Search results for: manipulative standard score

Authors: C. V. Nnamani, O. L. Adedeji

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The contemporary global economic meltdown has devastating effect on the Nigerian’s economy and its frantic search for alternative source of national revenue aside from oil and gas has become imperative for economic emancipation for Nigerians. Apicultural entrepreneurship could provide a source of livelihood if the basic knowledge of those plant genetic resources needed by bees is made available. A palynological evaluation of those palynotaxa which honey bees forage for pollen and nectar was carried out after standard acetolysis method. Results showed that the honey samples were highly diversified and rich in honey plants. A total of 9544.3 honey pollen, consisting of 39 honey plants belonging to 21 plant families and distributed within 38 genera were identified excluding 238 unidentified pollen grains. Data from the analysis equally revealed that Elaeis guineensis Jacq, Anacardium occidentale L, Diospyros mespiliformis Hochist xe ADC, Alchornea cordifolia Muell, Arg, Daniella oliveri (Rolfe) Hutch & Dalz, Irvingia wombolu Okafor ex Baill, Treculia africana Decne, Nauclea latifolia Smith and Crossopteryx febrifuga Afzil ex Benth were the predominant honey plants. It provided a guide to the optimal utilization of floral resources by honeybees in these regions, showing the opportunity and amazing potentials for apiculture entrepreneurship of these palytaxa. Most of these plants are rare, threatened and endangered. It calls for urgent conservation techniques and step by all players. Critical awareness creation to ensure farmers knowledge of these palynotaxa to ensure proper understanding and attendance boost from them as economic empowerment is needed.

Keywords: palynotaxa, acetolysis, enterprise, livelihood, Nigeria

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Authors: Enze Zhang

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One of the most challenging steps in implementing virtual water content (VWC) analysis of crops is to get properly the total volume of consumptive water use (CWU) and, therefore, the choice of a reliable crop CWU estimation method. In practice, lots of previous researches obtaining CWU of crops follow a classical procedure for calculating crop evapotranspiration which is determined by multiplying reference evapotranspiration by appropriate coefficient, such as crop coefficient and water stress coefficients. However, this manner of calculation requires lots of field experimental data at point scale and more seriously, when current growing conditions differ from the standard conditions, may easily produce deviation between the calculated CWU and the actual CWU. Since evapotranspiration caused by crop planting always plays a vital role in surface water-energy balance in an agricultural region, this study decided to alternatively estimates crop evapotranspiration by Budyko framework. After brief introduce the development process of Budyko framework. We choose a modified Budyko framework under unsteady-state to better evaluated the actual CWU and apply it in an agricultural irrigation area in North China Plain which rely on underground water for irrigation. With the agricultural statistic data, this calculated CWU was further converted into VWC and its subdivision of crops at the annual scale. Results show that all the average values of VWC, VWC_blue and VWC_green show a downward trend with increased agricultural production and improved acreage. By comparison with the previous research, VWC calculated by Budyko framework agree well with part of the previous research and for some other research the value is greater. Our research also suggests that this methodology and findings may be reliable and convenient for investigation of virtual water throughout various agriculture regions of the world.

Keywords: virtual water content, Budyko framework, consumptive water use, crop evapotranspiration

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Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

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Authors: Te Kīpa Kēpa B. Morgan, Oliver W. Mcmillan, Dylan N. Taute, Tumanako N. Fa'aui

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Epistemologies are ways of knowing. Indigenous Peoples are aware that they do not perceive and experience the world in the same way as others. So it is important when empowering Indigenous epistemologies, such as that of the New Zealand Māori, to also be able to represent a scientific understanding within the same analysis. A geothermal development assessment tool has been developed by adapting the Mauri Model Decision Making Framework. Mauri is a metric that is capable of representing the change in the life-supporting capacity of things and collections of things. The Mauri Model is a method of grouping mauri indicators as dimension averages in order to allow holistic assessment and also to conduct sensitivity analyses for the effect of worldview bias. R-shiny is the coding platform used for this Vision Mātauranga research which has created an expert decision support tool (DST) that combines a stakeholder assessment of worldview bias with an impact assessment of mauri-based indicators to determine the sustainability of proposed geothermal development. The initial intention was to develop guidelines for quantifying mātauranga Māori impacts related to geothermal resources. To do this, three typical scenarios were considered: a resource owner wishing to assess the potential for new geothermal development; another party wishing to assess the environmental and cultural impacts of the proposed development; an assessment that focuses on the holistic sustainability of the resource, including its surface features. Indicator sets and measurement thresholds were developed that are considered necessary considerations for each assessment context and these have been grouped to represent four mauri dimensions that mirror the four well-being criteria used for resource management in Aotearoa, New Zealand. Two case studies have been conducted to test the DST suitability for quantifying mātauranga Māori and other biophysical factors related to a geothermal system. This involved estimating mauri0meter values for physical features such as temperature, flow rate, frequency, colour, and developing indicators to also quantify qualitative observations about the geothermal system made by Māori. A retrospective analysis has then been conducted to verify different understandings of the geothermal system. The case studies found that the expert DST is useful for geothermal development assessment, especially where hapū (indigenous sub-tribal grouping) are conflicted regarding the benefits and disadvantages of their’ and others’ geothermal developments. These results have been supplemented with evaluations for the cumulative impacts of geothermal developments experienced by different parties using integration techniques applied to the time history curve of the expert DST worldview bias weighted plotted against the mauri0meter score. Cumulative impacts represent the change in resilience or potential of geothermal systems, which directly assists with the holistic interpretation of change from an Indigenous Peoples’ perspective.

Keywords: decision support tool, holistic geothermal assessment, indigenous knowledge, mauri model decision-making framework

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Authors: Jamerson Felipe Pereira Lima, Jeane Cecília Bezerra de Melo

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The difficulty and cost related to obtaining of protein tertiary structure information through experimental methods, such as X-ray crystallography or NMR spectroscopy, helped raising the development of computational methods to do so. An approach used in these last is prediction of tridimensional structure based in the residue chain, however, this has been proved an NP-hard problem, due to the complexity of this process, explained by the Levinthal paradox. An alternative solution is the prediction of intermediary structures, such as the secondary structure of the protein. Artificial Intelligence methods, such as Bayesian statistics, artificial neural networks (ANN), support vector machines (SVM), among others, were used to predict protein secondary structure. Due to its good results, artificial neural networks have been used as a standard method to predict protein secondary structure. Recent published methods that use this technique, in general, achieved a Q3 accuracy between 75% and 83%, whereas the theoretical accuracy limit for protein prediction is 88%. Alternatively, to achieve better results, support vector machines prediction methods have been developed. The statistical evaluation of methods that use different AI techniques, such as ANNs and SVMs, for example, is not a trivial problem, since different training sets, validation techniques, as well as other variables can influence the behavior of a prediction method. In this study, we propose a prediction method based on artificial neural networks, which is then compared with a selected SVM method. The chosen SVM protein secondary structure prediction method is the one proposed by Huang in his work Extracting Physico chemical Features to Predict Protein Secondary Structure (2013). The developed ANN method has the same training and testing process that was used by Huang to validate his method, which comprises the use of the CB513 protein data set and three-fold cross-validation, so that the comparative analysis of the results can be made comparing directly the statistical results of each method.

Keywords: artificial neural networks, protein secondary structure, protein structure prediction, support vector machines

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Authors: Omojokun G. Aju, Adedayo O. Sule

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ZigBee wireless sensor and control network is one of the most popularly deployed wireless technologies in recent years. This is because ZigBee is an open standard lightweight, low-cost, low-speed, low-power protocol that allows true operability between systems. It is built on existing IEEE 802.15.4 protocol and therefore combines the IEEE 802.15.4 features and newly added features to meet required functionalities thereby finding applications in wide variety of wireless networked systems. ZigBee‘s current focus is on embedded applications of general-purpose, inexpensive, self-organising networks which requires low to medium data rates, high number of nodes and very low power consumption such as home/industrial automation, embedded sensing, medical data collection, smart lighting, safety and security sensor networks, and monitoring systems. Although the ZigBee design specification includes security features to protect data communication confidentiality and integrity, however, when simplicity and low-cost are the goals, security is normally traded-off. A lot of researches have been carried out on ZigBee technology in which emphasis has mainly been placed on ZigBee network performance characteristics such as energy efficiency, throughput, robustness, packet delay and delivery ratio in different scenarios and applications. This paper investigate and analyse the data accuracy, network implementation difficulties and security challenges of ZigBee network applications in star-based and mesh-based topologies with emphases on its home monitoring application using the ZigBee ProBee ZE-10 development boards for the network setup. The paper also expose some factors that need to be considered when designing ZigBee network applications and suggest ways in which ZigBee network can be designed to provide more resilient to network attacks.

Keywords: home monitoring, IEEE 802.14.5, topology, wireless security, wireless sensor network (WSN), ZigBee

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Authors: Coulibaly Fatoumata, Gragnon Biego, Aka N. David, Mbari K. Benjamin, Soro Y. René, Ndiaye Jean-louis

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Poultry is nowadays one of the most consumed sources of protein, and its livestock represents one of the few opportunities for savings, investment and protection against risk. It provides income for the most vulnerable sections of society, in particular, women (70%) and children who mainly practice this breeding. A study was conducted in the commune of Korhogo at the level of 52 poultry farms, the objective of which was to know the epidemiological situation of parasitism external and internal poultry in order to contribute to the improvement of the health status of modern poultry farms in the said commune. The method described by OIE (2005), consisting of using the standard formula (n = δ2*p*(1-p) *c /i2), made it possible to calculate the size of the sample. Then, samples of droppings and ectoparasites were taken from the affected farms. After analysis and identification, two (2) species of mallophagous lice, including Menopon gallinae (50%) and Menacanthus stramineus (33%) and a species of bug Cimex lectularius (17%) were highlighted. The laying hens were more infested than broilers. Regarding gastrointestinal parasites, different species (six) have been identified: Trichostrongylus tenuis (17%), Syngamus trachea (19%), Heterakis sp (10%), Ascaridia sp (17%), Raillietina sp (8%) and Eimeria sp (29%). In addition, coccidiosis (Eimeria sp) proved to be the dominant pathology representing 67% of pathologies in broiler farms and 33% in poultry farms. The presence of these parasitoses in these modern farms constitutes a constraint major contribution to productivity and their development In view of all these difficulties, proposals have been made in order to participate in the establishment of a good prophylaxis program (health and medical). In addition, the Ivorian government, with the support of veterinarians, must interfere more in the organization of the health monitoring of traditional chickens and poultry in general through supervision and training in order to preserve public health ( animal, human and environmental health).

Keywords: gastrointestinal parasites, ectoparasites, pathologies, poultry, korhogo.

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Authors: Israa A. Qari

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Learning to request in a foreign language is a key ability within pragmatics language teaching. This paper examines how requests are taught in English Unlimited Book 3 (Cambridge University Press), an EFL textbook series employed by King Abdulaziz University in Jeddah, Saudi Arabia to teach advanced foundation year students English. The focus of analysis is the evaluation of the request linguistic strategies present in the textbook, frequency of the use of these strategies, and the contextual information provided on the use of these linguistic forms. The researcher collected all the linguistic forms which consisted of the request speech act and divided them into levels employing the CCSARP request coding manual. Findings demonstrated that simple and commonly employed request strategies are introduced. Looking closely at the exercises throughout the chapters, it was noticeable that the book exclusively employed the most direct form of requesting (the imperative) when giving learners instructions: e.g. listen, write, ask, answer, read, look, complete, choose, talk, think, etc. The book also made use of some other request strategies such as ‘hedged performatives’ and ‘query preparatory’. However, it was also found that many strategies were not dealt with in the book, specifically strategies with combined functions (e.g. possibility, ability). On a sociopragmatic level, a strong focus was found to exist on standard situations in which relations between the requester and requestee are clear. In general, contextual information was communicated implicitly only. The textbook did not seem to differentiate between formal and informal request contexts (register) which might consequently impel students to overgeneralize. The paper closes with some recommendations for textbook and curriculum designers. Findings are also contrasted with previous results from similar body of research on EFL requests.

Keywords: EFL, requests, saudi, speech acts, textbook evaluation

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Authors: Anza-Vhudziki Mboyi, Ilunga Kamika, Maggy Momba

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The aim of this study was to ascertain the survival limit and capability of commonly found wastewater protozoan (Aspidisca sp, Trachelophyllum sp, and Peranema sp) and bacterial (Bacillus licheniformis, Brevibacillus laterosporus, and Pseudomonas putida) species to remove COD while exposed to commercial nanomaterials under varying pH conditions. The experimental study was carried out in modified mixed liquor media adjusted to various pH levels (pH 2, 7 and 10), and a comparative study was performed to determine the difference between the cytotoxicity effects of commercial zinc oxide (nZnO) and silver (nAg) nanomaterials (NMs) on the target wastewater microbial communities using standard methods. The selected microbial communities were exposed to lethal concentrations ranging from 0.015 g/L to 40 g/L for nZnO and from 0.015 g/L to 2 g/L for nAg for a period of 5 days of incubation at 30°C (100 r/min). Compared with the absence of NMs in wastewater mixed liquor, the relevant environmental concentration ranging between 10 µg/L and 100 µg/L, for both nZnO and nAg caused no adverse effects, but the presence of 20 g of nZnO/L and 0.65 g of nAg/L significantly inhibited microbial growth. Statistical evidence showed that nAg was significantly more toxic compared to nZnO, but there was an insignificant difference in toxicity between microbial communities and pH variations. A significant decrease in the removal of COD by microbial populations was observed in the presence of NMs with a moderate correlation of r = 0.3 to r = 0.7 at all pH levels. It was evident that there was a physical interaction between commercial NMs and target wastewater microbial communities; although not quantitatively assessed, cell morphology and cell death were observed. Such phenomena suggest the high resilience of the microbial community, but it is the accumulation of NMs that will have adverse effects on the performance in terms of COD removal.

Keywords: bacteria, biological treatment, chemical oxygen demand (COD) and nanomaterials, consortium, pH, protozoan

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Authors: Birhanu Kassa

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The knowledge of temperature effect on index properties and, thus, the understanding of its behavior may be essential for a complete understanding of the various cases of Geotechnical Engineering problems and for conducting meaningful practical research, analysis, and design in tropical regions, such as the Ethiopian environment. The scarcity of the proper geotechnical information on the subsoil makes foundation and engineering works risk able, difficult, and sometimes hazardous. Seasonal variations, environmental effects, terrain challenges, and temperature effects all affect the quality of soil. Simada is a city which is found in south Gondar and it is developing rapidly both in horizontal and vertical construction. Rapid urbanization in the city area has led to an increased interest in the basic properties of soils that are present within the city area. There has been no previous research that looks into the effect of temperature on the investigation of clay soil index qualities in Simada. This work focuses mainly on investigating the Index and some other properties of soil in Simada Town with varying temperatures. To explore the influence of temperature change, samples were collected from various regions of the city, and routine laboratory tests were performed on the collected samples at various temperatures. Disturbed samples were taken at intervals where an average depth of 1.5-2m depths below natural ground level. The standard laboratory tests performed on all twenty-four soil samples were the water content, gradation analysis, Atterberg limits, specific gravity, and compaction test. All specimens were tested at different temperatures (25°C, 35 °C, 45 °C, 65 °C,75 and 105 °C). The variation of the plasticity characteristics of the soils has been determined based on the temperature variation. From the test result, we can conclude that temperature has a significant effect on the index properties of clay soil, in our case, red clay soil.

Keywords: airdried, oven dried, soils index properties, compaction test

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Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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This paper proposes a method to optimize the layout of an emergency department (ED) based on real executions of care processes by considering several planning objectives simultaneously. Recently, demand for healthcare services has been dramatically increased. As the demand for healthcare services increases, so do the need for new healthcare buildings as well as the need for redesign and renovating existing ones. The importance of implementation of a standard set of engineering facilities planning and design techniques has been already proved in both manufacturing and service industry with many significant functional efficiencies. However, high complexity of care processes remains a major challenge to apply these methods in healthcare environments. Process mining techniques applied in this study to tackle the problem of complexity and to enhance care process analysis. Process related information such as clinical pathways extracted from the information system of an ED. A 0-1 goal programming approach is then proposed to find a single layout that simultaneously satisfies several goals. The proposed model solved by optimization software CPLEX 12. The solution reached using the proposed method has 42.2% improvement in terms of walking distance of normal patients and 47.6% improvement in walking distance of critical patients at minimum cost of relocation. It has been observed that lots of patients must unnecessarily walk long distances during their visit to the emergency department because of an inefficient design. A carefully designed layout can significantly decrease patient walking distance and related complications.

Keywords: healthcare operation management, goal programming, facility layout problem, process mining, clinical processes

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Authors: B. Baba Ahmed, P. Yanogo, B. Djibryl. N. Medas

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Introduction: Polio is a highly contagious viral infection, with children under 5 years of age being the most affected. It is a public health emergency of international concern. Polio surveillance in Mauritania has been ongoing since 1998 and has achieved "polio free" status in 2007. our objective is to analyse a pidemiological surveillance database of poliomyélitis in Mauritania from 2012-2019. Method: A transversal descriptive analysis of poliomyélitis database was carried out in Mauritania from 2012-2019.An exhaustive sampling was done on all suspected polio cases recorded in the database from 2012 -2019. This study used EPI-INFO 7.4 for frequency calculation for qualitative variables, mean and standard deviation for quantitative variables. Results: We found 459 suspected cases of polio over the study period with an average rate of acute non-polio flaccid paralysis of 25.4 cases/100,000 children under 15 years of age. The age group 0-6 years represented 75.2%. Males constituted 50.2%. Females represented 49.78% with a ratio of M/F=1.Among the 422 observations, the average age is 4 years +/- 3.38. The four regions, TIRIS-ZEMMOUR, INCHIRI, TAGANT, NOUACHCHOTT OUEST recorded the lowest percentages of notifications, respectively (3.28%; 3.93%; 4.37%; 4.8%). 99.34% [98.09-99.78] of cases presented acute flaccid paralysis. And 56.77% [52.19-61.23], had limb asymmetry. We showed that 82.93% [79.21-86.10], had fever. we found that 89.5% of suspected polio cases were investigated before 48 hours. And 88.39% of suspected cases had two adequate samples taken 48 hours apart and within 14 days after the onset of symptoms. Only 30.95% of samples arrived at the referral laboratory before 72 hours. Conclusion: This study has shown that Mauritania has achieved the objectives in most of the quantitative performance indicators of polio surveillance. This study has shown a low notification of cases in the northern and central regions of the country. There is a problem with the transport of samples to the laboratory.

Keywords: analysis, data base, Epi-Info, polio

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Authors: Malihe Moeinin, Robert Hill, Ferranti Wong

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Background: A white spot lesion (WSL) is defined as subsurface enamel porosity from carious demineralisation on the smooth surfaces of the tooth. It appears as a milky white opacity. Lesions shown an apparently intact surface layer, followed underneath by the more porous lesion body. The small pores within the body of the lesion act as diffusion pathway for both acids and minerals, so allowing the demineralisation of enamel to occur at the advancing front of the lesion. Objectives: The objective is to mapthe porosity and its size on WSL with Focused Ion Bean- Scanning Electron Microscopy (FIB-SEM) Method: The basic method used for FIB-SEM consisted of depositing a one micron thick layer of platinum over 25μmx 25μm of the interest region of enamel. Then, making a rough cut (25μmx 5μmx 20μm) with 3nA current and 30Kv was applied with the help of drift suppression (DS), using a standard “cross-sectional” cutting pattern, which ended at the front of the deposited platinum layer. Two adjacent areas (25μmx 5μmx 20μm) on the both sides of the platinum layer were milled under the same conditions. Subsequent, cleaning cross-sections were applied to polish the sub-surface edge of interest running perpendicular to the surface. The "slice and view" was carried out overnight for milling almost 700 slices with 2Kv and 4nA and taking backscattered (BS) images. Then, images were imported into imageJ and analysed. Results: The prism structure is clearly apparent on FIB-SEM slices of WSL with the dissolution of prism boundaries as well as internal porosity within the prism itself. Porosity scales roughly 100-400nm, which is comparable to the light wavelength (500nm). Conclusion: FIB-SEM is useful to characterize the porosity of WSL and it clearly shows the difference between WSL and normal enamel.

Keywords: white spot lesion, FIB-SEM, enamel porosity, porosity

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Authors: Farshad Ghodoosi

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This article analyzes the effect of supervening events in contracts. Contracts serve an important function: allocation of risks. In spite of its importance, the case law and the doctrine are messy and inconsistent. This article provides a fresh look at excuse doctrines (i.e., force majeure, impracticability, impossibility, and frustration) with a focus on force majeure clauses. The article makes the following contributions: First, it furnishes a new conceptual and theoretical framework of excuse doctrines. By distilling the decisions, it shows that excuse doctrines rests on the triangle of control, foreseeability, and contract language. Second, it analyzes force majeure clauses used by S&P 500 companies to understand the stickiness and similarity of such clauses and the events they cover. Third, using computational and statistical tools, it analyzes US cases since 1810 in order to assess the weight given to the triangle of control, foreseeability, and contract language. It shows that the control factor plays an important role in force majeure analysis, while the contractual interpretation is the least important factor. The Article concludes that it is the standard for control -whether the supervening event is beyond the control of the party- that determines the outcome of cases in the force majeure context and not necessarily the contractual language. This article has important implications on COVID-19-related contractual cases. Unlike the prevailing narrative that it is the language of the force majeure clause that’s determinative, this article shows that the primarily focus of the inquiry will be on whether the effects of COVID-19 have been beyond the control of the promisee. Normatively, the Article suggests that the trifactor of control, foreseeability, and contractual language are not effective for allocation of legal risks in times of crises. It puts forward a novel approach to force majeure clauses whereby that the courts should instead focus on the degree to which parties have relied on (expected) performance, in particular during the time of crisis.

Keywords: contractual risks, force majeure clauses, foreseeability, control, contractual language, computational analysis

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Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

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The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

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Authors: Atma Sahu

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After 9/11, there will only be cyberwars. The cyberwars increase in intensity the country's cybersecurity workforce's hiring and retention issues. Currently, many organizations have unfilled cybersecurity positions, and to a lesser degree, their cybersecurity teams are understaffed. Therefore, there is a critical need to develop a new program to help meet the market demand for cybersecurity engineers (CYSE) and personnel. Coppin State University in the United States was responsible for developing a cybersecurity engineering BS degree program. The CYSE curriculum design methodology consisted of three parts. First, the ACM Cross-Cutting Concepts standard's pervasive framework helped curriculum designers and students explore connections among the core courses' knowledge areas and reinforce the security mindset conveyed in them. Second, the core course context was created to assist students in resolving security issues in authentic cyber situations involving cyber security systems in various aspects of industrial work while adhering to the NIST standards framework. The last part of the CYSE curriculum design aspect was the institutional student learning outcomes (SLOs) integrated and aligned in content courses, representing more detailed outcomes and emphasizing what learners can do over merely what they know. The CYSE program's core courses express competencies and learning outcomes using action verbs from Bloom's Revised Taxonomy. This aspect of the CYSE BS degree program's design is based on these three pillars: the ACM, NIST, and SLO standards, which all CYSE curriculum designers should know. This unique CYSE curriculum design methodology will address how students and the CYSE program will be assessed and evaluated. It is also critical that educators, program managers, and students understand the importance of staying current in this fast-paced CYSE field.

Keywords: cyber security, cybersecurity engineering, systems engineering, NIST standards, physical systems

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Authors: Som Pal Baliyan

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The purpose of this quantitative study was to analyze farm management skills in broiler poultryproducers in Botswana. The study adopted a descriptive and correlation research design. The population of the study was the poultry farm operators who had been in broiler poultry farming at least for two years. Based on the information from literature, a questionnaire was constructed for data collection on seven areas of farm management skills namely; planning skills, accounting and financial management skills, production management skills, product procurement and marketing skills, decision making skills, risk management skills, and specific technical skills. The validity and reliability of the questionnaire were accomplished by a panel of experts and by calculating the Cronbach’s alpha coefficient, respectively. Data were collected through a survey of 60 randomly sampled poultry farm operators in Botswana. Data were analyzed through descriptive statistical tools whereby the level of farm management skills were determined by calculating means and standard deviations of the management skills among the broiler producers. The level of farm management skills in broilers producers was discussed. All the seven farm management skills were ranked based on their calculated means. The specific technical skills and risk management skills were the highest and the lowest ranked farm management skills, respectively.Findings revealed that the broiler producers had skills above the average level only in specific technical skills whereas the skill levels in the remaining six farm management skills under study were found below the average level. This prevailing low level of farm management skills can be justified asthe cause of failure or poor performance of the broiler poultry farms in Botswana. Therefore, in order to improve the efficiency and productivityin broiler production in the country, it was recommended that the broiler poultry producers should be adequately trained in areas of planning skills, financial management skills, production management skills, product procurement and marketing skills, decision making skills and risk management skills.

Keywords: poultry production, broiler production, management skills, levels of skills

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: Bahareh Yazdanparast Chaharmahali

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The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

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Authors: Abdullahi Mannir Rawayau

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This paper identifies the problems that have aided the decoy to adequate basic infrastructural amenities, sub-standard housing, over-crowding, poor ventilation in homes and work places, sanitation, and non-compliance with building bye-laws and regulation. The paper also asserts the efficient disposal of solid and liquid waste is one of the challenges in the informal areas due to threats on the environment and public health. Sanitation services in the informal settlements have been found to be much lower compared to the average for unban. Bearing in mind a factor which prevents sustainable sanitation in informal areas which include low incomes, insecure tenure, low education levels, difficulty topography and transitory populations, and this study aim to identify effective strategies for achieving sustainable sanitation with specific reference to the informal settlement. Using the Shanghai Low-Cost as a case study. The primary data collected was through observation and interview method. Similarly, the secondary data used for the study was collected through literature reviews from extent studies with specific reference to informal settlement. A number of strategies towards achieving sustainable sanitation in the study were identified here in classified into three (3):- Advocacy and capacity building, infrastructural provision and institutionalization of systems and processes. The paper concludes with the premise on the need to build alliances between the government and stakeholders concerned with sanitation provision through the creation of sanitation and employ adaptable technology. Provision of sanitation facilities in public areas and to establish a statutory body for timely response to sanitation waste management in Katsina. It is imperative to check and prevent further decay for harmonious living and sustainable development.

Keywords: built environment, sanitation, facilities, settlement

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Authors: Suangsuda Subjaroen, Chutikarn Sriviboon, Rosjana Chandhasa

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This research aims to examine the graduates' overall satisfaction and influential factors that affect the image of Suan Sunandha Rajabhat University, according to the graduates' viewpoints on the graduation rehearsal day. In accordance with the graduates' perceptions, the study is related to the levels of graduates' satisfaction, their perceived quality, perceived value, and the image of Suan Sunandha Rajabhat University. The sample group in this study involved 1,129 graduates of Suan Sunandha Rajabhat University who attended on 2019 graduation rehearsal day. A questionnaire was used as an instrument in order to collect data. By the use of computing software, the statistics used for data analysis were various, ranging from frequencies, percentage, mean, and standard deviation, One-Way ANOVA, and Multiple Regression Analysis. The majority of participants were graduates with a bachelor's degree, followed by masters graduates and PhD graduates, respectively. Among the participants, most of them graduated from the Faculty of Management Sciences, followed by the Faculty of Humanities and Social Sciences and Faculty of Education, respectively. Overall, the graduates were satisfied with the graduation rehearsal day, and each aspect was rated at a satisfactory level. Formality, steps, and procedures were the aspects that graduates were most satisfied with, followed by graduation rehearsal personnel and staff, venue, and facilities. Referring to graduates' perceptions, the perceived quality was rated at a very good level, the perceived value was at a good level, whereas the image of Suan Sunandha Rajabhat University was perceived at a good level, respectively. There were differences in satisfaction levels among graduates with a bachelor's degree, graduates with a master's degree and a doctoral degree with statistical significance at the level of 0.05. There was a statistical significance at the level of 0.05 in perceived quality and perceived value affecting the image of Suan Sunandha Rajabhat University. The image of Suan Sunandha Rajabhat University influenced graduates' satisfaction level with statistical significance at the level of 0.01.

Keywords: university image, perceived quality, perceived value, intention to study higher education, intention to recommend the university to others

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Authors: Waraphorn Sribuakaew, Chutikarn Sriviboon, Rosjana Chandhasa

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The purpose of this research is to study the satisfaction level of graduates and factors that affect the image of Suan Sunandha Rajabhat University based on the perceptions of graduates on the graduation ceremony day. By studying the satisfaction of graduates, the image of Suan Sunandha Rajabhat University according to the graduates' perceptions and the loyalty to the university (in the aspects of intention to continue studying at a higher level, intention to recommend the university to a friend), the sample group used in this study was 1,000 graduates of Suan Sunandha Rajabhat University who participated on the 2019 graduation ceremony day. A questionnaire was utilized as a tool for data collection. By the use of computing software, the statistics used for data analysis were frequencies, percentage, mean, and standard deviation, One-Way ANOVA, and multiple regression analysis. Most of the respondents were graduates with a bachelor's degree, followed by graduates with a master's degree and PhD graduates, respectively. Major participants graduated from the Faculty of Management Sciences, followed by the Faculty of Humanities and Social Sciences and Faculty of Education, respectively. The graduates were satisfied on the ceremony day as a whole and rated each aspect at a satisfactory level. Formality, steps, and procedures were the aspects that graduates were most satisfied with, followed by graduation ceremony personnel and staff, venue, and facilities. On the perception of the graduates, the image of Suan Sunandha Rajabhat University was at a good level, while loyalty to the university was at a very high level. The intention of recommendation to others was at the highest level, followed by the intention to pursue further education at a very high level. The graduates graduating from different faculties have different levels of satisfaction on the graduation day with statistical significance at the level of 0.05. The image of Suan Sunandha Rajabhat University affected the satisfaction of graduates with statistical significance at the level of 0.01. The satisfactory level of graduates on the graduation ceremony day influenced the level of loyalty to the university with statistical significance at the level of 0.05.

Keywords: university image, loyalty to the university, intention to study higher education, intention to recommend the university to others, graduates' satisfaction

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Authors: Rafid Doulab

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Elemental Impurities in the Pharmaceuticals industryis are indispensable to ensure pharmaceuticalssafety for 24 elements. Although atomic absorption and inductively coupled plasma are used in the U.S Pharmacopeia and the European Pharmacopoeia, FESEM with energy dispersive spectrometers can be applied as an alternative analysis method for quantitative and qualitative results for a variety of elements without chemical pretreatment, unlike other techniques. This technique characterizes by shortest time, with more less contamination, no reagent consumption, and generation of minimal residue or waste, as well as sample preparations time limiting, with minimal analysis error. Simple dilution for powder or direct analysis for liquid, we analyzed the usefulness of EDS method in testing with field emission scanning electron microscopy (FESEM, SUPRA 55 Carl Zeiss Germany) with an X-ray energy dispersion (XFlash6l10 Bruker Germany). The samples analyzed directly without coating by applied 5µ of known concentrated diluted sample on carbon stub with accelerated voltage according to sample thickness, the result for this spot was in atomic percentage, and by Avogadro converted factor, the final result will be in microgram. Conclusion and recommendation: The conclusion of this study is application of FESEM-EDS in US pharmacopeia and ICH /Q3D guideline to reach a high-precision and accurate method in element impurities analysis of drugs or bulk materials to determine the permitted daily exposure PDE in liquid or solid specimens, and to obtain better results than other techniques, by the way it does not require complex methods or chemicals for digestion, which interfere with the final results with the possibility of to keep the sample at any time for re analysis. The recommendation is to use this technique in pharmacopeia as standard methods like inductively coupled plasma both ICP-AES, ICP-OES, and ICP-MS.

Keywords: pharmacopoeia, FESEM-EDS, element impurities, atomic concentration

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Authors: Muhammad Sohail Sajid, Mahvish Maqbool, Hafiz Muhammad Rizwan, Muhammad Saqib, Haroon Ahmad

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Ticks are blood-sucking ectoparasite that causes a decrease in production and economic losses and affects mammals, reptiles, and birds. Hyalomma anatolicum is the main vector for CCHF transmission and Pakistan has faced several outbreaks of CCHF in the recent past. Ferritin (fer)is a highly conserved molecule that is ubiquitous in most tick tissues and responsible for iron metabolism and storage. It was hypothesized that the development of acaricidal resistance and residual effects of commercially used acaricides could be controlled by using alternative control methods, including RNA interference. The current study aimed to evaluate the fer silencing effects on tick feeding, average body weight, egg mass index, and mortality. Ticks, collected through the standard collection protocols were further subjected to RNA isolation using the Trizol method. Commercially available kit procedures were followed for cDNA and dsRNA synthesis. The soaking/Immersion method was used for dsRNA delivery. Our findings have shown a 27% reduction in body weight of fer silenced group and showed a significant association of fer and body weight. Silencing of fer had a significant effect on the engorgement percentage (P= 0.0007), oviposition (P=0.008), egg mass (P= 0.004) and hatching (P= 0.001). The soaking method was used for dsRNA delivery and 15°C was found to be an optimum temperature for inducing gene silencing in ticks as at this temperature, maximum survivability after immersion was attained. This study along with previous studies, described that iron toxicity due to the silencing of fer could play an important role in the control of ticks and fer can be used as a potent candidate for vaccine development.

Keywords: ticks, iron, ferritin, engorgement, oviposition, immersion, RNA interference

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Authors: Chaebong Kim, Yongmin Cho, Minkyung Han, Mooyoung Kim, KooSang Kim

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Background: Air pollution from global warming has a considerable influence on respiratory disease and atopic dermatitis (AD). Present studies base on a hypothesis about correlation between air pollutant and AD, and the results are analyzed from various points of view. Objectives: This study aimed to integrate the relevant researches for air pollutant and AD, and to perform the systematic literature review and meta-analysis to provide the basis of air pollutant control. Methods: Research materials were collected from original articles published in English academic journals including medicine, nursing and health science from August 1 to 31, 2016. We collected the materials from Pubmed, Medline, Embase, Cochrane Central database with Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) based on the Cochrane Systematic Review Manual, and performed the evaluation and analysis for selected materials. We got the research results for risk of bias using Rev-Man ver. 5.2, and meta analyses using STATA. Results: The prevalence of infantile atopic dermatitis were 1.05 times higher than other groups who were exposed to air pollution, and exposure to NO2 (1.08, 95% CI: 1.02 – 1.14), O3 (1.09, 95% CI: 1.04 – 1.15), SO2 (1.07, 95% CI: 1.02 – 1.12) in subgroup air pollutant was considerably associated with infantile atopic dermatitis. The prevalence of infantile atopic dermatitis was 1.03 times higher than other groups who were exposed to PM2.5, but the results were not statistically similar. Conclusion: Health effect from environmental pollution risen people’s interest in environmental diseases. Air pollutant was associated with AD in this study, but selected literature was based on non-RCT (Randomized Controlled Trial) study. Therefore, there was a limit in study method including control, matching, and correction of confounding variables. For clear conclusion, it is necessary to develop the appropriate tool for object of study and clear standard to measure of air pollutant.

Keywords: air pollution, atopic dermatitis, children, meta-analysis

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Authors: F. A. Gberindyer, M. O.Abatan, A. B. Saba

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Background: Gentamicin is an aminoglycoside antibiotic used in the treatment of infections caused by Gram-negative aerobic bacteria organisms in human and animals. In Nigeria, there are arrays of multisource generic versions of injectable gentamicin sulphate in the drug markets. There is a high prevalence of counterfeit and substandard drugs in the third world countries with consequent effect on their therapeutic efficacy and safety. Aim: The aim of this study was to investigate pharmaceutical equivalence of some of these generics used in veterinary practice in Nigeria. Methodology: About 20 generics of injectable gentamicin sulphate were sampled randomly across Nigeria but 15 were analyzed for identity and potency. Identity test was done using Fourier transform infra red spectroscopy and the spectral for each product compared with that of the USP reference standard for similarity. Microbiological assay using agar diffusion method with E. coli as a test organism on nutrient agar was employed and the respective diameters of bacterial inhibition zones obtained after 24 hour incubation at 37°C. The percent potency for each product was thereafter calculated and compared with the official specification. Result And Discussion: None of the generics is produced in any African country. About 75 % of the products are imported from China whereas 60 % of the veterinary generics are manufactured in Holland. Absorption spectra for the reference and test samples were similar. Percent potencies of all test products were within the official specification of 95-115 %. Nigeria relies solely on imported injectable gentamicin sulphate products. All sampled generic versions passed both identity and potency tests. Clinicians should ensure that drugs are used rationally since the converse could be contributing to the therapeutic failures reported for most of these generics. Bioequivalence study is recommended to ascertain their interchangeability when parenteral extra venous routes are indicated.

Keywords: generics, gentamicin, identity, multisource, potency

Procedia PDF Downloads 428

Authors: J. O. Idoko, C. N. Michael, T. O. Fasuan

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This study investigated the effects of cooking time, seed-to-water ratio and soaking time on proximate and functional properties of African walnut seed using Box-Behnken design and Response Surface Methodology (BBD-RSM) with a view to increase its utilization in the food industry. African walnut seeds were sorted washed, soaked, cooked, dehulled, sliced, dried and milled. Proximate analysis and functional properties of the samples were evaluated using standard procedures. Data obtained were analyzed using descriptive and inferential statistics. Quadratic models were obtained to predict the proximate and functional qualities as a function of cooking time, seed-to-water ratio and soaking time. The results showed that the crude protein ranged between 11.80% and 23.50%, moisture content ranged between 1.00% and 4.66%, ash content ranged between 3.35% and 5.25%, crude fibre ranged from 0.10% to 7.25% and carbohydrate ranged from 1.22% to 29.35%. The functional properties showed that soluble protein ranged from 16.26% to 42.96%, viscosity ranged from 23.43 mPas to 57 mPas, emulsifying capacity ranged from 17.14% to 39.43% and water absorption capacity ranged from 232% to 297%. An increase in the volume of water used during cooking resulted in loss of water soluble protein through leaching, the length of soaking time and the moisture content of the dried product are inversely related, ash content is inversely related to the cooking time and amount of water used, extraction of fat is enhanced by increase in soaking time while increase in cooking and soaking times result into decrease in fibre content. The results obtained indicated that African walnut could be used in several food formulations as protein supplement and binder.

Keywords: African walnut, functional properties, proximate analysis, response surface methodology

Procedia PDF Downloads 396

Authors: Lung-Lung Hu

Abstract:

Ronald Dworkin offered a legal theory of ‘chain enterprise’ that all the judges in legal history altogether create a ‘law’ aiming a specific purpose. Those judges are like co-writers of a chain-story who not only create freely but also are constrained by the story made by the judges before them. The law created by Chinese traditional judges is another case, they, compared with the judges mentioned by Ronald Dworkin, have relatively narrower space of making a legal sentence according to their own discretions because the statutes in Chinese traditional law at the very beginning have been designed as panel code that leaves small room to judge’s discretion. Furthermore, because law is a representative of the authority of the government, i.e. the emperor, any misjudges and misuses deviated from the law will be considered as a challenge to the supreme power. However, different from judges as the defenders of law, Chinese litigation masters who want to win legal cases have to be offenders challenging the verdict that does not favor his or his client’s interest. Besides, litigation master as an illegal or non-authorized profession does not belong to any legal system, therefore, they are relatively freer to ‘create’ the law. According to Stanley Fish’s articles that question Ronald Dworkin and Owen Fiss’ ideas about law, he construes that, since law is made of language, law is open to interpretations that cannot be constrained by any rules or any particular legal purposes. Stanley Fish’s idea can also be applied on the analysis about the stories of Chinese litigation masters in traditional Chinese literature. These Chinese litigation masters’ legal opinions in the so-called chain enterprise are like an unexpected episode that tries to revise the fixed story told by law. Although they are not welcome to the officials and also to the society, their existence is still a phenomenon representing another version of justice different from the official’s and can be seen as a de-structural power to the government. Hence, in this present paper the language and strategy applied by Chinese litigation masters in Chinese legal stories will be analysed to see how they refute made legal judgments and challenge the official standard of justice.

Keywords: Chinese legal stories, interdisciplinary, litigation master, post-structuralism

Procedia PDF Downloads 387

Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

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Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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