Search results for: remote patient care

Authors: Ling-Lang Huang, Yih-Jer Wu

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Empathy is crucial for a patient-physician relationship and medical professionalism. Internet activity, gaming, or even addiction, have been more and more common among medical students. However, there’s been no report showing whether internet behavior has a substantial impact on empathy in medical students to our best knowledge. All year-2 medical students taking the optional course 'Narrative, Comprehension, and Communication' were enrolled. Internet behaviors are divided into two groups, 'internet users without online gaming (IU)' and 'internet users with online gaming (IG)', each group was further divided into 3 groups according to their average online retention time each day (< 2, 2 - 6, > 6 hours). Empathy was evaluated by the scores of the reports and humanities reflection after watching indicated movies, and by self-measured empathy questionnaire. All students taking the year-2 optional course 'Narrative, Comprehension, and Communication' were enrolled. As compared with students in the IU group, those in the IG group had significantly lower scores for the reports (81.3 ± 3.7 vs. 86.4 ± 5.1, P = 0.014). If further dividing the students into 5 groups (IU < 2, IU 2-6, IG < 2, IG 2 - 6, and IG > 6 hours), the scores were significantly and negatively correlated to online gaming with longer hours (r = -0.556, P = 0.006). However, there was no significant difference between IU and IG groups (33.0 ± 5.4 vs. 34.8 ± 3.2, P = n.s.), in terms of scores in the self-measured empathy questionnaire, neither was there any significant trend of scores along with longer online hours across the 5 groups (r = -0.164, P = n.s.). To date, there has been no evidence showing whether different internet behaviors (with or without online gaming) have distinct impacts on empathy. Although all of the medical students had a similarly good self-perception for empathy, our data suggested that online gaming did have a negative impact on their actual expression of empathy. Our observation has brought up an important issue for pondering: May IT- or gaming-assisted medical learning actually harm students’ empathy? In conclusion, this data suggests that long hours of online gaming harms expression of empathy, though all medics think themselves a person of high empathy.

Keywords: empathy. Internet, medical students, online gaming

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Authors: Adel A. Ghobbar, Ahmad Bakkar

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Although special care is given to maintenance, aircraft systems fail, and these failures cause delays and cancellations. The occurrence of Delays and Cancellations affects operators and manufacturers negatively. To reduce technical delays and cancellations, one should be able to determine the important systems causing them. The goal of this research is to find a method to define the most expensive delays and cancellations systems for Airline operators. A predictive model was introduced to forecast the failure and their impact after carrying out research that identifies relevant information to tackle the problems faced while answering the questions of this paper. Data were obtained from the manufacturers’ services reliability team database. Subsequently, delays and cancellations evaluation methods were identified. No cost estimation methods were used due to their complexity. The model was developed, and it takes into account the frequency of delays and cancellations and uses weighting factors to give an indication of the severity of their duration. The weighting factors are based on customer experience. The data Analysis approach has shown that delays and cancellations events are not seasonal and do not follow any specific trends. The use of weighting factor does have an influence on the shortlist over short periods (Monthly) but not the analyzed period of three years. Landing gear and the navigation system are among the top 3 factors causing delays and cancellations for all three aircraft types. The results did confirm that the cooperation between certain operators and manufacture reduce the impact of delays and cancellations.

Keywords: reliability, availability, delays & cancellations, aircraft maintenance

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Authors: Molly Pui Man Wong

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In this study, a blended and interactive e-learning Courseware that our team developed will be introduced, and our team’s experiences on how the e-learning Courseware and the flipped classroom benefit student learning in bioethics in the medical program will be shared. This study is a continuation of the previously established study, which provides a summary of the well-developed e-learning Courseware in a blended learning approach and an update on its efficiency and efficacy. First, a collection of animated videos capturing selected topics of bioethics and related ethical issues and dilemma will be introduced. Next, a selection of problem-based learning videos (“simulated doctor-patient role play”) with pop-up questions and discussions will be further discussed. Our recent findings demonstrated that these activities launched by the Courseware strongly engaged students in bioethics education and enhanced students’ critical thinking and creativity, which were consistent with the previous data in the preliminary studies. Moreover, the educational benefits of the online art exhibition, art jamming, and competition will be discussed, through which students could express bioethics through arts and enrich their learning in medical research in an interactive, fun, and entertaining way, strengthening their interests in bioethics. Furthermore, online survey questionnaires and focus group interviews were conducted. Consistent with the preliminary studies, our results indicated that implementing the e-learning Courseware with a flipped classroom in bioethics education enhanced both active learning and student engagement. In conclusion, our Courseware not only reinforces education in art, bioethics, and medicine but also benefits students in understanding and critical thinking in socio-ethical issues and serves as a valuable learning tool in bioethics teaching and learning.

Keywords: bioethics, courseware, e-learning, flipped classroom

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Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

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Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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Authors: Arvin Baes

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This study was conducted to assess the holistic needs of cancer patients in terms of physiological, psychological, social, and spiritual needs and to determine how they respond through coping. It was conducted from January-April 2018 from various hospitals in Laguna, with 20 respondents. It utilized a survey descriptive type of research, a checklist type of questionnaire, and purposive sampling in selecting the respondents. It was found out that in terms of physiological needs, fatigue is the most common symptoms they experienced. In terms of psychological, social, and spiritual needs, most of the patients experienced a significant concern. Meanwhile, in coping, religion dominates among the 14 strategies followed by Use of Emotional Support and Positive Reframing, and Substance Use obtained the lowest response. Most of the respondents were female, and its significant relationship in terms of Positive Reframing agrees significantly. In coping and civil status, Positive Reframing and Humor are significant among married respondents. In coping and stage of cancer, 'Positive Reframing' and 'Humor' are significant with the stage of cancer. In coping and treatment modalities, Active Coping, Use of Emotional Support, and Religion are significantly related to patients’ treatment modalities. There is also a significant relationship between Active Coping and Physiological Needs, Religion and Psychological Needs, and Self-blaming and Psychological, Social, and Spiritual Needs. Thus, it is concluded that holistic needs and coping are essential to each other to meet the wholeness of cancer patients. A formulated care intervention program would be beneficial among this group of patients.

Keywords: coping strategies, cancer, cancer patients, holistic needs

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Authors: Saba Fahham, Supak Ngamsom, Suchaya Damrongsri

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Objective: The objective is to determine the optimal threshold of Romexis software for the airway volume and minimum cross-section area (MCA) analysis using Image J as a gold standard. Materials and Methods: A total of ten cone-beam computed tomography (CBCT) images were collected. The airway volume and MCA of each patient were analyzed using the automatic airway segmentation function in the CBCT DICOM viewer (Romexis). Airway volume and MCA measurements were conducted on each CBCT sagittal view with fifteen different threshold values from the Romexis software, Ranging from 300 to 1000. Duplicate DICOM files, in axial view, were imported into Image J for concurrent airway volume and MCA analysis as the gold standard. The airway volume and MCA measured from Romexis and Image J were compared using a t-test with Bonferroni correction, and statistical significance was set at p<0.003. Results: Concerning airway volume, thresholds of 600 to 850 as well as 1000, exhibited results that were not significantly distinct from those obtained through Image J. Regarding MCA, employing thresholds from 400 to 850 within Romexis Viewer showed no variance from Image J. Notably, within the threshold range of 600 to 850, there were no statistically significant differences observed in both airway volume and MCA analyses, in comparison to Image J. Conclusion: This study demonstrated that the utilization of Planmeca Romexis Viewer 6.4.3.3 within threshold range of 600 to 850 yields airway volume and MCA measurements that exhibit no statistically significant variance in comparison to measurements obtained through Image J. This outcome holds implications for diagnosing upper airway obstructions and post-orthodontic surgical monitoring.

Keywords: airway analysis, airway segmentation, cone beam computed tomography, threshold

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Authors: Ranjith Menon, Abathar Aladi, Hans-Christean Nahser, Maneesh Bhojak, Sacha Nevin, Paul Eldridge

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Background: Spontaneous subarachnoid haemorrhage (SAH) accounts for approximately 5% of all strokes. Patients with spontaneous SAH (as shown by CT or lumbar puncture) undergo investigations to identify or exclude an underlying structural cause, typically cerebral aneurysm. However in 10 - 20% of cases, no structural cause is found. This includes more than one imaging modality (intracranial MRA, CTA, 4DCTA and/or DSA) and in some spinal MRI. Objective: To determine; 1) If an underlying structural or vascular cause can be identified in non-aneurysmal SAH patients by comparing different imaging modalities at presentation and at follow-up. 2) If MRI spine in patients with non-aneurysmal SAH reveals an underlying SAH cause. 3)The functional outcome at discharge. Results: We performed a retrospective analysis of all non-traumatic SAH patients admitted to the Walton centre from January 2009 to December 2015. There were 1457 patients with non-traumatic SAH admitted to the Walton centre of whom 21.8% (n=300) patients were diagnosed with non-aneurysmal SAH. Males were 65.6% and females were 43.3%. The presenting symptoms were sudden onset headache (93.6%), the focal neurological deficit (12%), loss of consciousness (10.6%) and others (6%). About 285 patients received 2 modalities of imaging (CTA & DSA), 192 received 3 modalities of imaging (CTA, MRA & DSA) and 137 received MRI spine (51/137 whole spine). The modified Rankin Score at discharge were: mRS 0 = 292 (97.33%), mRS 1-2 = 6, mRS 6 = 1 (cardiac arrest in IHD patient) and unknown in 1. Follow-up imaging at 3 to 6 months in 190 (63.3%) patients did not identify an underlying cause. Conclusion: This retrospective analysis concludes that non-aneurysmal SAH has a good functional outcome. A single imaging modality (CTA (4DCTA) or MRA or DSA) was adequate to exclude an underlying cause of SAH and a delayed imaging failed to identify a cause. Routinely performing MRI spine in this group of patients appears not to be necessary according to this evidence.

Keywords: stroke, non-aneurysmal subarachnoid haemorrhage, neuroimaging, modified rankin score

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Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

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Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

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Authors: Ranitha Guna Selvi D, Ramakrishnan R, Mohideen Abdul Kader

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Purpose: To study the role of Vision centers in managing preventable blindness through refractive error correction in Rural South India. Methods: A retrospective analysis of patients attending 15 Vision centers in Rural South India from a period of January 2021 to December 2021 was done. Medical records of 10,85,81 patients both new and reviewed, 79,562 newly registered patients and 29,019 review patient’s from15 Vision centers were included for data analysis. All the patients registered at the vision center underwent basic eye examination, including visual acuity, IOP measurement, Slit-lamp examination, retinoscopy, Fundus examination etc. Results: A total of 1,08,581 patients were included in the study. Of the total 1,08,581 patients, 79,562 were newly registered patients at Vision center and 29,019 were review patients. Males were 52,201(48.1%) and Females were 56,308(51.9) among them. The mean age of all examined patients was 41.03 ± 20.9 years (Standard deviation) and ranged from 01 – 113 years. Presenting mean visual acuity was 0.31 ± 0.5 in the right eye and 0.31 ± 0.4 in the left eye. Of the 1,08,581 patients 22,770 patients had refractive error in right eye and 22,721 patients had uncorrected refractive error in left eye. Glass prescription was given to 17,178 (15.8%) patients. 8,109 (7.5%) patients were referred to the base hospital for specialty clinic expert opinion or for cataract surgery. Conclusion: Vision center utilizing teleconsultation for comprehensive eye screening unit is a very effective tool in reducing the avoidable visual impairment caused due to uncorrected refractive error. Vision Centre model is believed to be efficient as it facilitates early detection and management of uncorrected refractive errors.

Keywords: refractive error, uncorrected refractive error, vision center, vision technician, teleconsultation

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Authors: Meshal M. Abdullah, Rusty A. Feagin, Layla Musawi

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When humans mismanage arid landscapes, soil erosion can become a primary mechanism that leads to desertification. This study focuses on applying soil erosion models to a disturbed landscape in Umm Nigga, Kuwait, and identifying its predicted change under restoration plans, The northern portion of Umm Nigga, containing both coastal and desert ecosystems, falls within the boundaries of the Demilitarized Zone (DMZ) adjacent to Iraq, and has been fenced off to restrict public access since 1994. The central objective of this project was to utilize GIS and remote sensing to compare the MPSIAC (Modified Pacific South West Inter Agency Committee), EMP (Erosion Potential Method), and USLE (Universal Soil Loss Equation) soil erosion models and determine their applicability for arid regions such as Kuwait. Spatial analysis was used to develop the necessary datasets for factors such as soil characteristics, vegetation cover, runoff, climate, and topography. Results showed that the MPSIAC and EMP models produced a similar spatial distribution of erosion, though the MPSIAC had more variability. For the MPSIAC model, approximately 45% of the land surface ranged from moderate to high soil loss, while 35% ranged from moderate to high for the EMP model. The USLE model had contrasting results and a different spatial distribution of the soil loss, with 25% of area ranging from moderate to high erosion, and 75% ranging from low to very low. We concluded that MPSIAC and EMP were the most suitable models for arid regions in general, with the MPSIAC model best. We then applied the MPSIAC model to identify the amount of soil loss between coastal and desert areas, and fenced and unfenced sites. In the desert area, soil loss was different between fenced and unfenced sites. In these desert fenced sites, 88% of the surface was covered with vegetation and soil loss was very low, while at the desert unfenced sites it was 3% and correspondingly higher. In the coastal areas, the amount of soil loss was nearly similar between fenced and unfenced sites. These results implied that vegetation cover played an important role in reducing soil erosion, and that fencing is much more important in the desert ecosystems to protect against overgrazing. When applying the MPSIAC model predictively, we found that vegetation cover could be increased from 3% to 37% in unfenced areas, and soil erosion could then decrease by 39%. We conclude that the MPSIAC model is best to predict soil erosion for arid regions such as Kuwait.

Keywords: soil erosion, GIS, modified pacific South west inter agency committee model (MPSIAC), erosion potential method (EMP), Universal soil loss equation (USLE)

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Authors: Alexander Rincón Ruiz

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This article is based on an exhaustive review and interdisciplinary effort spanning three years. It involved interviews, dialogues, discussion panels, and collective work on various visions of bio-economy in Colombia. The dialogue included government institutions, universities, local communities, activist groups, research institutes, the productive sector, and politicians, integrating perspectives such as Latin American environmental thought, complexity theory, modern visions, local worldviews (Afro-Colombian, indigenous, peasant), decoloniality, political ecology, ecological economics, and environmental economies. This work highlighted the need to redefine the traditional bio-economy concept, typically focused on markets and biotechnology, and to revisit the original idea of a bio-economy as an ‘economy for life’. In a country as diverse as Colombia—both biophysically and in its varied relationships with the territory—this redefinition is crucial. It emphasizes alternative logics of well-being related to resilience, care, and cooperation, reflecting Indigenous, Afro-Colombian, and peasant worldviews. This article is significant for proposing, for the first time, a viable approach to diverse and alternative economies for life tailored to the Colombian context. It represents not only academic work but also a political commitment to inclusion and plurality, aligning with the Colombian context and potentially extendable to other regions.

Keywords: ecological economics, decoloniality, complexity, Biodiversity

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Authors: Georgitta Joseph Valiyamattam

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Autism spectrum disorders (ASD) are a growing phenomenon in India with over 10 million cases being recorded. Children with various levels and forms of ASD can be a major challenge both within the context of regular or special schooling. According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD) against a ratio of one in 110 few years back. The growing number of children with autism spectrum disorders places greater demands on health services and necessitates the roping in of non-traditional modes of treatment to complement or even substitute traditional health care methods when possible. Research evidence, particularly from Western countries, as also some parts of Asia, suggests that animal-assisted therapy, or zootherapy, may be used as an effective individual or complementary therapeutic tool for increasing overall wellbeing and quality of life among children with Autism spectrum disorders. The paper through a case-study format seeks to evaluate the efficacy (initial stage) of animal assisted therapy (canine-therapy with visiting dog: breed-Golden retriever), as a non-conventional treatment modality for improving cognitive functioning and managing the behavioral and psychological symptoms of Autism Spectrum Disorders. As a pilot study forming the basis for subsequent larger application of AAT, it analyses areas of efficacy as also the challenges faced, both with regard to the mode of therapy, as also particular to the Indian setting.

Keywords: animal assisted therapy, autism, canine therapy, analyzing initial efficacy

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Authors: Rati Sandeep Choudhari

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Mobility flows are considered one of the most important elements of urbanisation, with transport infrastructure serving as a backbone of urban fabrics. Although rapid urbanisation and changing land use patterns have led to an increase in urban mobility levels around the globe, mobility, in general, has become an unpleasant experience for city dwellers, making locations around the city inconvenient to access. With public transport featured in almost every sustainable mobility plan in developing countries, the intermodality and integration with appropriate non–motorised transport infrastructure is often neglected. As a result, people choose to use private cars and two-wheelers to travel, rendering public transit systems underutilised, and encroaching onto pedestrian space on streets, thus making urban mobility unsafe and inconvenient for a major section of society. On the other hand, cities in the West, especially in Europe, depend heavily on inter–modal transit systems, allowing people to shift between metros, buses, trams, walking, and cycling to access even the remote locations of the city. Keeping accessibility as the focal point while designing urban mobility plans and policies, these cities have appropriately refined their urban form, optimised urban densities, developed a multimodal transit system, and adopted place-making strategies to foster a sense of place, thus, improving the quality of urban mobility experience in cities. Using a qualitative research approach, the research looks in detail into the existing literature on what kind of strategies can be applied to improve the urban mobility experience for city dwellers. It further studies and draws out a comparative analysis of cities in both developed and developing parts of the world where these strategies have been used to create people-centric mobility systems, fostering a sense of place with respect to urban mobility and how these strategies affected their social, economic, and environmental dynamics. The examples reflect on how different strategies like redefining land use patterns to form close knit neighbourhoods, development of non – motorise transit systems, and their integration with public transport infrastructure and place-making approach has helped in enhancing the quality and experience of mobility infrastructure in cities. The research finally concludes by laying out strategies that can be adopted by cities of the Global South to develop future mobility systems in a people-centric and sustainable way.

Keywords: urban mobility, sustainable transport, strategic planning, people-centric approach

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Authors: Manaphol Kulpraneet, Anirut Limtrakul, Surangrat Srisurapanon, Piyatida Tangteerawatana

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Tuberculosis (TB) remains a global health care disease world-wide. Control of the global TB epidemic has been impaired by the lack of an effective vaccine, by the emergence of drug resistant forms of Mycobacterium tuberculosis and by lack of sensitive and rapid diagnostics. Cytokines play a major role in defense against M. tuberculosis infection. Polymorphisms in the genes encoding various cytokines have been associated with tuberculosis susceptibility. Polymorphisms of the regulatory cytokine gene, the interleukin (IL)-10 is associated with the risk of tuberculosis (TB) in different populations. However, IL-10 gene polymorphism and susceptibility to TB in Thai is still unknown. The purpose of this study was to evaluate whether the common IL-10 promoter gene polymorphisms are associated with TB in Thai population. Forty eight patients with newly diagnosed pulmonary tuberculosis were studied. DNA samples were extracted from leukocytes and used to investigate -1087A/G, -819C/T, -252C/A (rs1800896, rs1800871, rs1800872) in IL-10 gene using restriction fragment length polymorphism (PCR-RFLP) methods. In this study, the genotype and allele frequencies of IL-10-1087A/G, -819C/T, -252C/A polymorphism did not significantly different between TB patients and healthy controls ((genotype: p=0.38, p=0.92, p=1; allele: p=0.57, p=0.77, p=0.89, respectively). The lack of association between common IL-10 promoter polymorphisms and TB susceptibility in this study may provide clue for better understanding of IL-10-1087A/G, -819C/T, -252C/A polymorphism and TB susceptibility in Thai population, which might facilitate the rationale design of vaccines. However, further studies in large scales population are required for confirmation.

Keywords: IL-10, cytokines, single nucleotide polymorphism (SNP), tuberculosis

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: Arundhuti Devi, Gitumani Devi, Krishna G. Bhattacharyya

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The goal of this study was to assess the characteristics of the airborne dust created by opencast coal mining and its relation to population hospitalization risk for skin and lung diseases in Margherita Coalfield, Assam, India. Air samples were collected for 24 h in three 8-h periods. For the collection of particulate matter (PM10) and total suspended particulate matter (SPM) samples, respiratory dust samplers with glass microfiber filter papers were used. PM10 was analyzed for Cu, Cd, Cr, Mn, Zn, Ni, Fe and Pb with Flame Atomic Absorption Spectrophotometer (FAAS). SPM and PM10 concentrations were respectively found to be as high as 1,035 and 265.85 μg/m³ in work zone air. The concentration of metals associated with PM10 showed values higher than the permissible limits. It was observed that the average concentrations of the metals Fe, Pb, Ni, Zn, and Cu were very high during the winter month of December, those of Cd and Cr were high during the month of May and Mn was high during February. The morphology of the particles studied with scanning electron microscopy (SEM) gave significant results. Due to opencast coal mining, the air in the work zone, as well as the general ambient air, was found to be highly polluted with respect to dust. More than 8000 patient records maintained by the hospital authority were collected from three hospitals in the area. The highest percentage of people suffering from lung diseases are found in Margherita Civil Hospital (~26.77%) whereas most people suffering from skin diseases reported for treatment in the ESIC hospital (47.47%). Both PM10 and SPM were alarmingly high, and the results were in conformity with the high incidence of lung and other respiratory diseases in the study area.

Keywords: heavy metals, open cast coal mining, PM10, respiratory diseases

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Authors: Mónica Catarina Soares

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Neoliberal rationality is currently changing the ways concepts like freedom or equality are framed. As an omnipresent and context-sensitive paradigm, homo oeconomicus is continuously taking place in realms of life previously insulated from economic and market-driven principles. This presentation is based on the argument that, more than ever, this paradigm is nowadays framing institutional and everyday discourses in regard to social problems. Although neoliberal rationality is based on the putative ideological basis that everyone is equal, equality seems to be reshaped by specific meanings apprehended by this rationality. In this sense, an illusion of equality seems to be relevant to legitimize different social inequalities (e.g., access to health care or to habitation). Political psychology has studied how ideology is relevant to legitimize market and unequal systems, but still the specific relation between markets, (in)equality and neoliberal languages is not widely addressed. The goal is to discuss the smithereens of the neoliberal rationality when it comes to legitimizing social inequalities by contesting the arguments of meritocracy, progressive freedom and minimal guarantees obeying to market-rules and principles. This analysis can be helpful to grasp for instance the continuously dismantlement of the welfare-state in different countries of the global north and how it is turning the regulation/emancipation tension inside out. The ultimate goal is to contribute to the breaking up of a paradigm that is still too big to capture, too depoliticized and chameleonic to fully acknowledge the biopolitics of power that is helping to create it.

Keywords: discourses, legitimacy, neoliberal rationality, social inequality

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Authors: Jyoti Pandey, Rajiv Kumar Bhatt

Abstract:

In the absence of proper sanitation, people suffered from high levels of infectious diseases leading to high incidences of morbidity and mortality. This directly affected the ability of a country to maintain an efficient economy and implied great personal suffering among infected individuals and their families. This paper aims to estimate the catastrophic expenditure of households in terms of direct and indirect losses which a person has to face due to the illness of WASH diseases; the severity of the scenario is answered by finding out the impoverishment effect. We used the primary data survey for the objective outlined. Descriptive and analytical research types are used. The survey is done with the questionnaire formulated precisely, taking care of the inclusion of all the variables and probable outcomes. A total of 300 households is covered under this study. In order to pursue the objectives outlined, multistage random sampling of households is used. In this study, the cost of illness approach is followed for accessing economic impact. The study brought out the attention that a significant portion of the total consumption expenditure is going lost for the treatment of water and sanitation related diseases. The infectious and water vector-borne disease can be checked by providing sufficient required sanitation facility, and that 2.02% loss in income can be gained if the mechanisms of the pathogen is checked.

Keywords: water, sanitation, impoverishment, catastrophic expenditure

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Authors: Shu-Pin Huang, Pai-Chi Teng, Hao-Han Chang, Chia-Hsin Liu, Yung-Lun Lin, Shu-Chi Wang, Hsin-Chih Yeh, Chih-Pin Chuu, Jiun-Hung Geng, Li-Hsin Chang, Wei-Chung Cheng, Chia-Yang Li

Abstract:

The emergence of immune checkpoint inhibitors (ICIs) targeting proteins like PD-1 and PD-L1 has changed the treatment paradigm of bladder cancer. However, not all patients benefit from ICIs, with some experiencing early death. There's a significant need for biomarkers associated with the PD-1 pathway in bladder cancer. Current biomarkers focus on tumor PD-L1 expression, but a more comprehensive understanding of PD-1-related biology is needed. Our study has developed a seven-gene risk score panel, employing a comprehensive bioinformatics strategy, which could serve as a potential prognostic and predictive biomarker for bladder cancer. This panel incorporates the FYN, GRAP2, TRIB3, MAP3K8, AKT3, CD274, and CD80 genes. Additionally, we examined the relationship between this panel and immune cell function, utilizing validated tools such as ESTIMATE, TIDE, and CIBERSORT. Our seven-genes panel has been found to be significantly associated with bladder cancer survival in two independent cohorts. The panel was also significantly correlated with tumor infiltration lymphocytes, immune scores, and tumor purity. These factors have been previously reported to have clinical implications on ICIs. The findings suggest the potential of a PD-1 pathway-based transcriptomic panel as a prognostic and predictive biomarker in bladder cancer, which could help optimize treatment strategies and improve patient outcomes.

Keywords: bladder cancer, programmed cell death protein 1, prognostic biomarker, immune checkpoint inhibitors, predictive biomarker

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Authors: Oyekan Kolawole Jamiu

Abstract:

The right to life is a moral principle based on the belief that a human being has the right to life and, in particular, should not be unjustly killed by another human being. However, the most worrisome security challenge in Nigeria which has cut short the lives of innocent Nigerians is the activities of the dreaded terrorist group known as Boko Haram (which means Western Education is a sin). Between 2004 till date, over 15000 people have been gruesomely murdered by this terrorist group. However, despite the facts that suspected terrorists are arrested and paraded almost on a daily basis, cases of terrorism in our courts in Nigeria today have not been expeditiously dealt with by the judiciary. This paper examines the concept of right to life. The right to life is an inherent right for each and every person. From his or her birth; the individual is considered a living being that must be protected. The right to life connotes also right to live and grow in a healthy environment where there is appropriate health care, qualitative education and adequate security of lives and property. The paper also examines the fight against terrorism and the duty of the government to protect right to life of every individual even in the midst of the fight against terrorism. The paper further reviews the Terrorism Act 2011(as amended) and the clogs in the wheel of prosecution of suspected terrorists. The paper concludes that since terrorism is a new security challenge, to prevent conflict of interest, only one security agency should be trained and saddled with the responsibility of prosecuting suspected terrorist, Law should be enacted to compel intelligent gathering and sharing of information among security agencies and in addition, a special court should be established to deal expeditiously with cases of terrorism in Nigeria.

Keywords: terrorism, intelligent gathering, right to life, prosecution

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Authors: Andrea Giacomelli, Luciano Massetti, Elena Maggi, Antonio Raschi

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The presentation will report the activities managed during the Summer of 2017 by a team composed by staff from a University Department, a National Research Council Institute, and an outreach NGO, collecting measurements of night sky brightness and other information on artificial lighting, in order to characterize light pollution issues on portions of the Tuscan coast, in Central Italy. These activities combine measurements collected by the principal scientists, citizen science observations led by students, and outreach events targeting a broad audience. This campaign aggregates the efforts of three actors: the BuioMetria Partecipativa project, which started collecting light pollution data on a national scale in 2008 with an environmental engineering and free/open source GIS core team; the Institute of Biometeorology from the National Research Council, with ongoing studies on light and urban vegetation and a consolidated track record in environmental education and citizen science; the Department of Biology from the University of Pisa, which started experiments to assess the impact of light pollution in coastal environments in 2015. While the core of the activities concerns in situ data, the campaign will account also for remote sensing data, thus considering heterogeneous data sources. The aim of the campaign is twofold: (1) To test actions of citizen and student engagement in monitoring sky brightness (2) To collect night sky brightness data and test a protocol for applications to studies on the ecological impact of light pollution, with a special focus on marine coastal ecosystems. The collaboration of an interdisciplinary team in the study of artificial lighting issues is not a common case in Italy, and the possibility of undertaking the campaign in Tuscany has the added value of operating in one of the territories where it is possible to observe both sites with extremely high lighting levels, and areas with extremely low light pollution, especially in the Southern part of the region. Combining environmental monitoring and communication actions in the context of the campaign, this effort will contribute to the promotion of night skies with a good quality as an important asset for the sustainability of coastal ecosystems, as well as to increase citizen awareness through star gazing, night photography and actively participating in field campaign measurements.

Keywords: citizen science, light pollution, marine coastal biodiversity, environmental education

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Authors: Deniz Yurtoğlu

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Aerosols directly affect the radiative balance of the earth by absorbing and/or scattering the sun rays reaching the atmosphere and indirectly affect the balance by acting as a nucleus in cloud formation. The composition, physical, and chemical properties of aerosols vary depending on their sources and the time spent in the atmosphere. The Eastern Mediterranean Basin has a high aerosol load that is formed from different sources; such as anthropogenic activities, desert dust outbreaks, and the spray of sea salt; and the area is subjected to atmospheric transport from other locations on the earth. This region, which includes the deserts of Africa, the Middle East, and the Mediterranean sea, is one of the most affected areas by climate change due to its location and the chemistry of the atmosphere. This study aims to investigate the spatiotemporal deviation of aerosol load in the Eastern Mediterranean Basin between the years 2018-2022 with the help of a new pioneer satellite of ESA (European Space Agency), Sentinel-5P. The TROPOMI (The TROPOspheric Monitoring Instrument) traveling on this low-Earth orbiting satellite is a UV (Ultraviolet)-sensing spectrometer with a resolution of 5.5 km x 3.5 km, which can make measurements even in a cloud-covered atmosphere. By using Absorbing Aerosol Index data produced by this spectrometer and special scripts written in Python language that transforms this data into images, it was seen that the majority of the aerosol load in the Eastern Mediterranean Basin is sourced from desert dust and anthropogenic activities. After retrieving the daily data, which was separated from the NaN values, seasonal analyses match with the normal aerosol variations expected, which are high in warm seasons and lower in cold seasons. Monthly analyses showed that in four years, there was an increase in the amount of Absorbing Aerosol Index in spring and winter by 92.27% (2019-2021) and 39.81% (2019-2022), respectively. On the other hand, in the summer and autumn seasons, a decrease has been observed by 20.99% (2018-2021) and 0.94% (2018-2021), respectively. The overall variation of the mean absorbing aerosol index from TROPOMI between April 2018 to April 2022 reflects a decrease of 115.87% by annual mean from 0.228 to -0.036. However, when the data is analyzed by the annual mean values of the years which have the data from January to December, meaning from 2019 to 2021, there was an increase of 57.82% increase (0.108-0.171). This result can be interpreted as the effect of climate change on the aerosol load and also, more specifically, the effect of forest fires that happened in the summer months of 2021.

Keywords: aerosols, eastern mediterranean basin, sentinel-5p, tropomi, aerosol index, remote sensing

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Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: adverse reactions, contrast media, computed tomography, iodinated contrast agents

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Authors: S. Abera, T. Gidey, W. Terefe

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Introduction: Testing for HIV is the key entry point to HIV prevention, treatment, and care and support services. Hence, predictive data mining techniques can greatly benefit to analyze and discover new patterns from huge datasets like that of EDHS 2011 data. Objectives: The objective of this study is to build a predictive modeling for HIV testing and identify determinants of HIV testing for adults with age above fourteen years using data mining techniques. Methods: Cross-Industry Standard Process for Data Mining (CRISP-DM) was used to predict the model for HIV testing and explore association rules between HIV testing and the selected attributes among adult Ethiopians. Decision tree, Naïve-Bayes, logistic regression and artificial neural networks of data mining techniques were used to build the predictive models. Results: The target dataset contained 30,625 study participants; of which 16, 515 (53.9%) were women. Nearly two-fifth; 17,719 (58%), have never been tested for HIV while the rest 12,906 (42%) had been tested. Ethiopians with higher wealth index, higher educational level, belonging 20 to 29 years old, having no stigmatizing attitude towards HIV positive person, urban residents, having HIV related knowledge, information about family planning on mass media and knowing a place where to get testing for HIV showed an increased patterns with respect to HIV testing. Conclusion and Recommendation: Public health interventions should consider the identified determinants to promote people to get testing for HIV.

Keywords: data mining, HIV, testing, ethiopia

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Authors: Ganratchakan Ninlawan, Witthaya Mekhum

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The objective of this research was to investigate motivation needs in working of the employees in Rayong Province at Panakom Co., Ltd. The sample group included 59 operational employees of Panakom Co., Ltd divided into 2 main parts to complete the questionnaires. Part 1 dealt with personal information of the staff in the form of checklist questions. Part 2 was about the motivation needs in working in the form of 5 rating scales. The data were analyzed to find frequency, percentage, arithmetic mean, and SD with the results as follows. They reported their working conditions in the moderate level while the first aspect was on the regulation of the Working Support Department. The second rated aspect was on the modern facilities and office stationeries followed by the working environment such as lighting, temperature, sound system, and atmosphere. The last aspect was on the provision of enough working equipment. On the part of work stability and work progress, they rated this aspect at the moderate level with the details below. The first aspect was their satisfaction in work rotation followed by the encouragement in joining training and seminar to increase working knowledge. The third aspect was their perception on the progress of their careers. The last aspect was on the chance to get promoted in special cases. On the payment and fringe benefit, they rated this part in the moderate level with the highest aspect being on the provided fringe benefit such as health care. The second aspect was on the suitable salary compared to their knowledge and proficiency. The third aspect was on the satisfaction on the activities and seminars provided by the company. Finally, the last aspect was on the sufficient salary when compared with the current cost of living.

Keywords: motivation needs, working, employees, Rayong Province

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Authors: Meltem Koray, Arda Ozgon, Duygu Ofluoglu, Mehmet Yaltirik

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Oral ulcerations can be seen as a side effect of different drugs. These ulcers usually appear within a few weeks following drug treatment. In most of cases, these ulcers resist to conventional treatments, such as anesthetics, antiseptics, anti-inflammatory agents, cauterization, topical tetracycline and corticosteroid treatment. The diagnosis is usually difficult, especially in patients receiving multiple drug therapies. Hyaluronan or hyaluronic acid (HA) is a biomaterial that has been introduced as an alternative approach to enhance wound healing and also used for oral ulcer treatment. The aim of this report is to present the treatment of drug-induced oral ulceration on maxillary mucosa with HA gel. 60-year-old male patient was referred to Department of Oral and Maxillofacial Surgery complaining of oral ulcerations during few weeks. He had received chemotherapy and radiotherapy in 2014 with the diagnosis of nasopharyngeal carcinoma, and he has accompanying systemic diseases such as; cardiological, neurological diseases and gout. He is medicated with Escitalopram (Cipralex® 20mg), Quetiapine (Seroquel® 100mg), Mirtazapine (Zestat® 15mg), Acetylsalicylic acid (Coraspin® 100mg), Ramipril-hydrochlorothiazide (Delix® 2.5mg), Theophylline anhydrous (Teokap Sr® 200mg), Colchicine (Colchicum Dispert® 0.5mg), Spironolactone (Aldactone® 100mg), Levothyroxine sodium (Levotiron® 50mg). He had painful oral ulceration on the right side of maxillary mucosa. The diagnosis was 'drug-induced oral ulceration' and HA oral gel (Aftamed® Oral gel) was prescribed 3 times a day for 2 weeks. Complete healing was achieved within 3 weeks without any side effect and discomfort. We suggest that HA oral gel is a potentially useful local drug which can be an alternative for management of drug-induced oral ulcerations.

Keywords: drug-induced, hyaluronic acid, oral ulceration, maxillary mucosa

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Authors: Hadas Sopher, Davide Schaumann, Yehuda E. Kalay

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This paper addresses the shortcomings of architectural computation tools in representing human behavior in built environments, prior to construction and occupancy of those environments. Evaluating whether a design fits the needs of its future users is currently done solely post construction, or is based on the knowledge and intuition of the designer. This issue is of high importance when designing complex buildings such as hospitals, where the quality of treatment as well as patient and staff satisfaction are of major concern. Existing computational pre-occupancy human behavior evaluation methods are geared mainly to test ergonomic issues, such as wheelchair accessibility, emergency egress, etc. As such, they rely on Agent Based Modeling (ABM) techniques, which emphasize the individual user. Yet we know that most human activities are social, and involve a number of actors working together, which ABM methods cannot handle. Therefore, we present an event-based model that manages the interaction between multiple Actors, Spaces, and Activities, to describe dynamically how people use spaces. This approach requires expanding the computational representation of Actors beyond their physical description, to include psychological, social, cultural, and other parameters. The model presented in this paper includes cognitive abilities and rules that describe the response of actors to their physical and social surroundings, based on the actors’ internal status. The model has been applied in a simulation of hospital wards, and showed adaptability to a wide variety of situated behaviors and interactions.

Keywords: agent based modeling, architectural design evaluation, event modeling, human behavior simulation, spatial cognition

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Authors: Bencherif Kada

Abstract:

In the forest management practice, landscape and Mediterranean forest are never posed as linked objects. But sustainable forestry requires the valorization of the forest landscape, and this aim involves assessing the spatial distribution of biodiversity by mapping forest landscaped units and subunits and by monitoring the environmental trends. This contribution aims to highlight, through object-oriented classifications, the landscaped biodiversity of the National Park of Tlemcen (Algeria). The methodology used is based on ground data and on the basic processing units of object-oriented classification, that are segments, so-called image-objects, representing a relatively homogenous units on the ground. The classification of Landsat Enhanced Thematic Mapper plus (ETM+) imagery is performed on image objects and not on pixels. Advantages of object-oriented classification are to make full use of meaningful statistic and texture calculation, uncorrelated shape information (e.g., length-to-width ratio, direction, and area of an object, etc.), and topological features (neighbor, super-object, etc.), and the close relation between real-world objects and image objects. The results show that per object classification using the k-nearest neighbor’s method is more efficient than per pixel one. It permits to simplify of the content of the image while preserving spectrally and spatially homogeneous types of land covers such as Aleppo pine stands, cork oak groves, mixed groves of cork oak, holm oak, and zen oak, mixed groves of holm oak and thuja, water plan, dense and open shrub-lands of oaks, vegetable crops or orchard, herbaceous plants, and bare soils. Texture attributes seem to provide no useful information, while spatial attributes of shape and compactness seem to be performant for all the dominant features, such as pure stands of Aleppo pine and/or cork oak and bare soils. Landscaped sub-units are individualized while conserving the spatial information. Continuously dominant dense stands over a large area were formed into a single class, such as dense, fragmented stands with clear stands. Low shrublands formations and high wooded shrublands are well individualized but with some confusion with enclaves for the former. Overall, a visual evaluation of the classification shows that the classification reflects the actual spatial state of the study area at the landscape level.

Keywords: forest, oaks, remote sensing, diversity, shrublands

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