ridzuan Masri

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Despite the existence of large volume of waqf assets, it is argued that the potential of these assets not fully unleashed. There are many waqf assets especially in the form of land waqf that are idle and undeveloped mainly because of the insufficient fund and lack of investment expertise. This paper attempts to explore few cases on the innovation of waqf development in Malaysia and some countries that demonstrate synergistic collaboration between stakeholders, e.g., the government, nazir, Islamic religious councils, corporate entities and Islamic financial institutions for waqf development. This paper shows that cash waqf, corporate waqf, Build-Operate-Transfer (BOT) and Sukuk are found to be contemporary mechanisms within Islamic finance ecosystem that drive and rejuvenate the development of waqf to the next level. It further highlights few samples of waqf Sukuk that were successfully issued in selected countries. This paper also demonstrates that the benefit of waqf is beyond religious matters, which may also include education, healthcare, social care, infrastructure and corporate social responsibility (CSR) activities. This research is qualitative in nature, whereby the researcher employs descriptive method on the collected data. The researcher applies case study and library research method to collect and analyse data from journal articles, research papers, conference paper and annual reports. In a nutshell, the potential of contemporary models as demonstrated in this paper is very promising, in which the practical application of those instruments should be expanded for the rejuvenation of waqf asset.

Keywords: cash waqf, corporate waqf, Sukuk waqf, build-operate-transfer

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Authors: Asrarul H. Jeelani

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Arsenic contamination of groundwater and its’ health implications in lower Gangetic plain of Indian states started reporting in the 1980s. The same period was declared as the first water decade (1981-1990) to achieve ‘water for all.’ To fulfill the aim, the Indian government, with the support of international agencies installed millions of hand-pumps through water resources development programs. The hand-pumps improve the accessibility if the groundwater, but over-extraction of it increases the chances of mixing of trivalent arsenic which is more toxic than pentavalent arsenic of dug well water in Gangetic plain and has different physical manifestations. Now after three decades, Bihar (middle Gangetic plain) is also facing arsenic contamination of groundwater and its’ health implications. Objective: This interdisciplinary research attempts to understand the health and social implications of arsenicosis among different castes in Haldi Chhapra village and to find the association of ramifications with water resources development. Methodology: The Study used concurrent quantitative dominant mix method (QUAN+qual). The researcher had employed household survey, social mapping, interviews, and participatory interactions. However, the researcher used secondary data for retrospective analysis of hand-pumps and implications of arsenicosis. Findings: The study found 88.5% (115) household have hand-pumps as a source of water however 13.8% uses purified supplied water bottle and 3.6% uses combinations of hand-pump, bottled water and dug well water for drinking purposes. Among the population, 3.65% of individuals have arsenicosis, and 2.72% of children between the age group of 5 to 15 years are affected. The caste variable has also emerged through quantitative as well as geophysical locations analysis as 5.44% of arsenicosis manifested individual belong to scheduled caste (SC), 3.89% to extremely backward caste (EBC), 2.57% to backward caste (BC) and 3% to other. Among three clusters of arsenic poisoned locations, two belong to SC and EBC. The village as arsenic affected is being discriminated, whereas the affected individual is also facing discrimination, isolation, stigma, and problem in getting married. The forceful intervention to install hand-pumps in the first water decades and later restructuring of the dug well destroyed a conventional method of dug well cleaning. Conclusion: The common manifestation of arsenicosis has increased by 1.3% within six years of span in the village. This raised the need for setting up a proper surveillance system in the village. It is imperative to consider the social structure for arsenic mitigation program as this research reveals caste as a significant factor. The health and social implications found in the study; retrospectively analyzed as the collateral impact of water resource development programs in the village.

Keywords: arsenicosis, caste, collateral impact, water resources

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Authors: Leila Alidokht

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PFAS (poly- and perfluoroalkyl substances) are a large collection of environmentally persistent organic chemicals of industrial origin that have a negative influence on human health and ecosystems. Many distinct PFAS are being utilized in a wide range of applications (on the order of thousands), and there is no comprehensive source of information on the many different compounds and their roles in diverse applications. Facilities are increasingly looking into ways to reduce waste from cleanup projects. PFAS are widespread in the environment, have been found in a wide range of human biomonitoring investigations, and are a rising source of regulatory concern for federal, state, and local governments. Nanotechnology has the potential to contribute considerably to the creation of a cleaner, greener technologies with considerable environmental and health benefits. Nanotechnology approaches are being studied for their potential to provide pollution management and mitigation options, as well as to increase the effectiveness of standard environmental cleanup procedures. Diversified nanoparticles have shown useful in removing certain pollutants from their original environment, such as sewage spills and landmines. Furthermore, they have a low hazardous effect during production rates and can thus be thoroughly explored in the future to make them more compatible with lower production costs.

Keywords: PFOS, PFOA, PFAS, soil remediation

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Authors: A. Albaridi Najla

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Flaxseed (Linum usitatissimum) is well known to have beneficial effect on health. The seeds are rich in protein, α-linolenic fatty acid and dietary fiber. Bakery products are important part of our daily meals. Functional food recently received considerable attention among consumers. The increase in bread daily consumption leads to the production of breads with functional ingredients such as flaxseed The aim of this Study was to improve the nutritional value of bread by adding flaxseed flour and assessing the effect of adding 0, 5, 10 and 15% flaxseed on whole wheat bread rheological and sensorial properties. The total consumer's acceptability of the flaxseed bread was assessed. Dough characteristics were determined using Farinograph (C.W. Brabender® Instruments, Inc). The result shows no change was observed in water absorption between the stander dough (without flaxseed) and the bread with flaxseed (67%). An Increase in the peak time and dough stickiness was observed with the increase in flaxseed level. Further, breads were evaluated for sensory parameters, colour and texture. High flaxseed level increased the bread crumb softness. Bread with 5% flaxseed was optimized for total sensory evaluation. Overall, flaxseed bread produced in this study was highly acceptable for daily consumption as a functional foods with a potentially health benefits.

Keywords: bread, flaxseed, rheological properties, whole-wheat bread

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Authors: Sabria Barka, Imen Gdara, Zouhour Ouanès, Samia Mouelhi, Monia El Bour, Amel Hamza-Chaffai

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Because dams are large semi-closed reservoirs of pollutants originating from numerous anthropogenic activities, they represent a threat to aquatic life and they should be monitored. The present work aims to use freshwater zooplankton (Copepods and Cladocerans) in order to evaluate the environmental health status of Bir M'cherga dam in Tunisia. Animals were collected in situ monthly between October and August. Genotoxicity (micronucleus test), neurotoxicity (acetylcholinesterase, AChE) and oxidative stress (catalase, CAT and malondialdehyde, MDA) biomarkers were analyzed in zooplankton. High frequencies of micronucleus were observed in zooplankton cells during summer. AChE activities were inhibited during early winter and summer. CAT and MDA biomarker levels showed high seasonal variability, suggesting that animals are permanently exposed to multiple oxidative stress. The results of this study suggest that the Bir Mcherga dam is subject to continuous multi-origin stress, probably amplified by abiotic parameters. It is then recommended to urgently monitor freshwater environments in Tunisia, especially those used for irrigation and consumption.

Keywords: Biomonitoring, Bir Mcherga Dam, cladocerans, copepods, freshwater zooplankton, genotoxicity, neurotoxicity, oxidative stress, Tunisia

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Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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Authors: Yasmina Bendaali, Cristian Vaquero, Carlos Escott, Carmen González, Antonio Morata

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Consumer tendencies to healthy eating habits and request for organic beverages led to the production of new drinks from fruit juices as a source of nutrients and bioactive compounds. Grape juice is a rich source of sugars, organic acids, and phenolic compounds, which define its beneficial effect on health and the attractive sensory profile for consumers' choices (color, taste, flavor). Thus, grape juice was used as a source of sugars, avoiding the addition of sweeteners by diluting it with mineral water to obtain the sugar concentration recommended for isotonic drinks (6% to 8%) to provide energy during physical activities. In addition, phenolic compounds of grape juice are associated with many human health benefits, mainly antioxidant activity, which helps to prevent different diseases associated with oxidative stress, including cancers and cardiovascular and neurodegenerative diseases. Furthermore, physical exercise has been shown to increase the production of free radicals and other reactive oxygen species. Thus, athletes need to improve their antioxidant defense systems to prevent oxidative damage. Different studies have demonstrated the positive effect of grape juice consumption during physical activities, which improves antioxidant activity and performance, protects against oxidative damage, and reduces inflammation. Thus, the use of grape juice to develop isotonic drinks can provide isotonic drinks with antioxidant and biological activities in addition to their principal role of rehydration and replacement of minerals and carbohydrates during physical exercises. Moreover, attractive sensory characteristics, mainly color, which is provided by anthocyanin content, have a great contribution to making the drinks more natural and help to dispense the use of synthetic dyes in addition to the health benefits which will be a novel product in the field of healthy beverages responding on the demand of consumers for new, innovative, and healthy products.

Keywords: grape juice, isotonic, antioxidants, anthocyanins, natural, sport

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Authors: Polly Parkinson, Emma Mecham, Fawn Groves, Amy Wilson-Lopez, Ivonne Santiago

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In the rush to meet electric vehicle (EV) adoption goals that address environmental and health concerns, engineering planners and community policy experts cannot separate the socioeconomic and equity factors from transportation needs. Two gaps are identified in existing research: concrete proposals that address affordable micromobility options and provide for needs of community members without cars, and community-engaged research that elevates the concerns and solutions brought forward by historically-marginalized community members. This data analysis from a recent case study in a vulnerable community indicates that because transportation decisions are inextricably linked to health, work, and housing, EV adoption must also address multifaceted human needs. Communities focused on building more electric vehicle charging stations must find ways for lower-income households to also benefit. This research engaged residents in the planning process and resulted in a template for charging stations to advance mobility justice with a range of options that purposefully benefit the whole community.

Keywords: community engagement, electric vehicle charging, environmental justice, participatory research, transportation equity

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Authors: Katie-Beth Webster

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Mucormycosis is a rare opportunistic fungal infection that, if left untreated, can cause large scale tissue necrosis and death. There are a number of cases of this in the literature, most commonly in the head and neck region arising from sinuses. It is also usually found in immunocompromised patient subgroups. This study reviewed a number of cases of mucormycosis in previously fit and healthy young trauma patients to assess predisposing factors for infection and adequacy of current treatment paradigms. These trauma patients likely contracted the fungal infection from the soil at the site of the incident. Despite early washout and debridement of the wounds at the scene of the injury and on arrival in hospital, both these patients contracted mucormycosis. It was suspected that inadequate early debridement of soil contaminated limbs was one of the major factors that can lead to catastrophic tissue necrosis. In both cases, this resulted in the patients having a higher level of amputation than would have initially been required based on the level of their injury. This was secondary to cutaneous and soft tissue necrosis secondary to the fungal infiltration leading to osteomyelitis and systemic sepsis. In the literature, it appears diagnosis is often protracted in this condition secondary to inadequate early treatment and long processing times for fungal cultures. If fungal cultures were sent at the time of first assessment and adequate debridements are performed aggressively early, it could lead to these critically unwell trauma patients receiving appropriate antifungal and surgical treatment earlier in their episode of care. This is likely to improve long term outcomes for these patients.

Keywords: mucormycosis, plastic surgery, osteomyelitis, trauma

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Authors: Inkyong Yi

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Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

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