Search results for: patient safety

Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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Authors: Ajeni Ari, Chiara Maria Leva, Lorraine D’Arcy, Mary Kinahan

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In addressing gender and transport, considerations of mobility disparities amongst users are important. Public transport (PT) policy and design do not efficiently account for the varied mobility practices between men and women, with literature only recently showing a movement towards gender inclusion in transport. Arrantly, transport policy and designs remain gender-blind to the variation of mobility needs. The global movement towards sustainability highlights the need for expeditious strategies that could mitigate biases within the existing system. At the forefront of such a plan of action, in part, may be mandated inclusive infrastructural designs that stimulate user engagement with the transport system. Fundamentally access requires a means or an opportunity for the entity, which for PT is an establishment of its physical environment and/or infrastructural design. Its practicality may be utilised with knowledge of shortcomings in tangible or intangible aspects of the service offerings allowing access to opportunities. To inform on existing biases in PT planning and design, this study analyses qualitative data to examine the opinions and lived experiences among transport users in Ireland. Findings show that infrastructural design plays a significant role in users’ engagement with the service. Paramount to accessibility are service provisions that cater to both user interactions and those of their dependents. Apprehension to use the service is more so evident in women in comparison to men, particularly while carrying out household duties and caring responsibilities at peak times or dark hours. Furthermore, limitations are apparent with infrastructural service offerings that do not accommodate the physical (dis)ability of users, especially universal design. There are intersecting factors that impinge on accessibility, e.g., safety and security, yet essentially; the infrastructural design is an important influencing parameter to user perceptual conditioning. Additionally, data discloses the need for user intricacies to be factored in transport planning geared towards gender inclusivity, including mobility practices, travel purpose, transit time or location, and system integration.

Keywords: infrastructure design, public transport, accessibility, women, gender

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Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

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Authors: F. Murilo T. Luna, Vanessa F. Oliveira, Alysson Rocha, Expedito J. S. Parente, Andre V. Bueno, Matheus C. M. Farias, Celio L. Cavalcante Jr.

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Aviation jetfuel used in aircraft gas-turbine engines is customarily obtained from the kerosene distillation fraction of petroleum (150-275°C). Mineral jetfuel consists of a hydrocarbon mixture containing paraffins, naphthenes and aromatics, with low olefins content. In order to ensure their safety, several stringent requirements must be met by jetfuels, such as: high energy density, low risk of explosion, physicochemical stability and low pour point. In this context, aviation fuels eventually obtained from biofeedstocks (which have been coined as ‘biojetfuel’), must be used as ‘drop in’, since adaptations in aircraft engines are not desirable, to avoid problems with their operation reliability. Thus, potential aviation biofuels must present the same composition and physicochemical properties of conventional jetfuel. Among the potential feedtstocks for aviation biofuel, the babaçu oil, extracted from a palm tree extensively found in some regions of Brazil, contains expressive quantities of short chain saturated fatty acids and may be an interesting choice for biojetfuel production. In this study, biojetfuel was synthesized through homogeneous transesterification of babaçu oil using methanol and its properties were compared with petroleum-based jetfuel through measurements of oxidative stability, physicochemical properties and low temperature properties. The transesterification reactions were carried out using methanol and after decantation/wash procedures, the methyl esters were purified by molecular distillation under high vacuum at different temperatures. The results indicate significant improvement in oxidative stability and pour point of the products when compared to the fresh oil. After optimization of operational conditions, potential biojetfuel samples were obtained, consisting mainly of C8 esters, showing low pour point and high oxidative stability. Jet engine tests are being conducted in an automated test bed equipped with pollutant emissions analysers to study the operational performance of the biojetfuel that was obtained and compare with a mineral commercial jetfuel.

Keywords: biojetfuel, babaçu oil, oxidative stability, engine tests

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Authors: Amos Sunday Onikanni, Bashir Lawal, Babatunji Emmanuel Oyinloye, Gomaa Mostafa-Hedeab, Mohammed Alorabi, Simona Cavalu, Augustine O. Olusola, Chih-Hao Wang, Gaber El-Saber Batiha

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The increasing global burden of diabetes mellitus has called for the search for a therapeutic alternative that offers better activities and safety than conventional chemotherapy. Herein, we evaluated the neuroprotective and antioxidant properties of different fractions (ethyl acetate, N-butanol and residual aqueous) of Clompanus pubescens leaves in streptozotocin (STZ)-induced diabetic rats. Our results revealed a significant elevation in the levels of blood glucose, pro-inflammatory cytokines, lipid peroxidation, neuronal activities of acetylcholinesterase, butyrylcholinesterase, nitric oxide, epinephrine, norepinephrine, and Na+/K+-ATPase in diabetic non treated rats. In addition, decreased levels of enzymatic and non-enzymatic antioxidants were observed. Treatment with different fractions of C. pubescens leaves resulted in a significant reversal of the biochemical alteration and improved the neurocognitive deficit in STZ-induced diabetic rats. However, the ethyl-acetate fraction demonstrated higher activities than the other fractions and was characterized for its phytoconstituents, revealing the presence of Gallic acid (713.00 ppm), catechin (0.91 ppm), ferulic acid (0.98 ppm), rutin (59.82 ppm), quercetin (3.22 ppm) and kaempferol (4.07 ppm). Our molecular docking analysis revealed that these compounds exhibited different binding affinities and potentials for targeting BChE/AChE/ IL-1 β/Na+-K+-ATPase. However, only Kampferol and ferulic exhibited good drug-like, ADMET, and permeability properties suitable for use as a neuronal drug target agent. Hence, the ethyl-acetate fraction of C. pubescent leaves could be considered a source of promising bioactive metabolite for the treatment and management of cognitive impairments related to type II diabetes mellitus.

Keywords: diabetes mellitus, neuroprotective, antioxidant, pro-inflammatory cytokines

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Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

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Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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Authors: René A. Sørensen, Søren Skovsen, Peter Christiansen, Henrik Karstoft

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Autonomous agricultural machines act in stochastic surroundings and therefore, must be able to perceive the surroundings in real time. This perception can be achieved using image sensors combined with advanced machine learning, in particular Deep Learning. Deep convolutional neural networks excel in labeling and perceiving color images and since the cost of high-quality RGB-cameras is low, the hardware cost of good perception depends heavily on memory and computation power. This paper investigates the possibility of designing lightweight convolutional neural networks for semantic segmentation (pixel wise classification) with reduced hardware requirements, to allow for embedded usage in autonomous agricultural machines. Using compression techniques, a lightweight convolutional neural network is designed to perform real-time semantic segmentation on an embedded platform. The network is trained on two large datasets, ImageNet and Pascal Context, to recognize up to 400 individual classes. The 400 classes are remapped into agricultural superclasses (e.g. human, animal, sky, road, field, shelterbelt and obstacle) and the ability to provide accurate real-time perception of agricultural surroundings is studied. The network is applied to the case of autonomous grass mowing using the NVIDIA Tegra X1 embedded platform. Feeding case-specific images to the network results in a fully segmented map of the superclasses in the image. As the network is still being designed and optimized, only a qualitative analysis of the method is complete at the abstract submission deadline. Proceeding this deadline, the finalized design is quantitatively evaluated on 20 annotated grass mowing images. Lightweight convolutional neural networks for semantic segmentation can be implemented on an embedded platform and show competitive performance with regards to accuracy and speed. It is feasible to provide cost-efficient perceptive capabilities related to semantic segmentation for autonomous agricultural machines.

Keywords: autonomous agricultural machines, deep learning, safety, visual perception

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Authors: Irene Buj-Corral, Ali Bagheri, Alejandro Dominguez-Fernandez

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In recent years, use of ceramic prostheses as an implant in some parts of body has become common. In the present study, research has focused on replacement of the acetabulum bone, which is a part of the pelvis bone. Metallic prostheses have shown some problems such as release of metal ions into patient's blood. In addition, fracture of liners and squeezing between surface of femoral head and inner surface of acetabulum have been reported. Ceramic prostheses have the advantage of low debris and high strength, although they are more difficult to be manufactured than metallic ones. Specifically, new designs try to attempt an acetabulum in which the outer surface will be porous for proliferation of cells and fixation of the prostheses by means of osteointegration, while inner surface must be smooth enough to assure that the movement between femoral head and inner surface will be carried out with on feasibility. In the present study, 3D printing technologies are used for manufacturing ceramic prostheses. In Fused Deposition Modelling (FDM) process, 3D printed plastic prostheses are obtained by means of melting of a plastic filament and subsequent deposition on a glass surface. A similar process is applied to ceramics in which ceramic powders need to be mixed with a liquid polymer before depositing them. After 3D printing, parts are subjected to a sintering process in an oven so that they can achieve final strength. In the present paper, influence of printing parameters on surface roughness 3D printed ceramic parts are presented. Three parameter full factorial design of experiments was used. Selected variables were layer height, infill and nozzle diameter. Responses were average roughness Ra and mean roughness depth Rz. Regression analysis was applied to responses in order to obtain mathematical models for responses. Results showed that surface roughness depends mainly on layer height and nozzle diameter employed, while infill was found not to be significant. In order to get low surface roughness, low layer height and low infill should be selected. As a conclusion, layer height and infill are important parameters for obtaining good surface finish in ceramic 3D printed prostheses. However, use of too low infill could lead to prostheses with low mechanical strength. Such prostheses could not be able to bear the static and dynamic charges to which they are subjected once they are implanted in the body. This issue will be addressed in further research.

Keywords: ceramic, hip prostheses, surface roughness, 3D printing

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Authors: Ella Tyuryumina, Alexey Neznanov

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Finding algorithms to predict the growth of tumors has piqued the interest of researchers ever since the early days of cancer research. A number of studies were carried out as an attempt to obtain reliable data on the natural history of breast cancer growth. Mathematical modeling can play a very important role in the prognosis of tumor process of breast cancer. However, mathematical models describe primary tumor growth and metastases growth separately. Consequently, we propose a mathematical growth model for primary tumor and primary metastases which may help to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoM-IV and corresponding software. We are interested in: 1) modelling the whole natural history of primary tumor and primary metastases; 2) developing adequate and precise CoM-IV which reflects relations between PT and MTS; 3) analyzing the CoM-IV scope of application; 4) implementing the model as a software tool. The CoM-IV is based on exponential tumor growth model and consists of a system of determinate nonlinear and linear equations; corresponds to TNM classification. It allows to calculate different growth periods of primary tumor and primary metastases: 1) ‘non-visible period’ for primary tumor; 2) ‘non-visible period’ for primary metastases; 3) ‘visible period’ for primary metastases. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. Thus, the CoM-IV model and predictive software: a) detect different growth periods of primary tumor and primary metastases; b) make forecast of the period of primary metastases appearance; c) have higher average prediction accuracy than the other tools; d) can improve forecasts on survival of BC and facilitate optimization of diagnostic tests. The following are calculated by CoM-IV: the number of doublings for ‘nonvisible’ and ‘visible’ growth period of primary metastases; tumor volume doubling time (days) for ‘nonvisible’ and ‘visible’ growth period of primary metastases. The CoM-IV enables, for the first time, to predict the whole natural history of primary tumor and primary metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on primary tumor sizes. Summarizing: a) CoM-IV describes correctly primary tumor and primary distant metastases growth of IV (T1-4N0-3M1) stage with (N1-3) or without regional metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and manifestation of primary metastases.

Keywords: breast cancer, exponential growth model, mathematical modelling, primary metastases, primary tumor, survival

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Authors: Jonix Owino

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Aging Out of Place refers to the physical and emotional experience of growing older in a foreign or unfamiliar environment. Refugees flee their home countries and migrate to foreign countries such as the United States for safety. The emotional and psychological distress experienced by refugees who are compelled to leave their home countries can compromise their ability to adapt to new countries, thereby affecting their well-being. In particular, implications of immigration may be felt more acutely in later life stages, especially when life-long attachments have been made in the country of origin. However, aging studies in the United States have failed to conceptualize refugee aging experiences, more so for refugees who entered the country as adults. Specifically, little is known about the quality of life among aging refugees. Research studies on whether the quality of life varies among refugees by sociodemographic factors are limited. Research studies examining the role of social connectedness in aging refugees’ quality of life are also sparse. As such, the present study seeks to investigate the sociodemographic (i.e., age, sex, country of origin, and length of residence) and social connection factors associated with quality of life among aging refugees. The study consisted of a total of 108 participants from ages 50 years and above. The refugees represented in the study were from Bhutan, Burundi, and Somalia and were recruited from an upper Midwestern region of the United States. The participants completed an in-depth survey assessing social factors and well-being. Hierarchical regression was used for analysis. The results showed that females, older individuals, and refugees who were from Africa reported lower quality of life. Length of residence was not associated with quality of life. Furthermore, when controlling for sociodemographic factors, greater social integration was significantly associated with a higher quality of life, whereas lower loneliness was significantly associated with a higher quality of life. The results also indicated a significant interaction between loneliness and sex in predicting quality of life. This suggests that greater loneliness was associated with reduced quality of life for female refugees but not males. The present study highlights cultural variations within refugee groups which is important in determining how host communities can best support aging refugees’ well-being and develop social programs that can effectively cater to issues of aging among refugees.

Keywords: aging refugees, quality of life, social integration, migration and integration

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Authors: Navpreet Kaur, Himkusha Thakur, Nirmal Prabhakar

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The most controversial issue in crop production is the use of Organophosphate insecticides. This is evident in many reports that Organophosphate (OP) insecticides, among the broad range of pesticides are mainly involved in acute and chronic poisoning cases. OPs detection is of crucial importance for health protection, food and environmental safety. In our study, a nanocomposite of poly (3,4 ethylenedioxythiophene) (PEDOT) and multi-walled carbon nanotubes (MWCNTs) has been deposited electrochemically onto the surface of fluorine doped tin oxide sheets (FTO) for the analysis of malathion OP. The -COOH functionalization of MWCNTs has been done for the covalent binding with amino groups of AChE enzyme. The use of PEDOT-MWCNT films exhibited an excellent conductivity, enables fast transfer kinetics and provided a favourable biocompatible microenvironment for AChE, for the significant malathion OP detection. The prepared biosensors were characterized by Fourier transform infrared spectrometry (FTIR), Field emission-scanning electron microscopy (FE-SEM) and electrochemical studies. Various optimization studies were done for different parameters including pH (7.5), AChE concentration (50 mU), substrate concentration (0.3 mM) and inhibition time (10 min). Substrate kinetics has been performed and studied for the determination of Michaelis Menten constant. The detection limit for malathion OP was calculated to be 1 fM within the linear range 1 fM to 1 µM. The activity of inhibited AChE enzyme was restored to 98% of its original value by 2-pyridine aldoxime methiodide (2-PAM) (5 mM) treatment for 11 min. The oxime 2-PAM is able to remove malathion from the active site of AChE by means of trans-esterification reaction. The storage stability and reusability of the prepared biosensor is observed to be 30 days and seven times, respectively. The application of the developed biosensor has also been evaluated for spiked lettuce sample. Recoveries of malathion from the spiked lettuce sample ranged between 96-98%. The low detection limit obtained by the developed biosensor made them reliable, sensitive and a low cost process.

Keywords: PEDOT-MWCNT, malathion, organophosphates, acetylcholinesterase, biosensor, oxime (2-PAM)

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Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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Authors: May Fadheel Estephan, Richard Perks

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Context: Cancer is a serious health concern that affects millions of people worldwide. Early detection and treatment are essential for improving patient outcomes. However, current methods for cancer detection have limitations, such as low sensitivity and specificity. Research Aim: The aim of this study was to develop an optical sensor for cancer detection using elastic light scattering spectroscopy (ELSS). ELSS is a noninvasive optical technique that can be used to characterize the size and concentration of particles in a solution. Methodology: An optical probe was fabricated with a 100-μm-diameter core and a 132-μm centre-to-centre separation. The probe was used to measure the ELSS spectra of polystyrene spheres with diameters of 2, 0.8, and 0.413 μm. The spectra were then analysed to determine the size and concentration of the spheres. Findings: The results showed that the optical probe was able to differentiate between the three different sizes of polystyrene spheres. The probe was also able to detect the presence of polystyrene spheres in suspension concentrations as low as 0.01%. Theoretical Importance: The results of this study demonstrate the potential of ELSS for cancer detection. ELSS is a noninvasive technique that can be used to characterize the size and concentration of cells in a tissue sample. This information can be used to identify cancer cells and assess the stage of the disease. Data Collection: The data for this study were collected by measuring the ELSS spectra of polystyrene spheres with different diameters. The spectra were collected using a spectrometer and a computer. Analysis Procedures: The ELSS spectra were analysed using a software program to determine the size and concentration of the spheres. The software program used a mathematical algorithm to fit the spectra to a theoretical model. Question Addressed: The question addressed by this study was whether ELSS could be used to detect cancer cells. The results of the study showed that ELSS could be used to differentiate between different sizes of cells, suggesting that it could be used to detect cancer cells. Conclusion: The findings of this research show the utility of ELSS in the early identification of cancer. ELSS is a noninvasive method for characterizing the number and size of cells in a tissue sample. To determine cancer cells and determine the disease's stage, this information can be employed. Further research is needed to evaluate the clinical performance of ELSS for cancer detection.

Keywords: elastic light scattering spectroscopy, polystyrene spheres in suspension, optical probe, fibre optics

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Authors: Sheng-Yu Lee

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Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.

Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study

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Authors: Franca De Sarno, Alfonso Maria Ponsiglione, Enza Torino

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Recent advances in diagnostic imaging technology have significantly contributed to a better understanding of specific changes associated with diseases progression. Among different imaging modalities, Magnetic Resonance Imaging (MRI) represents a noninvasive medical diagnostic technique, which shows low sensitivity and long acquisition time and it can discriminate between healthy and diseased tissues by providing 3D data. In order to improve the enhancement of MRI signals, some imaging exams require intravenous administration of contrast agents (CAs). Recently, emerging research reports a progressive deposition of these drugs, in particular, gadolinium-based contrast agents (GBCAs), in the body many years after multiple MRI scans. These discoveries confirm the need to have a biocompatible system able to boost a clinical relevant Gd-chelate. To this aim, several approaches based on engineered nanostructures have been proposed to overcome the common limitations of conventional CAs, such as the insufficient signal-to-noise ratios due to relaxivity and poor safety profile. In particular, nanocarriers, labeling or loading with CAs, capable of carrying high payloads of CAs have been developed. Currently, there’s no a comprehensive understanding of the thermodynamic contributions enable of boosting the efficacy of conventional CAs by using biopolymers matrix. Thus, considering the importance of MRI in diagnosing diseases, here it is reported a successful example of the next generation of these drugs where the commercial gadolinium chelate is incorporate into a biopolymer nanostructure, formed by cross-linked hyaluronic acid (HA), with improved relaxation properties. In addition, they are highlighted the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA by adopting a multidisciplinary experimental approach. On the basis of these discoveries, it is clear that the main point consists in increasing the rigidification of readily-available Gd-CAs within the biopolymer matrix by controlling the water dynamics, the physicochemical interactions, and the polymer conformations. In the end, the acquired knowledge about polymer-CA systems has been applied to develop of Gd-based HA nanoparticles with enhanced relaxometric properties.

Keywords: biopolymers, MRI, nanoparticles, contrast agent

Procedia PDF Downloads 126

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Catia S. A. Sima, K. Bousson

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Congestion in the Terminal Maneuvering Areas (TMAs) of larger airports impacts all aspects of air traffic flow, not only at national level but may also induce arrival delays at international level. Hence, there is a need to monitor appropriately the air traffic flow in TMAs so that efficient decisions may be taken to manage their occupancy rates. It would be desirable to physically increase the existing airspace to accommodate all existing demands, but this question is entirely utopian and, given this possibility, several studies and analyses have been developed over the past decades to meet the challenges that have arisen due to the dizzying expansion of the aeronautical industry. The main objective of the present paper is to propose concepts to manage and reduce the degree of uncertainty in the air traffic operations, maximizing the interest of all involved, ensuring a balance between demand and supply, and developing and/or adapting resources that enable a rapid and effective adaptation of measures to the current context and the consequent changes perceived in the aeronautical industry. A central task is to emphasize the increase in air traffic flow management capacity to the present day, taking into account not only a wide range of methodologies but also equipment and/or tools already available in the aeronautical industry. The efficient use of these resources is crucial as the human capacity for work is limited and the actors involved in all processes related to air traffic flow management are increasingly overloaded and, as a result, operational safety could be compromised. The methodology used to answer and/or develop the issues listed above is based on the advantages promoted by the application of Markov Chain principles that enable the construction of a simplified model of a dynamic network that describes the air traffic flow behavior anticipating their changes and eventual measures that could better address the impact of increased demand. Through this model, the proposed concepts are shown to have potentials to optimize the air traffic flow management combined with the operation of the existing resources at each moment and the circumstances found in each TMA, using historical data from the air traffic operations and specificities found in the aeronautical industry, namely in the Portuguese context.

Keywords: air traffic flow, terminal maneuvering area, TMA, air traffic management, ATM, Markov chains

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Authors: Isalira Peroba Ramos, Cherley Borba Vieira de Andrade, Grazielle Suhett, Camila Salata, Paulo Cesar Canary, Guilherme Visconde Brasil, Antonio Carlos Campos de Carvalho, Regina Coeli dos Santos Goldenberg

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Background: The therapeutic options for patients with cancer now include increasingly complex combinations of medications, radiation therapy (RT), and surgical intervention. Many of these treatments have important potential adverse cardiac effects and are likely to have significant effects on patient outcomes. Cell therapy appears to be promising for the treatment of chronic and degenerative diseases, including cardiomyopathy induced by RT, as the current therapeutic options are insufficient. Aims: To evaluate the potential of bone marrow mesenchymal cells (BMMCs) in radioinduced cardiac damage Methods: Female Wistar rats, 3 months old (Ethics Committee 054/14), were divided into 2 groups, non-treated irradiated group (IR n=15) and irradiated and BMMC treated (IRT n=10). Echocardiography was performed to evaluate heart function. After euthanasia, 3 months post treatment; the left ventricle was removed and prepared for RT-qPCR (VEGF and Pro Collagen I) and histological (picrosirius) analysis. Results: In both groups, 45 days after irradiation, ejection fraction (EF) was in the normal range for these animals (> 70%). However, the BMMC treated group had EF (83.1%±2.6) while the non-treated IR group showed a significant reduction (76.1%±2.6) in relation to the treated group. In addition, we observed an increase in VEGF gene expression and a decrease in Pro Collagen I in IRT when compared to IR group. We also observed by histology that the collagen deposition was reduced in IRT (10.26%±0.83) when compared to IR group (25.29%±0.96). Conclusions: Treatment with BMMCs was able to prevent ejection fraction reduction and collagen deposition in irradiated animals. The increase of VEGF and the decrease of pro collagen I gene expression might explain, at least in part, the cell therapy benefits. All authors disclose no financial or personal relationships with individuals or organizations that could be perceived to bias their work. Sources of funding: FAPERJ, CAPES, CNPq, MCT.

Keywords: mesenchymal cells, radioation, cardiotoxicity, bone marrow

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Authors: S. Sandri, G. M. Contessa, C. Poggi

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An experimental nuclear fusion device could be seen as a step toward the development of the future nuclear fusion power plant. If compared with other possible solutions to the energy problem, nuclear fusion has advantages that ensure sustainability and security. In particular considering the radioactivity and the radioactive waste produced, in a nuclear fusion plant the component materials could be selected in order to limit the decay period, making it possible the recycling in a new reactor after about 100 years from the beginning of the decommissioning. To achieve this and other pertinent goals many experimental machines have been developed and operated worldwide in the last decades, underlining that radiation protection and workers exposure are critical aspects of these facilities due to the high flux, high energy neutrons produced in the fusion reactions. Direct radiation, material activation, tritium diffusion and other related issues pose a real challenge to the demonstration that these devices are safer than the nuclear fission facilities. In Italy, a limited number of fusion facilities have been constructed and operated since 30 years ago, mainly at the ENEA Frascati Center, and the radiation protection approach, addressed by the national licensing requirements, shows that it is not always easy to respect the constraints for the workers' exposure to ionizing radiation. In the current analysis, the main radiation protection issues encountered in the Italian Fusion facilities are considered and discussed, and the technical and legal requirements are described. The licensing process for these kinds of devices is outlined and compared with that of other European countries. The following aspects are considered throughout the current study: i) description of the installation, plant and systems, ii) suitability of the area, buildings, and structures, iii) radioprotection structures and organization, iv) exposure of personnel, v) accident analysis and relevant radiological consequences, vi) radioactive wastes assessment and management. In conclusion, the analysis points out the needing of a special attention to the radiological exposure of the workers in order to demonstrate at least the same level of safety as that reached at the nuclear fission facilities.

Keywords: fusion facilities, high energy neutrons, licensing process, radiation protection

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Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

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Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

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Authors: Gal Zagron, Nitza Abramson, Deena R. Zimmerman, Chen Stein-Zamir

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Background: Salmonella enteritidis is a common cause of foodborne outbreaks, primarily associated with poultry eggs. S. enteritidis This is the only Salmonella type that is found inside the eggshell. A rise in Salmonella enteritidis notifications was noted in spring 2017. Aims: The aim of this study is to describe the epidemiological investigation of the outbreak in the Jerusalem district, along with the containment measures taken. Methods: This study is a population-based epidemiological study with a description of environmental control activities. Results: During the months May - July, 2017 848 salmonellosis cases were reported to the Jerusalem district health office compared to 294 cases May - July 2016. Salmonella enteritidis was isolated in 58% of reported cases. Clusters and outbreaks ( > 2 cases) were reported among nursery schools, nursing homes, persons residing in one kibbutz and several cases in different food service establishments in the Jerusalem district. Epidemiological investigations revealed eggs consumption as a common feature among the cases (uncooked or undercooked eggs in most cases). A national investigation among egg suppliers revealed that most cases consumed eggs provided by a single provider with isolation of Salmonella enteritidis at the source as well. Containment measures were taken to control the epidemic including distributing information via electronic and written media to the public, searching for all egg distribution centers, informing local authorities, the poultry council and food stores. The eggs originating from the provider were recalled and extinguished. Written instructions to all food preparation facilities in the district were distributed regarding the proper storage and preparation of eggs. The number of reported cases declined and the outbreak vanished during correlating months of 2018. Conclusions: The investigation of Salmonella enteritidis outbreaks should include epidemiological and laboratory investigations, tracing the source of the eggs and testing the eggs and the source of eggs. Health education activities are essential as to the proper handling of eggs and egg products aiming to minimize susceptibility to Salmonella infection.

Keywords: epidemiological investigation, food-borne disease, food safety, Salmonella enteritidis

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Authors: Joseph Dodson, Robert Roth, Alexander Hodakowski, Leah Greenfield, Melissa Porterhouse, Natalie Maltby, Rachel Sadowsky

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Introduction: Throughout the COVID-19 pandemic, countless research publications were released regarding SARS-CoV-2 and its variants, suggested treatments, and vaccine safety and efficacy. Daily publication of research became overwhelming for health professionals and the general public to stay informed. To address this problem, a group of 70 students across the four colleges at Rush University created the “Rush University COVID-19 Journal Club.” To broaden the available audience, the journal club then expanded to social media. Methods: Easily accessible and understandable summaries of the research were written by students and sent to faculty sponsors for feedback. Following the revision, summaries were published weekly on the Rush University COVID-19 Journal Club website for clinicians and students to use for reference. An Instagram page was then created, and information was further condensed into succinct posts to address COVID-19 “FAQs.” Next, a survey was distributed to followers of the Instagram page with questions meant to assess the effectiveness of the platform and gain feedback. A 5-point Likert scale was used as the primary question format. Results: The Instagram page accrued 749 followers and posted 52 unique posts over a 2 year period. Preliminary results from the surveys demonstrate that over 80% of respondents strongly agree that the Instagram posts 1) are an effective platform for the public presentation of factual COVID-19-related information; 2) provide relevant and valuable information; 3) provide information that is clear, concise, and can be easily understood. Conclusion: These results suggest that the Rush COVID-19 Journal Club was able to successfully create a social media presence and convey information without sacrificing scholarly integrity. Other academic institutions may benefit from the application of this model to help students and clinicians with the interpretation and evaluation of research topics with large bodies of evidence.

Keywords: SARS-CoV-2, COVID-19, public health, social media, SARS-CoV-2 vaccine, SARS-CoV-2 variants

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Authors: E. A. Krasikov

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As a main barrier against radioactivity outlet reactor pressure vessel (RPV) is a key component in terms of NPP safety. Therefore, present-day demands in RPV reliability enhance have to be met by all possible actions for RPV in-service embrittlement mitigation. Annealing treatment is known to be the effective measure to restore the RPV metal properties deteriorated by neutron irradiation. There are two approaches to annealing. The first one is so-called ‘dry’ high temperature (~475°C) annealing. It allows obtaining practically complete recovery, but requires the removal of the reactor core and internals. External heat source (furnace) is required to carry out RPV heat treatment. The alternative approach is to anneal RPV at a maximum coolant temperature which can be obtained using the reactor core or primary circuit pumps while operating within the RPV design limits. This low temperature «wet» annealing, although it cannot be expected to produce complete recovery, is more attractive from the practical point of view especially in cases when the removal of the internals is impossible. The first RPV «wet» annealing was done using nuclear heat (US Army SM-1A reactor). The second one was done by means of primary pumps heat (Belgian BR-3 reactor). As a rule, there is no recovery effect up to annealing and irradiation temperature difference of 70°C. It is known, however, that along with radiation embrittlement neutron irradiation may mitigate the radiation damage in metals. Therefore, we have tried to test the possibility to use the effect of radiation-induced ductilization in ‘wet’ annealing technology by means of nuclear heat utilization as heat and neutron irradiation sources at once. In support of the above-mentioned conception the 3-year duration reactor experiment on 15Cr3NiMoV type steel with preliminary irradiation at operating PWR at 270°C and following extra irradiation (87 h at 330°C) at IR-8 test reactor was fulfilled. In fact, embrittlement was partly suppressed up to value equivalent to 1,5 fold neutron fluence decrease. The degree of recovery in case of radiation enhanced annealing is equal to 27% whereas furnace annealing results in zero effect under existing conditions. Mechanism of the radiation-induced damage mitigation is proposed. It is hoped that «wet » annealing technology will help provide a better management of the RPV degradation as a factor affecting the lifetime of nuclear power plants which, together with associated management methods, will help facilitate safe and economic long-term operation of PWRs.

Keywords: controlling, embrittlement, radiation, steel, wet annealing

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Authors: Aishwarya Pothula

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Euthanasia in India is a politically dormant policy issue in the sense that discussions around it are sporadic in nature (usually with developments in specific cases) and it stays as a dominant issue in the public domain for a fleeting period. In other words, it is a non-political issue that has been unable to successfully get on the policy agenda. This paper studies how the Supreme Court of India (SC) plays a role in euthanasia’s policy making. In 2011, the SC independently put a law in place that legalized passive euthanasia through its judgement in the Aruna Shanbaug v. Union of India case. According to this, it is no longer illegal to withhold/withdraw a patient’s medical treatment in certain cases. This judgement, therefore, is the empirical focus of this paper. The paper essentially employs two techniques of discourse analysis to study the SC’s system of argumentation. The two methods, Text Analysis using Gasper’s Analysis Table and Frame Analysis – are complemented by two discourse techniques called metaphor analysis and lexical analysis. The framework within which the analysis is conducted lies in 1) the judicial process of India, i.e. the SC procedures and the Constitutional rules and provisions, and 2) John W. Kingdon’s theory of policy windows and policy entrepreneurs. The results of this paper are three-fold: first, the SC dismiss the petitioner’s request for passive euthanasia on inadequate and weak grounds, thereby setting no precedent for the historic law they put in place. In other words, they leave the decision open for the Parliament to act upon. Hence the judgement, as opposed to arguments by many, is by no means an instance of judicial activism/overreach. Second, they define euthanasia in a way that resonates with existing broader societal themes. They combine this with a remarkable use of authoritative and protective tones/stances to settle at an intermediate position that balances the possible opposition to their role in the process and what they (perhaps) perceive to be an optimal solution. Third, they soften up the policy community (including the public) to the idea of passive euthanasia leading it towards a Parliamentarian legislation. They achieve this by shaping prevalent principles, provisions and worldviews through an astute use of the legal instruments at their disposal. This paper refers to this unconventional role of the SC as ‘judicial entrepreneurship’ which is also the first scholarly contribution towards research on euthanasia as a policy issue in India.

Keywords: argumentation analysis, Aruna Ramachandra Shanbaug, discourse analysis, euthanasia, judicial entrepreneurship, policy-making process, supreme court of India

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Authors: Inkeri Jääskeläinen

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The purpose of this study is to shed light on what is it like to study in apprenticeship training using Finnish as second language. This study examines the stories and experiences of apprenticeship students learning and studying Finnish as part of their vocational studies. Also, this pilot study examines the effects of learning to pronounce Finnish through body motions and gestures. Many foreign students choose apprenticeships and start vocational training too early, while their language skills in Finnish are still very weak. Both duties at work and school assignments require reasonably good general language skills (B1.1) and, especially at work, language skills are also a safety issue. At work students should be able to simultaneously learn Finnish and do vocational studies in a noisy, demanding, and stressing environment. Learning and understanding new things is very challenging under these circumstances and sometimes students get exhausted and experience a lot of stress - which makes learning even more difficult. Students are different from each other and so are their ways to learn. Thereafter, one of the most important features of apprenticeship training and second language learning is good understanding of adult learners and their needs. Kinaesthetic methods are an effective way to support adult students’ cognitive skills and make learning more relaxing and fun. Empirical findings show that language learning can indeed be supported physical ways, by body motions and gestures. The method used here, named TFFL (Touch and Feel Foreign Languages), was designed to support adult language learning, to correct or prevent language fossilization and to help the student to manage emotions. Finnish is considered as a difficult language to learn, mostly because it is so different from nearly all other languages. Many learners complain that they are lost or confused and there is a need to find a way to simultaneously learn the language and to handle negative emotion which come from Finnish language and the learning process itself. Due to the nature of Finnish language good pronunciation skills are needed just to understand the way the language work. Movements (body movements etc.) are a natural part of many cultures but not Finnish – In Finland students have traditionally been expected to stay still and that is not a natural way for many foreign students. However, kinaesthetic TFFL method proved out to be a useful way to help some L2 students to feel phonemes, rhythm and intonation, to improve their Finnish and, thereby, also to successfully complete their vocational studies.

Keywords: Finnish, fossilization, interference, kinaesthetic method

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Authors: Augustar Omoze Ehighalua, Itotenaan Henry Ogiri

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As a mono-product economy, Nigeria relies largely on oil revenues for its foreign exchange earnings and the exploration activities of firms operating in the Niger Delta region have left in its wake tales of environmental degradation, poverty and misery. This, no doubt, have created corporate social responsibility issues in the region. The focus of this research is the critical evaluation of the ethical response to Corporate Social Responsibility (CSR) practice by firms operating in Nigeria Delta Swamplands. While CSR is becoming more popular in developed society with effective practice guidelines and reporting benchmark, there is a relatively low level of awareness and selective applicability of existing international guidelines to effectively support CSR practice in Nigeria. This study, haven identified the lack of CSR institutional framework attempts to develop an ethically-driven CSR transparency benchmark laced within a regulatory framework based on international best practices. The research adopts a qualitative methodology and makes use of primary data collected through semi-structured interviews conducted across the six core states of the Niger Delta Region. More importantly, the study adopts an inductive, interpretivist philosophical paradigm that reveal deep phenomenological insights into what local communities, civil society and government officials consider as good ethical benchmark for responsible CSR practice by organizations. The institutional theory provides for the main theoretical foundation, complemented by the stakeholder and legitimacy theories. The Nvivo software was used to analyze the data collected. This study shows that ethical responsibility is lacking in CSR practice by firms in the Niger Delta Region of Nigeria. Furthermore, findings of the study indicate key issues of environmental, health and safety, human rights, and labour as fundamental in developing an effective CSR practice guideline for Nigeria. The study has implications for public policy formulation as well as managerial perspective.

Keywords: corporate social responsibility, CSR, ethics, firms, Niger-Delta Swampland, Nigeria

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Authors: Sang Wook Park, Jun Su Park, Byung Kwan Oh, Yousok Kim, Hyo Seon Park

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This study suggests the estimation method of stress distribution for the beam structures based on TLS (Terrestrial Laser Scanning). The main components of method are the creation of the lattices of raw data from TLS to satisfy the suitable condition and application of CSSI (Cubic Smoothing Spline Interpolation) for estimating stress distribution. Estimation of stress distribution for the structural member or the whole structure is one of the important factors for safety evaluation of the structure. Existing sensors which include ESG (Electric strain gauge) and LVDT (Linear Variable Differential Transformer) can be categorized as contact type sensor which should be installed on the structural members and also there are various limitations such as the need of separate space where the network cables are installed and the difficulty of access for sensor installation in real buildings. To overcome these problems inherent in the contact type sensors, TLS system of LiDAR (light detection and ranging), which can measure the displacement of a target in a long range without the influence of surrounding environment and also get the whole shape of the structure, has been applied to the field of structural health monitoring. The important characteristic of TLS measuring is a formation of point clouds which has many points including the local coordinate. Point clouds is not linear distribution but dispersed shape. Thus, to analyze point clouds, the interpolation is needed vitally. Through formation of averaged lattices and CSSI for the raw data, the method which can estimate the displacement of simple beam was developed. Also, the developed method can be extended to calculate the strain and finally applicable to estimate a stress distribution of a structural member. To verify the validity of the method, the loading test on a simple beam was conducted and TLS measured it. Through a comparison of the estimated stress and reference stress, the validity of the method is confirmed.

Keywords: structural healthcare monitoring, terrestrial laser scanning, estimation of stress distribution, coordinate transformation, cubic smoothing spline interpolation

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Danhua Xu, Zhenlan Qian, Zhu Wang, Jiayan Fu, Ling Wang

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A new business mode called rural complex is proposed by the China’s government to promote the development the economy in the rural area. However, for the sake of current national conditions including the great number of labor farmers owning the small scale farmlands and the uncertain enthusiasm from the enterprises, it is challenging to develop the big scale rural complex. To react to the dilemmas, this paper puts forward the micro-rural complex to boost the small scale farms by co-participation from a bottom-up mode. By analyzing the potential opportunities to find the suitable mode, exploring the interdisciplinary and interdepartmental co-participation way beyond architecture design and spatial planning between different actors, the paper tries to find a complete process towards the sustainable micro-rural complex and conducts an ongoing practice to optimize it, to bring new insights and reference to the rural development. According to the transformation of the economy, the micro-rural complex will develop into two phases, both of which can be discussed in three parts, the economic mode, the spatial support, and the Cooperating mechanism. The first stage is the agriculture co-participation based on the rise of Community supported agriculture (CSA) in which the consumers buy the products planted in an organic way from the farmers directly with a higher price to support the small-scale agriculture and overcome the food safety issues. The following stage sets up the agritourism catering the citizens with the restaurants, inns and other tourist service facilities to be planned and designed. In the whole process, the interdisciplinary co-participation will play an important role to provide the guidelines and consultation from the agronomists, architects and rural planners to the farmers. This mode has been applied to an on-going farm project, from which to explore the mode in a more practical way. In conclusion, the micro-rural complex aims at creating a balanced urban-rural relationship by co-participation taking advantage of the different actors. The spatial development is considered from the economic mode and social organization. The integration of the mode based on the small-scale agriculture will contribute to a sustainable growth and realize the long run development in the rural area.

Keywords: micro-rural complex, co-participation, sustainable development, China

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Authors: Yun Chan Lee

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Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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