Search results for: face skin cancer
557 Psoriasis Diagnostic Test Development: Exploratory Study
Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein
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The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy
Procedia PDF Downloads 118556 Pre-Primary Schools’ Earthquake Safety Initiative in Greece
Authors: A. Kourou, A. Ioakeimidou, A. Gakou
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Greece due to its location in the Eastern Mediterranean region is characterized by a high degree of seismicity and occurrence of severe earthquakes. It is generally accepted that preventive planning is vital in mitigating impacts, protecting those who are the most vulnerable namely children and increasing the degree of resilience of local communities. Worldwide, States have highlighted the need to ensure the safety of early childhood environments in case of disaster. A great number of children are enrolled in daycare facilities, so building and improving the preparedness of pre-primary schools to prevent injuries and fatalities in case of an earthquake becomes an important policy issue. It is more than evident that preparedness in early preschool level will be increased through awareness and education of the people who work to pre-primary classes and provide early childhood care. The aim of the present study is to assess the level of awareness and preparedness of the Greek pre-primary schools staff concerning earthquake protection issues, as well as their risk mitigation behaviors and earthquake management in case of a strong event. In this framework, specific questionnaire was developed and filled by the abovementioned target group at 30 different municipalities of Greece (2014-2016). Also in the framework of this study it is presented the Pre-Primary Schools’ Earthquake Safety Initiative that has been undertaken by Earthquake Planning and Protection Organization (EPPO) the last years. This initiative aims to develop disaster-resilient day care centers through awareness, self-help, cooperation and education. Recognizing the necessity of integration of the disaster safety concept at pre-primary environments, EPPO published practical guidelines that focused on earthquake planning of these workspaces. Furthermore, dozens of seminars are implemented in municipality or prefecture-level every year by EPPO, in order the early childhood schools’ staff to be appropriately educated and adequately trained to face the earthquake risk. Great progress has been made towards building awareness and increasing preschool preparedness in Greece but significant gaps still remain. Anyway, it is extremely important that the implementation of effective programs and practices and the broad collaboration of all involved parties have been recognized as essential in order to develop a comprehensive disaster management system at preschool environment.Keywords: awareness, earthquake, education, emergency plans, preparedness, pre-primary schools
Procedia PDF Downloads 196555 Exposure to Radon on Air in Tourist Caves in Bulgaria
Authors: Bistra Kunovska, Kremena Ivanova, Jana Djounova, Desislava Djunakova, Zdenka Stojanovska
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The carcinogenic effects of radon as a radioactive noble gas have been studied and show a strong correlation between radon exposure and lung cancer occurrence, even in the case of low radon levels. The major part of the natural radiation dose in humans is received by inhaling radon and its progenies, which originates from the decay chain of U-238. Indoor radon poses a substantial threat to human health when build-up occurs in confined spaces such as homes, mines and caves and the risk increases with the duration of radon exposure and is proportional to both the radon concentration and the time of exposure. Tourist caves are a case of special environmental conditions that may be affected by high radon concentration. Tourist caves are a recognized danger in terms of radon exposure to cave workers (guides, employees working in shops built above the cave entrances, etc.), but due to the sensitive nature of the cave environment, high concentrations cannot be easily removed. Forced ventilation of the air in the caves is considered unthinkable due to the possible harmful effects on the microclimate, flora and fauna. The risks to human health posed by exposure to elevated radon levels in caves are not well documented. Various studies around the world often detail very high concentrations of radon in caves and exposure of employees but without a follow-up assessment of the overall impact on human health. This study was developed in the implementation of a national project to assess the potential health effects caused by exposure to elevated levels of radon in buildings with public access under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018. The purpose of the work is to assess the radon level in Bulgarian caves and the exposure of the visitors and workers. The number of caves (sampling size) was calculated for simple random selection from total available caves 65 (sampling population) are 13 caves with confidence level 95 % and confidence interval (margin of error) approximately 25 %. A measurement of the radon concentration in air at specific locations in caves was done by using CR-39 type nuclear track-etch detectors that were placed by the participants in the research team. Despite the fact that all of the caves were formed in karst rocks, the radon levels were rather different from each other (97–7575 Bq/m3). An assessment of the influence of the orientation of the caves in the earth's surface (horizontal, inclined, vertical) on the radon concentration was performed. Evaluation of health hazards and radon risk exposure causing by inhaling the radon and its daughter products in each surveyed caves was done. Reducing the time spent in the cave has been recommended in order to decrease the exposure of workers.Keywords: tourist caves, radon concentration, exposure, Bulgaria
Procedia PDF Downloads 189554 Component Test of Martensitic/Ferritic Steels and Nickel-Based Alloys and Their Welded Joints under Creep and Thermo-Mechanical Fatigue Loading
Authors: Daniel Osorio, Andreas Klenk, Stefan Weihe, Andreas Kopp, Frank Rödiger
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Future power plants currently face high design requirements due to worsening climate change and environmental restrictions, which demand high operational flexibility, superior thermal performance, minimal emissions, and higher cyclic capability. The aim of the paper is, therefore, to investigate the creep and thermo-mechanical material behavior of improved materials experimentally and welded joints at component scale under near-to-service operating conditions, which are promising for application in highly efficient and flexible future power plants. These materials promise an increase in flexibility and a reduction in manufacturing costs by providing enhanced creep strength and, therefore, the possibility for wall thickness reduction. At the temperature range between 550°C and 625°C, the investigation focuses on the in-phase thermo-mechanical fatigue behavior of dissimilar welded joints of conventional materials (ferritic and martensitic material T24 and T92) to nickel-based alloys (A617B and HR6W) by means of membrane test panels. The temperature and external load are varied in phase during the test, while the internal pressure remains constant. At the temperature range between 650°C and 750°C, it focuses on the creep behavior under multiaxial stress loading of similar and dissimilar welded joints of high temperature resistant nickel-based alloys (A740H, A617B, and HR6W) by means of a thick-walled-component test. In this case, the temperature, the external axial load, and the internal pressure remain constant during testing. Numerical simulations are used for the estimation of the axial component load in order to induce a meaningful damage evolution without causing a total component failure. Metallographic investigations after testing will provide support for understanding the damage mechanism and the influence of the thermo-mechanical load and multiaxiality on the microstructure change and on the creep and TMF- strength.Keywords: creep, creep-fatigue, component behaviour, weld joints, high temperature material behaviour, nickel-alloys, high temperature resistant steels
Procedia PDF Downloads 119553 Continuity Through Best Practice. A Case Series of Complex Wounds Manage by Dedicated Orthopedic Nursing Team
Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad
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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in servicesKeywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply
Procedia PDF Downloads 105552 CSPG4 Molecular Target in Canine Melanoma, Osteosarcoma and Mammary Tumors for Novel Therapeutic Strategies
Authors: Paola Modesto, Floriana Fruscione, Isabella Martini, Simona Perga, Federica Riccardo, Mariateresa Camerino, Davide Giacobino, Cecilia Gola, Luca Licenziato, Elisabetta Razzuoli, Katia Varello, Lorella Maniscalco, Elena Bozzetta, Angelo Ferrari
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Canine and human melanoma, osteosarcoma (OSA), and mammary carcinomas are aggressive tumors with common characteristics making dogs a good model for comparative oncology. Novel therapeutic strategies against these tumors could be useful to both species. In humans, chondroitin sulphate proteoglycan 4 (CSPG4) is a marker involved in tumor progression and could be a candidate target for immunotherapy. The anti-CSPG4 DNA electrovaccination has shown to be an effective approach for canine malignant melanoma (CMM) [1]. An immunohistochemistry evaluation of CSPG4 expression in tumour tissue is generally performed prior to electrovaccination. To assess the possibility to perform a rapid molecular evaluation and in order to validate these spontaneous canine tumors as the model for human studies, we investigate the CSPG4 gene expression by RT qPCR in CMM, OSA, and canine mammary tumors (CMT). The total RNA was extracted from RNAlater stored tissue samples (CMM n=16; OSA n=13; CMT n=6; five paired normal tissues for CMM, five paired normal tissues for OSA and one paired normal tissue for CMT), retro-transcribed and then analyzed by duplex RT-qPCR using two different TaqMan assays for the target gene CSPG4 and the internal reference gene (RG) Ribosomal Protein S19 (RPS19). RPS19 was selected from a panel of 9 candidate RGs, according to NormFinder analysis following the protocol already described [2]. Relative expression was analyzed by CFX Maestro™ Software. Student t-test and ANOVA were performed (significance set at P<0.05). Results showed that gene expression of CSPG4 in OSA tissues is significantly increased by 3-4 folds when compared to controls. In CMT, gene expression of the target was increased from 1.5 to 19.9 folds. In melanoma, although an increasing trend was observed, no significant differences between the two groups were highlighted. Immunohistochemistry analysis of the two cancer types showed that the expression of CSPG4 within CMM is concentrated in isles of cells compared to OSA, where the distribution of positive cells is homogeneous. This evidence could explain the differences in gene expression results.CSPG4 immunohistochemistry evaluation in mammary carcinoma is in progress. The evidence of CSPG4 expression in a different type of canine tumors opens the way to the possibility of extending the CSPG4 immunotherapy marker in CMM, OSA, and CMT and may have an impact to translate this strategy modality to human oncology.Keywords: canine melanoma, canine mammary carcinomas, canine osteosarcoma, CSPG4, gene expression, immunotherapy
Procedia PDF Downloads 174551 Needs of Omani Children in First Grade during Their Transition from Kindergarten to Primary School: An Ethnographic Study
Authors: Zainab Algharibi, Julie McAdam, Catherine Fagan
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The purpose of this paper is to shed light on how Omani children in the first grade experience their needs during their transition to primary school. Theoretically, the paper was built on two perspectives: Dewey's concept of continuity of experience and the boundary objects introduced by Vygotsky (CHAT). The methodology of the study is based on the crucial role of children’s agency which is a very important activity as an educational tool to enhance the child’s participation in the learning process and develop their ability to face various issues in their life. Thus, the data were obtained from 45 children in grade one from 4 different primary schools using drawing and visual narrative activities, in addition to researcher observations during the start of the first weeks of the academic year for the first grade. As the study dealt with children, all of the necessary ethical laws were followed. This paper is considered original since it seeks to deal with the issue of children's transition from kindergarten to primary school in Oman, if not in the Arab region. Therefore, it is expected to fill an important gap in this field and present a proposal that will be a door for researchers to enter this research field later. The analysis of drawing and visual narrative was performed according to the social semiotics approach in two phases. The first is to read out the surface message “denotation,” while the second is to go in-depth via the symbolism obtained from children while they talked and drew letters and signs. This stage is known as “signified”; a video was recorded of each child talking about their drawing and expressing themself. Then, the data were organised and classified according to a cross-data network. Regarding the researcher observation analyses, the collected data were analysed according to the model was developed for the "grounded theory". It is based on comparing the recent data collected from observations with data previously encoded by other methods in which children were drawing alongside the visual narrative in the current study, in order to identify the similarities and differences, and also to clarify the meaning of the accessed categories and to identify sub-categories of them with a description of possible links between them. This is a kind of triangulation in data collection. The study came up with a set of findings, the most vital being that the children's greatest interest goes to their social and psychological needs, such as friends, their teacher, and playing. Also, their biggest fears are a new place, a new teacher, and not having friends, while they showed less concern for their need for educational knowledge and skills.Keywords: children’s academic needs, children’s social needs, transition, primary school
Procedia PDF Downloads 108550 The Application of Raman Spectroscopy in Olive Oil Analysis
Authors: Silvia Portarena, Chiara Anselmi, Chiara Baldacchini, Enrico Brugnoli
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Extra virgin olive oil (EVOO) is a complex matrix mainly composed by fatty acid and other minor compounds, among which carotenoids are well known for their antioxidative function that is a key mechanism of protection against cancer, cardiovascular diseases, and macular degeneration in humans. EVOO composition in terms of such constituents is generally the result of a complex combination of genetic, agronomical and environmental factors. To selectively improve the quality of EVOOs, the role of each factor on its biochemical composition need to be investigated. By selecting fruits from four different cultivars similarly grown and harvested, it was demonstrated that Raman spectroscopy, combined with chemometric analysis, is able to discriminate the different cultivars, also as a function of the harvest date, based on the relative content and composition of fatty acid and carotenoids. In particular, a correct classification up to 94.4% of samples, according to the cultivar and the maturation stage, was obtained. Moreover, by using gas chromatography and high-performance liquid chromatography as reference techniques, the Raman spectral features further allowed to build models, based on partial least squares regression, that were able to predict the relative amount of the main fatty acids and the main carotenoids in EVOO, with high coefficients of determination. Besides genetic factors, climatic parameters, such as light exposition, distance from the sea, temperature, and amount of precipitations could have a strong influence on EVOO composition of both major and minor compounds. This suggests that the Raman spectra could act as a specific fingerprint for the geographical discrimination and authentication of EVOO. To understand the influence of environment on EVOO Raman spectra, samples from seven regions along the Italian coasts were selected and analyzed. In particular, it was used a dual approach combining Raman spectroscopy and isotope ratio mass spectrometry (IRMS) with principal component and linear discriminant analysis. A correct classification of 82% EVOO based on their regional geographical origin was obtained. Raman spectra were obtained by Super Labram spectrometer equipped with an Argon laser (514.5 nm wavelenght). Analyses of stable isotope content ratio were performed using an isotope ratio mass spectrometer connected to an elemental analyzer and to a pyrolysis system. These studies demonstrate that RR spectroscopy is a valuable and useful technique for the analysis of EVOO. In combination with statistical analysis, it makes possible the assessment of specific samples’ content and allows for classifying oils according to their geographical and varietal origin.Keywords: authentication, chemometrics, olive oil, raman spectroscopy
Procedia PDF Downloads 332549 Bulbar Conjunctival Kaposi's Sarcoma Unmasked by Immune Reconstitution Syndrome
Authors: S. Mohd Afzal, R. O'Connell
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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus
Procedia PDF Downloads 337548 Application of Natural Dyes on Polyester and Polyester-Cellulosic Blended Fabrics
Authors: Deepali Rastogi, Akanksha Rastogi
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Comfort and safety are two essential factors in a newborn’s clothing. Natural dyes are considered safe for infant clothes because they are non-toxic and have medicinal properties. Natural dyes are sensitive to pH and may show changes in hue under different pH conditions. Infant garments face treatments different than adult clothing, for instance, exposure to infant’s saliva, milk, and urine. The present study was designed to study the suitability of natural dyes for infant clothes. Cotton fabric was dyed using fifteen natural dyes and two mordants, alum, and ferrous sulphate. The dyed samples were assessed for colour fastness to washing, rubbing, perspiration and light. In addition, fastness to milk, saliva, and urine was also tested. Simulated solutions of saliva and urine were prepared for the study. For milk, one of the commercial formulations for infants was taken and used as per the directions. A wide gamut of colours was obtained after dyeing the cotton with different natural dyes and mordants. The colour strength of all the dyed samples was determined in terms of K/S values. Most of the ferrous sulphate mordanted dyes gave higher K/S values than alum mordanted samples. The wash fastness of dyed cotton fabrics ranged from 3/4 -5. Perspiration fastness test for the samples was done in both acidic and alkaline mediums. The ratings ranged from 3-5, with most of the dyes falling in the range of 4-5. The rubbing fastness of the dyed samples was tested in dry and wet conditions. The results showed excellent rub fastness ranging between 4-5. Light fastness was found to be good to moderate. The main food for infants is milk, and this becomes one of the main agents to spot infants' garments. All dyes showed excellent fastness properties against milk with a grey scale rating of 4-5. Fastness against saliva is recommended by various eco-labels, standards, and organizations for fabrics of infants or babies. The fastness of most of the dyes was found to be satisfactory against saliva. Infant garments get frequently soiled with urine. Most of the natural dyes on cotton fabric had good to excellent fastness to simulated urine. The grey scale ratings ranged from 3/4 – 5. Thus, it can be concluded that most of the natural dyes can be successfully used for infant wear and accessories and are fast to various liquids to which infant wear are exposed. Therefore, we can surround little ones with beautiful hues from nature's garden and clothe them in natural fibres dyed with natural dyes.Keywords: fastness properties, infant wear, mordants, natural dyes
Procedia PDF Downloads 140547 The Path of Cotton-To-Clothing Value Chains to Development: A Mixed Methods Exploration of the Resuscitation of the Cotton-To-Clothing Value Chain in Post
Authors: Emma Van Schie
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The purpose of this study is to use mixed methods research to create typologies of the performance of firms in the cotton-to-clothing value chain in Zimbabwe, and to use these typologies to achieve the objective of adding to the small pool of studies on Sub-Saharan African value chains performing in the context of economic liberalisation and achieving development. The uptake of economic liberalisation measures across Sub-Saharan Africa has led to the restructuring of many value chains. While this action has resulted in some African economies positively reintegrating into global commodity chains, it has also been deeply problematic for the development impacts of the majority of others. Over and above this, these nations have been placed at a disadvantage due to the fact that there is little scholarly and policy research on approaches for managing economic liberalisation and value chain development in the unique African context. As such, the central question facing these less successful cases is how they can integrate into the world economy whilst still fostering their development. This paper draws from quantitative questionnaires and qualitative interviews with 28 stakeholders in the cotton-to-clothing value chain in Zimbabwe. This paper examines the performance of firms in the value chain, and the subsequent local socio-economic development impacts that are affected by the revival of the cotton-to-clothing value chain following its collapse in the wake of Zimbabwe’s uptake of economic liberalisation measures. Firstly, the paper finds the relatively undocumented characteristics and structures of firms in the value chain in the post-economic liberalisation era. As well as this, it finds typologies of the status of firms as either being in operation, closed down, or being placed under judicial management and the common characteristics that these typologies hold. The key findings show how a mixture of macro and local level aspects, such as value chain governance and the management structure of a business, leads to the most successful typology that is able to add value to the chain in the context of economic liberalisation, and thus unlock its socioeconomic development potential. These typologies are used in making industry and policy recommendations on achieving this balance between the macro and the local level, as well as recommendations for further academic research for more typologies and models on the case of cotton value chains in Sub-Saharan Africa. In doing so, this study adds to the small collection of academic evidence and policy recommendations for the challenges that African nations face when trying to incorporate into global commodity chains in attempts to benefit from their associated socioeconomic development opportunities.Keywords: cotton-to-clothing value chain, economic liberalisation, restructuring value chain, typologies of firms, value chain governance, Zimbabwe
Procedia PDF Downloads 167546 Acceptability and Challenges Experienced by Homosexual Indigenous Peoples in Southern Palawan
Authors: Crisanto H. Ecaldre
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Gender perception represents how an individual perceives the gender identity of a person. Since this is a subjective assessment, it paves the way to various social reactions, either in the form of acceptance or discrimination. Reports across the world show that lesbian, gay, bisexual, or transgender (LGBT) people often face discrimination, stigmatization, and targeted violence because of their sexual orientation or gender identity. However, the challenges faced by those who belong to both a sexual minority and a marginalized ethnic, religious, linguistic, or indigenous community are even more complex. Specifically, in Palaw’an community, members own those who identify themselves as gays or lesbians and use “bantut” to identify them. There was also the introduction of various scholarly works to facilitate dialogues that promote visibility and inclusivity across sectors in terms of gender preferences; however, there are still gaps that need to be addressed in terms of recognition and visibility. Though local research initiatives are slowly increasing in terms of numbers, culturally situating gender studies appropriately within the context of indigenous cultural communities is still lacking. Indigenous community-based discourses on gender or indigenizing gender discourses remain a challenge; hence, this study aimed to contribute to addressing these identified gaps. These research objectives were realized through a qualitative approach following an exploratory design. Findings revealed that the Palaw’an indigenous cultural community has an existing concept of homosexuality, which they termed “bantut.” This notion was culturally defined by the participants as (a) kaloob ng diwata; (b) a manifestation of physical inferiority; (c) hindi nakapag-asawa or hindi nagka-anak; and (d) based on the ascribed roles by the community. These were recognized and valued by the community. However, despite the recognition and visibility within the community, the outside people view them otherwise. The challenges experienced by the Palaw’an homosexuals are imposed by the people outside their community, and these include prejudice, discrimination, and double marginalization. Because of these struggles, they are forced to cope. They deal with these imposed limitations, biases, and burdens by non-Palaw’an through self-acceptance, strong self-perception, and the option to leave the community to seek a more open and progressive environment for LGBTs. While these are indications of their ‘resilience’ amidst difficult situations, this reality poses an important concern -how the recognition and visibility of indigenous homosexuals from the mainstream perspective can be attained.Keywords: gender preference, acceptability, challenge, recognition, visibility, coping
Procedia PDF Downloads 56545 A Semiotic Analysis of the Changes in the Visual Sign System of International Advertisements in the Arab World
Authors: Nabil Mohammed Nasser Salem
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International advertisements targeting the Arab world are usually modified to be compatible with the conservative culture in many Arab countries. The portrayal of female models in international advertisements in Arab magazines avoids direct sexual representation. Arab culture is guided by religious teachings and social restrictions that prohibit the display of many parts of the female body. Exposure of shoulders, arms, armpits, cleavage, legs, thighs, etc., of the female body is usually avoided in international advertisements published in Arab magazines. Exposure to parts of the female body other than the face and hands may be considered offensive in many parts of Arab countries. Although extensive research has been conducted on Arabic advertisements, to our best knowledge, there are no publications in the literature that address the recent changes in the visual sign system in international advertisements in Arab magazines using semiotics as a research method. The present study aims to analyze the changes in the visual sign system of international advertisements published in Arab magazines that promote female fragrances. It tries to analyze the differences in the sexual representations of the same female models in some selected advertisements during different periods. The magazines are randomly selected from the period between 2000 and 2019. The selection of magazines is based on their availability and popularity. The study focuses on the Dior Jadore ads because they reflect important changes in the appearance of the same female model between 2000 to 2019. The result of the study shows important changes in the sexual representation of the same female body. The Dior Jadore advertisement in 2000 shows only the head of the female model. The model is modestly portrayed and shows clear cultural and religious restrictions on the sexual representation of the female body. The result shows that the same female model is portrayed differently in the Dior Jadore advertisement from the period 2005 to 2019. These versions of advertisements show more parts of the female body that are covered in the older versions and show stronger sexual representations. The study is an important contribution as it fills an important gap in the literature by extending semiotic research to the study of recent visual changes in the sign system of international advertisements published in Arab magazines during an important period in the history of international advertisement targeting the Arab world, as they reflect changes in the sexual representation of female models.Keywords: Arab magazine, female body, international advertisements, semiotics, sexual representation
Procedia PDF Downloads 89544 Internal Financing Constraints and Corporate Investment: Evidence from Indian Manufacturing Firms
Authors: Gaurav Gupta, Jitendra Mahakud
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This study focuses on the significance of internal financing constraints on the determination of corporate fixed investments in the case of Indian manufacturing companies. Financing constraints companies which have less internal fund or retained earnings face more transaction and borrowing costs due to imperfections in the capital market. The period of study is 1999-2000 to 2013-2014 and we consider 618 manufacturing companies for which the continuous data is available throughout the study period. The data is collected from PROWESS data base maintained by Centre for Monitoring Indian Economy Pvt. Ltd. Panel data methods like fixed effect and random effect methods are used for the analysis. The Likelihood Ratio test, Lagrange Multiplier test, and Hausman test results conclude the suitability of the fixed effect model for the estimation. The cash flow and liquidity of the company have been used as the proxies for the internal financial constraints. In accordance with various theories of corporate investments, we consider other firm specific variable like firm age, firm size, profitability, sales and leverage as the control variables in the model. From the econometric analysis, we find internal cash flow and liquidity have the significant and positive impact on the corporate investments. The variables like cost of capital, sales growth and growth opportunities are found to be significantly determining the corporate investments in India, which is consistent with the neoclassical, accelerator and Tobin’s q theory of corporate investment. To check the robustness of results, we divided the sample on the basis of cash flow and liquidity. Firms having cash flow greater than zero are put under one group, and firms with cash flow less than zero are put under another group. Also, the firms are divided on the basis of liquidity following the same approach. We find that the results are robust to both types of companies having positive and negative cash flow and liquidity. The results for other variables are also in the same line as we find for the whole sample. These findings confirm that internal financing constraints play a significant role for determination of corporate investment in India. The findings of this study have the implications for the corporate managers to focus on the projects having higher expected cash inflows to avoid the financing constraints. Apart from that, they should also maintain adequate liquidity to minimize the external financing costs.Keywords: cash flow, corporate investment, financing constraints, panel data method
Procedia PDF Downloads 241543 Investigate the Competencies Required for Sustainable Entrepreneurship Development in Agricultural Higher Education
Authors: Ehsan Moradi, Parisa Paikhaste, Amir Alam Beigi, Seyedeh Somayeh Bathaei
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The need for entrepreneurial sustainability is as important as the entrepreneurship category itself. By transferring competencies in a sustainable entrepreneurship framework, entrepreneurship education can make a significant contribution to the effectiveness of businesses, especially for start-up entrepreneurs. This study analyzes the essential competencies of students in the development of sustainable entrepreneurship. It is an applied causal study in terms of nature and field in terms of data collection. The main purpose of this research project is to study and explain the dimensions of sustainability entrepreneurship competencies among agricultural students. The statistical population consists of 730 junior and senior undergraduate students of the Campus of Agriculture and Natural Resources, University of Tehran. The sample size was determined to be 120 using the Cochran's formula, and the convenience sampling method was used. Face validity, structure validity, and diagnostic methods were used to evaluate the validity of the research tool and Cronbach's alpha and composite reliability to evaluate its reliability. Structural equation modeling (SEM) was used by the confirmatory factor analysis (CFA) method to prepare a measurement model for data processing. The results showed that seven key dimensions play a role in shaping sustainable entrepreneurial development competencies: systems thinking competence (STC), embracing diversity and interdisciplinary (EDI), foresighted thinking (FTC), normative competence (NC), action competence (AC), interpersonal competence (IC), and strategic management competence (SMC). It was found that acquiring skills in SMC by creating the ability to plan to achieve sustainable entrepreneurship in students through the relevant mechanisms can improve entrepreneurship in students by adopting a sustainability attitude. While increasing students' analytical ability in the field of social and environmental needs and challenges and emphasizing curriculum updates, AC should pay more attention to the relationship between the curriculum and its content in the form of entrepreneurship culture promotion programs. In the field of EDI, it was found that the success of entrepreneurs in terms of sustainability and business sustainability of start-up entrepreneurs depends on their interdisciplinary thinking. It was also found that STC plays an important role in explaining the relationship between sustainability and entrepreneurship. Therefore, focusing on these competencies in agricultural education to train start-up entrepreneurs can lead to sustainable entrepreneurship in the agricultural higher education system.Keywords: sustainable entrepreneurship, entrepreneurship education, competency, agricultural higher education
Procedia PDF Downloads 144542 Characterization of the Lytic Bacteriophage VbɸAB-1 against Drug Resistant Acinetobacter baumannii Isolated from Hospitalized Pressure Ulcers Patients
Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi
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Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of variety of bacterial infection. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. In present study, analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F, and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin.According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Plasmaviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients.Keywords: acinetobacter baumannii, extremely drug- resistant, phage therapy, surgery wound
Procedia PDF Downloads 93541 Sequential Mixed Methods Study to Examine the Potentiality of Blackboard-Based Collaborative Writing as a Solution Tool for Saudi Undergraduate EFL Students’ Writing Difficulties
Authors: Norah Alosayl
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English is considered the most important foreign language in the Kingdom of Saudi Arabia (KSA) because of the usefulness of English as a global language compared to Arabic. As students’ desire to improve their English language skills has grown, English writing has been identified as the most difficult problem for Saudi students in their language learning. Although the English language in Saudi Arabia is taught beginning in the seventh grade, many students have problems at the university level, especially in writing, due to a gap between what is taught in secondary and high schools and university expectations- pupils generally study English at school, based on one book with few exercises in vocabulary and grammar exercises, and there are no specific writing lessons. Moreover, from personal teaching experience at King Saud bin Abdulaziz University, students face real problems with their writing. This paper revolves around the blackboard-based collaborative writing to help the undergraduate Saudi EFL students, in their first year enrolled in two sections of ENGL 101 in the first semester of 2021 at King Saud bin Abdulaziz University, practice the most difficult skill they found in their writing through a small group. Therefore, a sequential mixed methods design will be suited. The first phase of the study aims to highlight the most difficult skill experienced by students from an official writing exam that is evaluated by their teachers through an official rubric used in King Saud bin Abdulaziz University. In the second phase, this study will intend to investigate the benefits of social interaction on the process of learning writing. Students will be provided with five collaborative writing tasks via discussion feature on Blackboard to practice a skill that they found difficult in writing. the tasks will be formed based on social constructivist theory and pedagogic frameworks. The interaction will take place between peers and their teachers. The frequencies of students’ participation and the quality of their interaction will be observed through manual counting, screenshotting. This will help the researcher understand how students actively work on the task through the amount of their participation and will also distinguish the type of interaction (on task, about task, or off-task). Semi-structured interviews will be conducted with students to understand their perceptions about the blackboard-based collaborative writing tasks, and questionnaires will be distributed to identify students’ attitudes with the tasks.Keywords: writing difficulties, blackboard-based collaborative writing, process of learning writing, interaction, participations
Procedia PDF Downloads 191540 Understanding the Role of Concussions as a Risk Factor for Multiple Sclerosis
Authors: Alvin Han, Reema Shafi, Alishba Afaq, Jennifer Gommerman, Valeria Ramaglia, Shannon E. Dunn
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Adolescents engaged in contact-sports can suffer from recurrent brain concussions with no loss of consciousness and no need for hospitalization, yet they face the possibility of long-term neurocognitive problems. Recent studies suggest that head concussive injuries during adolescence can also predispose individuals to multiple sclerosis (MS). The underlying mechanisms of how brain concussions predispose to MS is not understood. Here, we hypothesize that: (1) recurrent brain concussions prime microglial cells, the tissue resident myeloid cells of the brain, setting them up for exacerbated responses when exposed to additional challenges later in life; and (2) brain concussions lead to the sensitization of myelin-specific T cells in the peripheral lymphoid organs. Towards addressing these hypotheses, we implemented a mouse model of closed head injury that uses a weight-drop device. First, we calibrated the model in male 12 week-old mice and established that a weight drop from a 3 cm height induced mild neurological symptoms (mean neurological score of 1.6+0.4 at 1 hour post-injury) from which the mice fully recovered by 72 hours post-trauma. Then, we performed immunohistochemistry on the brain of concussed mice at 72 hours post-trauma. Despite mice having recovered from all neurological symptoms, immunostaining for leukocytes (CD45) and IBA-1 revealed no peripheral immune infiltration, but an increase in the intensity of IBA1+ staining compared to uninjured controls, suggesting that resident microglia had acquired a more active phenotype. This microglia activation was most apparent in the white matter tracts in the brain and in the olfactory bulb. Immunostaining for the microglia-specific homeostatic marker TMEM119, showed a reduction in TMEM119+ area in the brain of concussed mice compared to uninjured controls, confirming a loss of this homeostatic signal by microglia after injury. Future studies will test whether single or repetitive concussive injury can worsen or accelerate autoimmunity in male and female mice. Understanding these mechanisms will guide the development of timed and targeted therapies to prevent MS from getting started in people at risk.Keywords: concussion, microglia, microglial priming, multiple sclerosis
Procedia PDF Downloads 102539 Social Ties and the Prevalence of Single Chronic Morbidity and Multimorbidity among the Elderly Population in Selected States of India
Authors: Sree Sanyal
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Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.Keywords: morbidity, multi-morbidity, prevalence, social ties
Procedia PDF Downloads 121538 Start-Up: The Perception of Brazilian Entrepreneurs about the Start-Up Brasil Program
Authors: Fernando Nobre Cavalcante
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In Brazil, and more recently in the city of Fortaleza, there is a new form of entrepreneurship that is focused on the information and communication technology service sector and that draws the attention of young people, investors, governments, authors and media companies: it is known as the start-up movement. Today, it is considered to be a driving force behind the creative economy. Rooted on progressive discourse, the words enterprise and innovation seduce new economic agents motivated by success stories from Silicon Valley in America along with increasing commercial activity for digital goods and services. This article assesses, from a sociological point of view, the new productive wave problematized by the light of Manuel Castells’ informational capitalism. Considering the skeptical as well as the optimistic opinions about the impact of this new entrepreneurial rearrangement, the following question is asked: How Brazilian entrepreneurs evaluate public policy incentives for startups Brazilian Federal Government? The raised hypotheses are based on employability factors as well as cultural, economical, and political matters related to innovation and technology. This study has produced a nationwide quantitative assessment with a special focus on the reality of these Ceará firms; as well as comparative qualitative interviews on Brazilian experiences lived by identified agents. This article outlines the public incentive policy of the federal government, the Start-up Brasil Program, from the perspective of these companies and provides details as to the discipline methods of the new enterprising way born in the United States. The startups are very young companies that are headed towards the economic sustainment of the productive sector services. These companies are dropping the seeds that will produce the re-enchantment of young people and bring them back to participation in political debate; they provide relief and reheats the job market; and they produce a democratization of the entrepreneurial ‘Do-It-Yourself’ culture. They capitalize the pivot of the wall street wolves and of agents being charged for new masks. There are developmental logic’s prophylaxis in the face of dreadful innovation stagnation. The lack of continuity in Brazilian governmental politics and cultural nuances related to entrepreneurship are barring the desired regional success of this ecosystem.Keywords: creative economy, entrepreneurship, informationalism, innovation, startups, start-up brasil program
Procedia PDF Downloads 368537 Management Problems in a Patient With Long-term Undiagnosed Permanent Hypoparathyroidism
Authors: Babarina Maria, Andropova Margarita
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Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria
Procedia PDF Downloads 108536 A Lightning Strike Mimic: The Abusive Use of Dog Shock Collar Presents as Encephalopathy, Respiratory Arrest, Cardiogenic Shock, Severe Hypernatremia, Rhabdomyolysis, and Multiorgan Injury
Authors: Merrick Lopez, Aashish Abraham, Melissa Egge, Marissa Hood, Jui Shah
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A 3 year old male with unknown medical history presented initially with encephalopathy, intubated for respiratory failure, and admitted to the pediatric intensive care unit (PICU) with refractory shock. During resuscitation in the emergency department, he was found to be in severe metabolic acidosis with a pH of 7.03 and escalated on vasopressor drips for hypotension. His initial sodium was 174. He was noted to have burn injuries to his scalp, forehead, right axilla, bilateral arm creases and lower legs. He had rhabdomyolysis (initial creatinine kinase 5,430 U/L with peak levels of 62,340 normal <335 U/L), cardiac injury (initial troponin 88 ng/L with peak at 145 ng/L, normal <15ng/L), hypernatremia (peak 174, normal 140), hypocalcemia, liver injury, acute kidney injury, and neuronal loss on magnetic resonance imaging (MRI). Soft restraints and a shock collar were found in the home. He was critically ill for 8 days, but was gradually weaned off drips, extubated, and started on feeds. Discussion Electrical injury, specifically lightning injury is an uncommon but devastating cause of injury in pediatric patients. This patient with suspected abusive use of a dog shock collar presented similar to a lightning strike. Common entrance points include the hands and head, similar to our patient with linear wounds on his forehead. When current enters, it passes through tissues with the least resistance. Nerves, blood vessels, and muscles, have high fluid and electrolyte content and are commonly affected. Exit points are extremities: our child who had circumferential burns around his arm creases and ankles. Linear burns preferentially follow areas of high sweat concentration, and are thought to be due to vaporization of water on the skin’s surface. The most common cause of death from a lightning strike is due to cardiopulmonary arrest. The massive depolarization of the myocardium can result in arrhythmias and myocardial necrosis. The patient presented in cardiogenic shock with evident cardiac damage. Electricity going through vessels can lead to vaporization of intravascular water. This can explain his severe hypernatremia. He also sustained other internal organ injuries (adrenal glands, pancreas, liver, and kidney). Electrical discharge also leads to direct skeletal muscle injury in addition to prolonged muscular spasm. Rhabdomyolysis, the acute damage of muscle, leads to release of potentially toxic components into the circulation which could lead to acute renal failure. The patient had severe rhabdomyolysis and renal injury. Early hypocalcemia has been consistently demonstrated in patients with rhabdomyolysis. This was present in the patient and led to increased vasopressor needs. Central nervous system injuries are also common which can include encephalopathy, hypoxic injury, and cerebral infarction. The patient had evidence of brain injury as seen on MRI. Conclusion Electrical injuries due to lightning strikes and abusive use of a dog shock collar are rare, but can both present in similar ways with respiratory failure, shock, hypernatremia, rhabdomyolysis, brain injury, and multiorgan damage. Although rare, it is essential for early identification and prompt management for acute and chronic complications in these children.Keywords: cardiogenic shock, dog shock collar, lightning strike, rhabdomyolysis
Procedia PDF Downloads 88535 The Importance of the Phases of Information, Diagnosis, Planning, Intervention and Management in a Historic Center
Authors: Giovanni Duran Polo
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Demonstrate the importance of the stages such as Information, Diagnosis, Management, and Intervention is fundamental to have a historical, live, and quality inhabited center. One of the major actions to take is to promote the concept of the management of a historic center with harmonious development. For that, concerned actors should strengthen the concept that said historic center may be the neighborhood of all and for all. The centers of historical cities, presented as any other urban area, social, environmental issues etc; yet they get added value that have no other city neighborhoods. The equity component, either by the urban plan, or environmental quality offered properties of architectural, landscape or some land uses are the differentiating element, while the tool that makes them attractive face pressure exerted by new housing developments or shopping centers. That's why through the experience of working in historical centers, they are declared the actions in heritage areas. This paper will show how the encounter with each of these places are trying to take the phases of information, to gather all the data needed to be closer to the territory with specific data, diagnosis; which allowed the actors to see what state they were, felt how the heart is related to the rest of the city, show what problems affected the situation and what potential it had to compete in a global market. Also, to discuss the importance of the organization, as it is legal and normative basis for it have an order and a concept, when you know what can and what cannot, in an area where the citizen has many myth or history, when he wanted to intervene in protected buildings. It is also appropriate to show how it could develop the intervention phase, where the shares on the tangible elements and intervention for the protection of the heritage property are executed. The management is the final phase which will carry out all that was raised on paper, it's time to orient, explain, persuade, promote, and encourage citizens to take care of the heritage. It is profitable and also an obligation and it is not an insurmountable burden. It has to be said this is the time to pull all the cards to make the historical center and heritage becoming more alive today. It is the moment to make it more inhabited and to transformer it into a quality place, so citizens will cherish and understand the importance of such a place. Inhabited historical centers, endowments and equipment required, with trade quality, with constant cultural offer, with well-preserved buildings and tidy, modern and safe public spaces are always attractive for tourism, but first of all, the place should be conceived for citizens, otherwise everything will be doomed to failure.Keywords: development, diagnosis, heritage historic center, intervention, management, patrimony
Procedia PDF Downloads 396534 First Year Experience of International Students in Malaysian Universities
Authors: Nur Hidayah Iwani Mohd Kamal
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The higher education institutions in Malaysia is challenged with a more socially and culturally diverse student population than ever before, especially with the increasing number of international students studying in Malaysia in the recent years. First year university is a critical time in students’ lives. Students are not only developing intelectually, they are also establishing and maintaining personal relationships, developing an identity, deciding about career and lifestyle, maintaining personal health and wellness, and developing an integrated philosohy of life. The higher education institutions work as a diverse community of learners to provide a supportive environment for these first year students in assisting them in their transition from high school to university. Although many universities are taking steps to improve the first year experience for their new local and international students, efforts must be taken to ensure organized and coordinated manner in order for the initiatives to be successful. The objectives of the study are to examine the international students’ perceptions and interpretation of their first year experiences in shaping and determining their attitudes toward study and the quality of their entire undergraduate academic career; and identify an appropriate mechanism to encounter the international students’ adjustment in the new environment in order to facilitate cross-functional communication and create a coherent and meaningful first year experience. A key construct in this study is that if universities wish to recruiting and retaining international students, it is their ethical responsibility to determine how they can best meet their needs at the academic and social level, create a supportive ‘learning community’ as a foundation of their educational experience, hence facilitate cross-cultural communication and create a coherent and meaningful first year experience. This study is simultaneously frames in relation to focus on the factors that influence a successful and satisfying transition to university life by the first year international students. The study employs a mixed-method data collection involving semi-structured interviews, questionnaire, classroom observation and document analysis. This study provides valuable insight into the struggles that many international students face as they attempt to make the adjustment not only to a new educational system but factors such as psychosocial and cultural problems. It would discuss some of the factors that impact the international students during their first year in university in their quest to be academically successful. It concludes with some recommendations on how Malaysian universities provide these students with a good first year experience based on some the best practices of universities around the world.Keywords: first year experience, Malaysian universities, international students, education
Procedia PDF Downloads 288533 Coastal Water Characteristics along the Saudi Arabian Coastline
Authors: Yasser O. Abualnaja1, Alexandra Pavlidou2, Taha Boksmati3, Ahmad Alharbi3, Hammad Alsulmi3, Saleh Omar Maghrabi3, Hassan Mowalad3, Rayan Mutwalli3, James H. Churchill4, Afroditi Androni2, Dionysios Ballas2, Ioannis Hatzianestis2, Harilaos Kontoyiannis2, Angeliki Konstantinopoulou2, Georgios Krokkos1, 5, Georgios Pappas2, Vassilis P. Papadopoulos2, Konstantinos Parinos2, Elvira Plakidi2, Eleni Rousselaki2, Dimitris Velaoras2, Panagiota Zachioti2, Theodore Zoulias2, Ibrahim Hoteit5.
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The coastal areas along the Kingdom of Saudi Arabia on both the Red Sea and Arabian Gulf have been witnessing in the past decades an unprecedented economic growth and a rapid increase in anthropogenic activities. Therefore, the Saudi Arabian government has decided to frame a strategy for sustainable development of the coastal and marine environments, which comes in the context of the Vision 2030, aimed at providing the first comprehensive ‘Status Quo Assessment’ of the Kingdom’s coastal and marine environments. This strategy will serve as a baseline assessment for future monitoring activities; this baseline is relied on scientific evidence of the drivers, pressures, and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressures of the hotspots analysis, which was developed following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. Ten hotspot sites were identified, eight in the Red Sea and two in the Arabian Gulf. Thus, multidisciplinary research cruises were conducted throughout the Red Sea and the Arabian Gulf coastal and marine environments in June/July 2021 and September 2021, respectively, in order to understand the relative impact of hydrography and the various pressures on the quality of seawater and sediments. The main objective was to record the physical and biogeochemical parameters along the coastal waters of the Kingdom, tracing the dispersion of contaminants related to specific pressures. The assessment revealed the effect of hydrography on the trophic status of the southern marine coastal areas of the Red Sea. Jeddah Lagoon system seems to face significant eutrophication and pollution challenges, whereas sediments are enriched in some heavy metals in many areas of the Red Sea and the Arabian Gulf. This multidisciplinary research in the Red Sea and the Arabian Gulf coastal waters will pave the way for future detailed environmental monitoring strategies for the Saudi Arabian marine environment.Keywords: arabian gulf, contaminants, hotspot, red sea
Procedia PDF Downloads 113532 “Japan’s New Security Outlook: Implications for the US-Japan Alliance”
Authors: Agustin Maciel-Padilla
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This paper explores the most significant change to Japan’s security strategy since the end of World War II, in particular Prime Minister Fumio Kishida’s government publication, in late 2022, of 3 policy documents (the National Security Strategy [NSS], the National Defense Strategy and the Defense Buildup Program) that basically propose to expand the country’s military capabilities and to increase military spending over a 5-year period. These policies represent a remarkable transformation of Japan’s defense-oriented policy followed since 1946. These proposals have been under analysis and debate since they were announced, as it was also Japan’s historic ambition to strengthening its deterrence capabilities in the context of a more complex regional security environment. Even though this new defense posture has attracted significant international attention, it is far from representing a done deal because of the fact that there is still a long way to go to implement this vision because of a wide variety of political and economic issues. Japan is currently experiencing the most dangerous security environment since the end of World War II, and this situation led Japan to intensify its dialogue with the United States to reflect a re-evaluation of deterrence in the face of a rapidly worsening security environment, a changing balance of power in East Asia, and the arrival of a new era of “great power competition”. Japan’s new documents, for instance, identify China and North Korea’s as posing, respectively, a strategic challenge and an imminent threat. Japan has also noted that Russia’s invasion of Ukraine has contributed to erode the foundation of the international order. It is considered that Russia’s aggression was possible because Ukraine’s defense capability was not enough for effective deterrence. Moreover, Japan’s call for “counterstrike capabilities” results from a recognition that China and North Korea’s ballistic and cruise missiles could overwhelm Japan’s air and missile defense systems, and therefore there is an urgent need to strengthen deterrence and resilience. In this context, this paper will focus on the impact of these changes on the US-Japan alliance. Adapting this alliance to Tokyo’s new ambitions and capabilities could be critical in terms of updating their traditional protection/access to bases arrangement, interoperability and joint command and control issues, as well as regarding the security–economy nexus. While China is Japan’s largest trading partner, and trade between the two has been growing, US-Japan economic relationship has been slower, notwithstanding the fact that US-Japan security cooperation has strengthened significantly in recent years.Keywords: us-japan alliance, japan security, great power competition, interoperability
Procedia PDF Downloads 65531 Analyzing the Job Satisfaction of Silver Workers Using Structural Equation Modeling
Authors: Valentin Nickolai, Florian Pfeffel, Christian Louis Kühner
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In many industrialized nations, the demand for skilled workers rises, causing the current market for employees to be more candidate-driven than employer-driven. Therefore, losing highly skilled and experienced employees due to early or partial retirement negatively impacts firms. Therefore, finding new ways to incentivize older employees (Silver Workers) to stay longer with the company and in their job can be crucial for the success of a firm. This study analyzes how working remotely can be a valid incentive for experienced Silver Workers to stay in their job and instead work from home with more flexible working hours. An online survey with n = 684 respondents, who are employed in the service sector, has been conducted based on 13 constructs that influence job satisfaction. These have been further categorized into three groups “classic influencing factors,” “influencing factors changed by remote working,” and new remote working influencing factors,” and were analyzed using structural equation modeling (SEM). Here, Cronbach’s alpha of the individual constructs was shown to be suitable. Furthermore, the construct validity of the constructs was confirmed by face validity, content validity, convergent validity (AVE > 0.5: CR > 0.7), and discriminant validity. Additionally, confirmatory factor analysis (CFA) confirmed the model fit for the investigated sample (CMIN/DF: 2.567; CFI: 0.927; RMSEA: 0.048). It was shown in the SEM-analysis that the influencing factor on job satisfaction, “identification with the work,” is the most significant with β = 0.540, followed by “Appreciation” (β = 0.151), “Compensation” (β = 0.124), “Work-Life-Balance” (β = 0.116), and “Communication and Exchange of Information” (β = 0.105). While the significance of each factor can vary depending on the work model, the SEM-analysis also shows that the identification with the work is the most significant factor in all three work models mentioned above and, in the case of the traditional office work model, it is the only significant influencing factor. The study shows that employees between the ages of 56 and 65 years have the highest job satisfaction when working entirely from home or remotely. Furthermore, their job satisfaction score of 5.4 on a scale from 1 (very dissatisfied) to 7 (very satisfied) is the highest amongst all age groups in any of the three work models. Due to the significantly higher job satisfaction, it can be argued that giving Silver Workers the offer to work from home or remotely can incentivize them not to opt for early retirement or partial retirement but to stay in their job full-time Furthermore, these findings can indicate that employees in the Silver Worker age are much more inclined to leave their job for early retirement if they have to entirely work in the office.Keywords: home office, remote work instead of early or partial retirement, silver worker, structural equation modeling
Procedia PDF Downloads 75530 Measurement System for Human Arm Muscle Magnetic Field and Grip Strength
Authors: Shuai Yuan, Minxia Shi, Xu Zhang, Jianzhi Yang, Kangqi Tian, Yuzheng Ma
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The precise measurement of muscle activities is essential for understanding the function of various body movements. This work aims to develop a muscle magnetic field signal detection system based on mathematical analysis. Medical research has underscored that early detection of muscle atrophy, coupled with lifestyle adjustments such as dietary control and increased exercise, can significantly enhance muscle-related diseases. Currently, surface electromyography (sEMG) is widely employed in research as an early predictor of muscle atrophy. Nonetheless, the primary limitation of using sEMG to forecast muscle strength is its inability to directly measure the signals generated by muscles. Challenges arise from potential skin-electrode contact issues due to perspiration, leading to inaccurate signals or even signal loss. Additionally, resistance and phase are significantly impacted by adipose layers. The recent emergence of optically pumped magnetometers introduces a fresh avenue for bio-magnetic field measurement techniques. These magnetometers possess high sensitivity and obviate the need for a cryogenic environment unlike superconducting quantum interference devices (SQUIDs). They detect muscle magnetic field signals in the range of tens to thousands of femtoteslas (fT). The utilization of magnetometers for capturing muscle magnetic field signals remains unaffected by issues of perspiration and adipose layers. Since their introduction, optically pumped atomic magnetometers have found extensive application in exploring the magnetic fields of organs such as cardiac and brain magnetism. The optimal operation of these magnetometers necessitates an environment with an ultra-weak magnetic field. To achieve such an environment, researchers usually utilize a combination of active magnetic compensation technology with passive magnetic shielding technology. Passive magnetic shielding technology uses a magnetic shielding device built with high permeability materials to attenuate the external magnetic field to a few nT. Compared with more layers, the coils that can generate a reverse magnetic field to precisely compensate for the residual magnetic fields are cheaper and more flexible. To attain even lower magnetic fields, compensation coils designed by Biot-Savart law are involved to generate a counteractive magnetic field to eliminate residual magnetic fields. By solving the magnetic field expression of discrete points in the target region, the parameters that determine the current density distribution on the plane can be obtained through the conventional target field method. The current density is obtained from the partial derivative of the stream function, which can be represented by the combination of trigonometric functions. Optimization algorithms in mathematics are introduced into coil design to obtain the optimal current density distribution. A one-dimensional linear regression analysis was performed on the collected data, obtaining a coefficient of determination R2 of 0.9349 with a p-value of 0. This statistical result indicates a stable relationship between the peak-to-peak value (PPV) of the muscle magnetic field signal and the magnitude of grip strength. This system is expected to be a widely used tool for healthcare professionals to gain deeper insights into the muscle health of their patients.Keywords: muscle magnetic signal, magnetic shielding, compensation coils, trigonometric functions.
Procedia PDF Downloads 57529 Combination Therapies Targeting Apoptosis Pathways in Pediatric Acute Myeloid Leukemia (AML)
Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills
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Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.Keywords: AML, drug repurposing, ABT-737, apoptosis
Procedia PDF Downloads 203528 Qualitative Profiling in Practice: The Italian Public Employment Services Experience
Authors: L. Agneni, F. Carta, C. Micheletta, V. Tersigni
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The development of a qualitative method to profile jobseekers is needed to improve the quality of the Public Employment Services (PES) in Italy. This is why the National Agency for Active Labour Market Policies (ANPAL) decided to introduce a Qualitative Profiling Service in the context of the activities carried out by local employment offices’ operators. The qualitative profiling service provides information and data regarding the jobseeker’s personal transition status, through a semi-structured questionnaire administered to PES clients during the guidance interview. The questionnaire responses allow PES staff to identify, for each client, proper activities and policy measures to support jobseekers in their reintegration into the labour market. Data and information gathered by the qualitative profiling tool are the following: frequency, modalities and motivations for clients to apply to local employment offices; clients’ expectations and skills; difficulties that they have faced during the previous working experiences; strategies, actions undertaken and activated channels for job search. These data are used to assess jobseekers’ personal and career characteristics and to measure their employability level (qualitative profiling index), in order to develop and deliver tailor-made action programmes for each client. This paper illustrates the use of the above-mentioned qualitative profiling service on the national territory and provides an overview of the main findings of the survey: concerning the difficulties that unemployed people face in finding a job and their perception of different aspects related to the transition in the labour market. The survey involved over 10.000 jobseekers registered with the PES. Most of them are beneficiaries of the “citizens' income”, a specific active labour policy and social inclusion measure. Furthermore, data analysis allows classifying jobseekers into a specific group of clients with similar features and behaviours, on the basis of socio-demographic variables, customers' expectations, needs and required skills for the profession for which they seek employment. Finally, the survey collects PES staff opinions and comments concerning clients’ difficulties in finding a new job and also their strengths. This is a starting point for PESs’ operators to define adequate strategies to facilitate jobseekers’ access or reintegration into the labour market.Keywords: labour market transition, public employment services, qualitative profiling, vocational guidance
Procedia PDF Downloads 140