Search results for: clinical and patient outcomes

Authors: Abiodun Ezekiel Adesina, Alice M. Olagunju

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This study determined the effects of Computer Assisted Instructions (CAI) and Academic Self-Concepts (ASC) on pre-service teachers’ achievement in AE concepts in CoE in Southwest, Nigeria. The study adopted pretest-posttest, control group, quasi-experimental design. Six CoE with e-library facilities were purposively selected. Two hundred and thirty-two intact 200 level Agricultural education students offering introduction to AE course across the six CoE were participants. The participants were assigned to three groups (D&PM, 77, TM, 73 and control, 82). Treatment lasted eight weeks. The AE achievement test (r=0.76), pre-service teachers’ ASC Scale (r=0.81); instructional guides for tutorial (r=0.76), drill and practice (r=0.81) and conventional lecture modes (r=0.83), and teacher performance assessment sheet were used for data collection. Data were analysed using analysis of covariance and Scheffe post-hoc at 0.05 level of significance. The participants were 55.6% female with mean age of 20.8 years. Treatment had significant main effects on pre-service teachers’ achievement (F(2,207)=60.52; η²=0.21; p < 0.05). Participants in D&PM (x̄ =27.83) had the best achievement compared to those in TM (x̄ =25.41) and control (x̄ =18.64) groups. ASC had significant main effect on pre-service teachers’ achievement (F(1,207)=22.011; η²=0.166; p < 0.05). Participants with high ASC (x̄ =27.52) had better achievement compared to those with low ASC (x̄ =22.37). The drill and practice and tutorial instructional modes enhanced students’ achievement in Agricultural Economics concepts. Therefore, the two instructional modes should be adopted for improved learning outcomes in agricultural economics concepts among pre-service teachers.

Keywords: achievement in agricultural economics concepts, colleges of education in southwestern Nigeria, computer-assisted instruction, drill and practice instructional mode, tutorial instructional mode

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Authors: Gadiri Sabiha

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Introduction : IgE-dependent cow's milk protein allergy (APLV) is one of the most common allergies in children and is one of the three most common allergies observed in children under 6 years of age. Its natural evolution is most often towards healing. The objective is to determine the sensitization profile of patients allergic to cow's milk (VL). Material and method :A retrospective study carried out on a pediatric population (age < 12 years) over a period of four years (2018-2021) in the context of a suspected food allergy to cow's milk proteins carried out on 121 children aged between 8 months -12 years The search for specific IgE was carried out by immunodot (EUROLINE Pediatric; EUROIMMUN) test which allows a semi-quantitative determination of specific IgE. Results 36 patients (29.7%) had a cow's milk protein allergy (ALPV) with a slight female predominance (58.33% girls vs 41.66% boys) The main clinical signs were: acute diarrhoea; vomiting; Intense abdominal pain, and cutaneous signs (pruritus/urticaria) with respective frequencies of 72%; 58%; 44% and 19%. The 3 major and specific VL allergens identified were beta-lactoglobulin 59% caseins 51% and alpha-lactalbumin 29.7%, The profile of sensitization to LV varies according to age, in infants before 1 year of anti-casein, IgE are predominant 83.3%, followed by beta-lactoglobulin 66.66% and alpha-lactolbumin 50% Conclusion CMPA is a frequent pathology which ranks among the three most common food allergies in children. This is the first to appear, most often starting in infants under 6 months old.

Keywords: specific Ige, food allergy, cow 's milk, child

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Authors: Zehra Betül Karakoç

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Aim: The aim of our study is to determine the changement pf plantar pressure after extracorporeal shock wave therapy (ESWT) in a patient with calcaneal spur (CS). Method: Thirty patients with CS who received ESWT treatment at Kartal Yavuz Selim State Hospital between May 2020 and November 2022 participated in this study. Demographic information of the cases was obtained. Pain levels and plantar pressure were measured with Visuel Analog Scale (VAS) and pedobarography, respectively. Pedobarography measured the maximal strength, peak pressure level, and contact area values of the hind, middle, forefoot, and toes. The cases were re-evaluated 4 weeks after the application of 15 Hz, 2-3 bar, 2,000 beats ESWT for 3 sessions. 22 cases participated in the second evaluation. The data of all patients were evaluated bilaterally. Results: Pain intensity levels after treatment were statistically significantly decreased compared to before treatment (p=0.012). Maximum force and contact area values of total foot and forefoot increased significantly (p < 0.05). Conclusion: We consider that the increased max force value of total foot and forefoot area after ESWT is due to the normal walking rate gained related to decreased pain. ESWT treatment may have positive effects on foot pressure distribution and body biomechanics. In order to interpret the results of our study more clearly, randomized controlled studies with a larger number of cases were planned in the future.

Keywords: calcaneal spur, ESWT, plantar pressure, pain

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Authors: Wissem Abdaoui, Nizar M. Mhaidat, Ilhem Mokhtari, Adel Gouri

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Colorectal cancer (CRC) is one of the most common tumors all over the world. Obesity, considered a risk factor of CRC, is characterized by a high level of secreted cytokines from adipose tissue. Among these inflammatory molecules, leptin is considered the key mediator for CRC cancer development and progression by activation of mitogenic and anti apoptotic signaling pathways. Gene expression can be significantly modulated by alterations in DNA methylation patterns. The aim of this study is to investigate the impact of leptin gene methylation on CRC prognosis and sensitivity to chemotherapy. The study involved 70 CRC tissue samples collected from King Abdullah University Hospital (KAUH) from which only 53 was analyzed because of bisulfate fragmentation and low yield of DNA extracted from FFPE tissues. A total of 22 blood samples were collected from healthy volunteers and enrolled as a control group. Leptin promoter methylation was analyzed by methylation specific PCR after bisulfate conversion. Results revealed that the incidence of leptin gene methylation was significantly higher in CRC patients in comparison to that of controls (P < 0.05). The correlation between patient’s demographics and leptin gene methylation was not significant (P < 0.05). However, a significant correlation between leptin gene methylation status and early cancer stages (I, II and III) was found in male but not in female (p < 0.05). Moreover, a significant correlation was found between leptin promoter methylation and early tumor localization T1-2 (p < 0.05). The correlation between epigenetic regulation of leptin and chemosensitivity was not significant. Taken together, these results suggest the possibility to use leptin gene methylation as a biomarker for the evaluation of CRC prognosis and metastasis.

Keywords: colorectal cancer, obesity, leptin, DNA methylation, disease prognosis, bisulfate conversion, chemoresistance

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: To analyze hematological changes in patients of oral cancer with history of smokable and chewable tobacco use, and to compare them with healthy controls. Study Design: Descriptive type of study survey. Setting: This study was conducted at the Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro. Study Period: One year July, 2013 to July, 2014. Subject and Methods: Histopathologically confirmed hundred cases of oral cancer with the history of smokable and non-smokable tobacco were selected to analyze the hematological variation. Inclusion Criteria: Histopathologically diagnosed patients of oral squamous cell carcinoma, with history of smokable and non-smokable tobacco. Exclusion Criteria: Patient with any systemic medically compromising problem, terminally ill patients, radio or chemotherapeutically treated patients, patients with metastasis to lungs or any distant metastasis, patients with the history of more than one well-defined etiological factor involved. Results: There were 73% patients of oral cancer reported with anemic. Significantly lower values of Hb, platelet, and higher mean values of ESR, TLC, and were observed in both groups of oral cancer patients; tobacco smokers and tobacco chewers as compared to non-smokers healthy controls. There was more decline in the level of haemoglobin and incline in the level of ESR observed in tobacco chewer oral cancer patients as compared to tobacco smokers patients, while TLC was more observed in smokers. Conclusion: Oral cancer patients with a history of chewable/smokable tobacco have likely worse hematological profile, which increases the anesthetic and surgical challenges for maxillofacial surgeons, which have a significant impact on treatment planning as well.

Keywords: oral cancer, hematological variations, tobacco, smokers

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Authors: Ndje Ndje Mireille

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The improvement in the physical aspects of hysterectomy has tended to make us forget the psychological burden of this operation for many women. African women closely associate fertility and femininity, and they fear that their desire will diminish, that they will be less desirable after having undergone a hysterectomy. Medicine may be tempted to trivialize this surgical intervention by relying on the evolution of current surgery that leaves little or no marks. It is possible to think that the uterus is useless for a nun who has decided to freely disregard her motherhood. We used the clinical research method for this study. Through a semi-directive interview guide, we collected the verbatims of an hysterectomized catholic nun. The verbatims were transcribed and analyzed with the thematic content analysis. This analysis shows that the medical reality does not always correspond to the subjective experience of women, for whom hysterectomy can imply strong symbolic damage. The uterus is not essential to life, but it is essential to give life, and this lack can reactivate a desire for motherhood. The experience of hysterectomy is unique for each woman in relation to her history. This operation will eliminate all hope of pregnancy; it will be felt as intimate mutilation and an attack on femininity, it will bring up concerns about sexuality. Even if a woman has past the age of having children, has gone through menopause, or has freely decided not to have children, she still find it difficult to accept this procedure. The lack of uterus make a woman feel useless.

Keywords: hysterectomy, symbolic damage, desire for motherhood, feminity, nun

Procedia PDF Downloads 142

Authors: Hossein Miri, Zhou YongQi, Chan Bormei-Suy

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The development of advanced technologies and innovative solutions has opened up exciting new possibilities for revolutionizing healthcare systems. One such emerging concept is the use of virtual and holographic health information platforms that aim to provide interactive and personalized medical information to users. This paper provides a review of notable virtual and holographic health information platforms. It begins by highlighting the need for information visualization and 3D representation in healthcare. It then proceeds to provide background knowledge on information visualization and historical developments in 3D visualization technology. Additional domain knowledge concerning holography, holographic computing, and mixed reality is then introduced, followed by highlighting some of their common applications and use cases. After setting the scene and defining the context, the need and importance of virtual and holographic visualization in medicine are discussed. Subsequently, some of the current research areas and applications of digital holography and holographic technology are explored, alongside the importance and role of virtual and holographic visualization in genetics and genomics. An analysis of the key principles and concepts underlying virtual and holographic health information systems is presented, as well as their potential implications for healthcare are pointed out. The paper concludes by examining the most notable existing mixed-reality applications and systems that help doctors visualize diagnostic and genetic data and assist in patient education and communication. This paper is intended to be a valuable resource for researchers, developers, and healthcare professionals who are interested in the use of virtual and holographic technologies to improve healthcare.

Keywords: virtual, holographic, health information platform, personalized interactive medical information

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Globally, the death rate from cardiovascular disease has risen over the past 20 years, but especially in low and middle-income countries (LMICS), reports the World Health Organization (WHO). Around 17.5 million deaths, or 31% of all deaths worldwide in 2012, were attributed to CVD, 80% of which occurred in low- and middle-income nations, and eighty five percent of all worldwide disability is attributable to cardiovascular disease. This study assessed the dietary habit and Cardiovascular Risk factors among the patients of coronary artery disease against matched controls. The research was a case-control study. Sample size for this case-control study was 410 CAD cases and 410 healthy controls. The case-control ratio was 1:1. Patients diagnosed with coronary artery disease were recruited from the outpatient departments and emergency rooms of four hospitals in Pakistan. The ages of people who were diagnosed with coronary artery disease were not significantly different from (mean 57.97 7.39 years) the healthy controls (mean 57.12 6.73 years). In order to determine the relationship between food consumption and the two binary outcomes, logistic regression analysis was carried out. Chicken (0.340 (0.245-0.47), p-value 0.0001), beef (0.38 (0.254-0.56), p-value 0.0001), eggs (0.297 (0.208-0.426), p-value 0.0001), and junk food (0.249 (0.167-0.372), p-value 0.0001)) were protective, while yogurt consumption more than twice weekly was risk. Conclusion: In conclusion, poor dietary habits are closely linked to the risk of CAD. Investigations based on dietary trends offer vital and practical knowledge about societal patterns.

Keywords: dietary habbits, cardiovasculardisease, CVD risk factors, hypercholesterolemia

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Authors: W. G. Kim, C. H. Jo

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We analyzed the effects of variations in the diameter of silicone rubber and polyvinyl chloride (PVC) tubings on the likelihood of tubing rupture during modeling of accidental arterial line clamping in cardiopulmonary bypass with a roller pump. A closed CPB circuit constructed with a roller pump was tested with both PVC and silicone rubber tubings of 1/2, 3/8, and 1/4 inch internal diameter. Arterial line pressure was monitored, and an occlusive clamp was placed across the tubing distal to the pressure monitor site to model an accidental arterial line occlusion. A CCD camera with 512(H) x 492(V) pixels was installed above the roller pump to measure tubing diameters at pump outlet, where the maximum deformations (distension) of the tubings occurred. Quantitative measurement of the changes of tubing diameters with the change of arterial line pressure was performed using computerized image processing techniques. A visible change of tubing diameter was generally noticeable by around 250 psi of arterial line pressure, which was already very high. By 1500 psi, the PVC tubings showed an increase of diameter of between 5-10 %, while the silicone rubber tubings showed an increase between 20-25 %. Silicone rubber tubings of all sizes showed greater distensibility than PVC tubings of equivalent size. In conclusion, although roller-pump induced tubing rupture remains a theoretical problem during cardiopulmonary bypass in terms of the inherent mechanism of the pump, in reality such an occurrence is impossible in real clinical conditions.

Keywords: roller pump, tubing rupture, cardiopulmonary bypass, arterial line

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Shin-Mei Hsu, Yin-Tzu Lin, Chi Wu

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Background: Obstructive Sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. In addition, Body parameters were identified high predictive importance for OSAS severity. However, the effects of body parameters on OSAS severity remain unclear. Objective: In this study, the objective is to establish a prediction model for OSAS by using body parameters and investigate the effects of body parameters in OSAS. Methodologies: Severity was quantified as the polysomnography and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI) with American Academy of Sleep Medicine (AASM) guideline. Body parameters, including neck circumference, waist size, and body mass index (BMI) were obtained from questionnaire. Next, dividing the collecting subjects into two groups: training and testing groups. The training group was used to establish the random forest (RF) to predicting, and test group was used to evaluated the accuracy of classification. Results: There were 3330 subjects recruited in this study, whom had been done polysomnography for evaluating severity for OSAS. A RF of 1000 trees achieved correctly classified 79.94 % of test cases. When further evaluated on the test cohort, RF showed the waist and BMI as the high import factors in OSAS. Conclusion It is possible to provide patient with prescreening by body parameters which can pre-evaluate the health risks.

Keywords: apnea and hypopnea index, Body parameters, obstructive sleep apnea syndrome, Random Forest

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Authors: Farhad Shafiepour Motlagh, Narges Salehi

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Purpose: The aim of the present study was a paradigm model of educational policy review strategies for the development of Professional schools in Iran. Research Methodology: The research method was based on Grounded theory. The statistical population included all articles of the ten years 2022-2010 and the method of sampling in a purposeful manner to the extent of theoretical saturation to 31 articles. For data analysis, open coding, axial coding and selective coding were used. Results: The results showed that causal conditions include social requirements (social expectations, educational justice, social justice); technology requirements (use of information and communication technology, use of new learning methods), educational requirements (development of educational territory, Development of educational tools and development of learning methods), contextual conditions including dual dimensions (motivational-psychological context, context of participation and cooperation), strategic conditions including (decentralization, delegation, organizational restructuring), intervention conditions (poor knowledge) Human resources, centralized system governance) and outcomes (school productivity, school professionalism, graduate entry into the labor market) were obtained. Conclusion: A review of educational policy is necessary to develop Iran's Professional schools, and this depends on decentralization, delegation, and, of course, empowerment of school principals.

Keywords: school productivity, professional schools, educational policy, paradigm

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Authors: Sarah A. Tobin

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Social justice outcomes, derived from customer satisfaction, serve as a main pathway and conduit for achieving Sustainable Development Goals (SDGs) because they prompt democratizing and socially-inclusive effects that are consistent with Islamic economic values. This paper argues that achieving higher levels of social justice and the SGDs is possible only through the realization of Islamic banking and finance customer satisfaction that aligns with Islamic values in the tradition of the Shari`a (or Islamic law). Through this key manifestation of Shari`a in the banks, social justice aims of achieving SDGs become possible. This paper utilizes a case study of a large-scale survey (N=127) comparing customer satisfaction between a conventional and an Islamic bank in Amman, Jordan. Based on a series of linear regressions, the statistically-significant findings suggest that when overall customer satisfaction is high, customers are more likely to become empowered citizens demanding inclusive, quality services and corruption-free management, as well as attribute their experiences to the Islamic nature of the financial endeavors. Social justice interests and expectations increase (and SDGs are more likely met) when a customer has high levels of satisfaction. The paper concludes with policy recommendations for Islamic financial institutions that enhance customer service experiences for better achieving the social justice aims of the Islamic economy and SDGs, including transparency in transactions, exemplary customer service and follow up, and attending to Islamic values in the aesthetics of bank.

Keywords: customer satisfaction, Islamic economy, social justice, sustainable development goals

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Authors: Silvia Boschetti, Jakub Binter, Robin Kopecký, Lenka PříPlatová, Jaroslav Flegr

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A strict dichotomy was present between religion and science, but recently, cognitive science focusses on the impact of supernatural beliefs on cognitive processes such as pattern recognition. It has been hypothesized that cognitive and perceptual processes have been under evolutionary pressures that ensured amplified perception of patterns, especially when in stressful and harsh conditions. The pattern detection in religious and non-religious individuals after induction of negative, anxious mood shall constitute a cornerstone of the general role of anxiety, cognitive bias, leading towards or against the by-product hypothesis, one of the main theories on the evolutionary studies of religion. The apophenia (tendencies to perceive connection and meaning on unrelated events) and perception of visual patterns (or pateidolia) are of utmost interest. To capture the impact of culture and upbringing, a comparative study of two European countries, the Czech Republic (low organized religion participation, high esoteric belief) and Italy (high organized religion participation, low esoteric belief), are currently in the data collection phase. Outcomes will be presented at the conference. A battery of standardized questionnaires followed by pattern recognition tasks (the patterns involve color, shape, and are of artificial and natural origin) using an experimental method involving the conditioning of (controlled, laboratory-induced) stress is taking place. We hypothesize to find a difference between organized religious belief and personal (esoteric) belief that will be alike in both of the cultural environments.

Keywords: culture, esoteric belief, pattern perception, religiosity

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Authors: Georgiana Onicescu, Yuqian Shen

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Due to the complex nature of geo-referenced data, multicollinearity of the risk factors in public health spatial studies is a commonly encountered issue, which leads to low parameter estimation accuracy because it inflates the variance in the regression analysis. To address this issue, we proposed a two-stage variable selection method by extending the least absolute shrinkage and selection operator (Lasso) to the Bayesian spatial setting, investigating the impact of risk factors to health outcomes. Specifically, in stage I, we performed the variable selection using Bayesian Lasso and several other variable selection approaches. Then, in stage II, we performed the model selection with only the selected variables from stage I and compared again the methods. To evaluate the performance of the two-stage variable selection methods, we conducted a simulation study with different distributions for the risk factors, using geo-referenced count data as the outcome and Michigan as the research region. We considered the cases when all candidate risk factors are independently normally distributed, or follow a multivariate normal distribution with different correlation levels. Two other Bayesian variable selection methods, Binary indicator, and the combination of Binary indicator and Lasso were considered and compared as alternative methods. The simulation results indicated that the proposed two-stage Bayesian Lasso variable selection method has the best performance for both independent and dependent cases considered. When compared with the one-stage approach, and the other two alternative methods, the two-stage Bayesian Lasso approach provides the highest estimation accuracy in all scenarios considered.

Keywords: Lasso, Bayesian analysis, spatial analysis, variable selection

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Authors: Jocelyn Solomons, Sheree Bekker, Ryan Groom, Wilbur Kraak

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Sports coaching is marked by inherent elements of complexity. Coaches constantly encounter ambiguity, as they are unable to have complete certainty regarding the perspectives and expectations of stakeholders. Moreover, the coaching environment is characterised by its dynamic nature and intricate micro-political dynamics which further add to the complexity that coaches must navigate. This research study offers a unique perspective on the practical manifestation of coaching effectiveness in the South African (SA) context, where the sport is in its early stages of development. With a predominant presence of male coaches training female players and players originating from diverse sporting backgrounds, including a majority of those who commence their rugby careers at the university level, this exploration, along with practical recommendations, becomes essential. It allows for a nuanced understanding of coaching practices within a rugby system that concurrently focuses on development and high performance. By integrating the views of both players and coaches, insights are gained that extend traditional assessments, enabling a comprehensive understanding of coaching effectiveness and its implications in this evolving Women’s Rugby landscape. Through semi-structured interviews, the research delves into their assessments of coaching strategies, methodologies, and outcomes, aiming to understand coaching efficacy and its impact on player development. The findings contribute to a nuanced understanding of coaching effectiveness, paving the way for evidence-based recommendations to enhance coaching development and positively impact the sport's growth and success in SA.

Keywords: women’s rugby, coaching effectiveness, coaching, rugby, coaching education

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Authors: Cecilia Estela Jiménez Pérez Campos

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Introduction: Amputation comes from a series of complications in diabetic persons; at that point, of the illness evolution they have a deplored aerobic capacity. Adding to that, cardiac rehabs programs are almost base in several activities in a standing position. The cardiac rehabilitation programs have to improve for them, based on scientific advice. Objective: Evaluation of aerobic capacity of diabetic amputee after an aerobic exercise program, with upper limb ergometer. Methodology: The design is longitudinal, prospective, comparative and no randomized. We include all diabetic pelvic limb amputees, who assist to the cardiac rehabilitation. We made 2 groups: an experimental and a control group. The patients did the exercise testing, with the author’s design protocol. The experimental group completed 24 exercise sessions (3 sessions/week), with an intensity determined with the training heart rate. At the end of 8 weeks period, the subjects did a second exercise test. Results: Both groups were a homogeneous sample in age (experimental n=15) 57.6+12.5 years old and (control n=8) 52.5+8.0 years old, sex, occupation, education and economic features. (square chi) (p=0.28). The initial aerobic capacity was similar in both groups. And the aerobic capacity accomplishes after the program was statistically greater in the experimental group than in the control one. The final media VO2peak (mlO2/kg/min) was experimental (17.1+3.8), control (10.5+3.8), p=0.001. (t student). Conclusions: The aerobic capacity improved after an arm ergometer exercise program and the quality of life improve too, in diabetic amputees. So this program is fundamental in diabetic amputee’s rehabilitation management.

Keywords: aerobic fitness, metabolic equivalent (MET), oxygen output, upper limb ergometer

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Authors: Babatunde Oluwole Ogunsile, Omosola Monisola Fasoranti

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High costs and toxicological hazards associated with the physicochemical methods of producing nanoparticles have limited their widespread use in clinical and biomedical applications. An ethically sound alternative is the utilization of plant bioresources as a low cost and eco–friendly biological approach. Silver nanoparticles (AgNPs) were synthesized from aqueous leaf extract of Tithonia diversifolia plant. The UV-Vis Spectrophotometer was used to monitor the formation of the AgNPs at different time intervals and different ratios of plant extract to the AgNO₃ solution. The biosynthesized AgNPs were characterized by FTIR, X-ray Diffraction (XRD) and Scanning Electron Microscope (SEM). Antimicrobial activities of the AgNPs were investigated against ten human pathogens using agar well diffusion method. The AgNPs yields were modeled using a second-order factorial design. The result showed that the rate of formation of the AgNPs increased with respect to time while the optimum ratio of plant extract to the AgNO₃ solution was 1:1. The hydroxyl group was strongly involved in the bioreduction of the silver salt as indicated by the FTIR spectra. The synthesized AgNPs were crystalline in nature, with a uniformly distributed network of the web-like structure. The factorial model predicted the nanoparticles yields with minimal errors. The nanoparticles were active against all the tested pathogens and thus have great potentials as antimicrobial agents.

Keywords: antimicrobial activities, green synthesis, silver nanoparticles, Tithonia diversifolia

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Authors: Carlson Murray, Ali Lazrak

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Robust experimental evidence of systematic violations of expected utility (EU) establishes that individuals facing risk overweight utility from low probability gains and losses when making choices. These findings motivated development of models of preferences with probability weighting functions, such as rank dependent utility (RDU). We solve for the optimal investing strategy of an RDU investor in a dynamic binomial setting from which we derive implications for investing behavior. We show that relative to EU investors with constant relative risk aversion, commonly measured probability weighting functions produce optimal RDU terminal wealth with significant downside protection and upside exposure. We additionally find that in contrast to EU investors, RDU investors optimally choose a portfolio that contains fair bets that provide payo↵s that can be interpreted as lottery outcomes or exposure to idiosyncratic returns. In a calibrated version of the model, we calculate that RDU investors would be willing to pay 5% of their initial wealth for the freedom to trade away from an optimal EU wealth allocation. The dynamic trading strategy that supports the optimal wealth allocation implies portfolio weights that are independent of initial wealth but requires higher risky share after good stock return histories. Optimal trading also implies the possibility of non-participation when historical returns are poor. Our model fills a gap in the literature by providing new quantitative and qualitative predictions that can be tested experimentally or using data on household wealth and portfolio choice.

Keywords: behavioral finance, probability weighting, portfolio choice

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Authors: Ana Fouto

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

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

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Authors: R. H. Bustos, L. Martinez, J. García, F. Suárez

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MRP1 (Multi-drug resistance associated protein 1) and MRP2 (Multi-drug resistance associated protein 2) are two proteins belonging to the transporters of ABC (ATP-Binding Cassette). These transporter proteins are involved in the efflux of several biological drugs and xenobiotic and also in multiple physiological, pathological and pharmacological processes. Evidence has been found that there is a correlation among different polymorphisms found and their clinical implication in the resistance to antiepileptic, chemotherapy and anti-infectious drugs. In our study, exonic regions of MRP1/ABCC1 y MRP2/ABCC2 were studied in the Colombian population, specifically in the region of the central Savannah (Cundinamarca) to determinate SNP (Single Nucleotide Polymorphisms) and determinate its allele frequency and its genomics frequency. Results showed that for our population, SNP are found that have been previously reported for MRP1/ABCC1 (rs200647436, rs200624910, rs150214567) as well as for MRP2/ABCC2 (rs2273697, rs3740066, rs142573385, rs17216212). In addition, 13 new SNP were identified. Evidences show an important clinic correlation for polymorphisms rs3740066 and rs2273697. The study object population displays genetic variability as compared to the one reported in other populations.

Keywords: ATP-binding cassette (ABCC), Colombian population, multidrug-resistance protein (MRP), pharmacogenetic, single nucleotide polymorphism (SNP)

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Authors: Wangxu Xia

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BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

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Authors: Shachi Joshi

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Purpose: The primary aim of this study was to determine the prevalence of pelvic dysfunction symptoms following OASI. The secondary aim was to assess the scope of a dedicated perineal trauma clinic in identifying and investigating women that have experienced faecal incontinence after OASI and if a transitional clinic arrangement to colorectal surgeons would be useful. Methods: The clinical database was used to identify and obtain information about 118 women who sustained an OASI (3rd/ 4th degree tear) between August 2016 and July 2017. A questionnaire was designed to assess symptoms of pelvic dysfunction; this was sent via the post in November 2018. Results: The questionnaire was completed by 45 women (38%). Faecal incontinence was experienced by 42% (N=19), flatus incontinence by 47% (N=21), urinary incontinence by 76% (N=34), dyspareunia by 49% (N=22) and pelvic pain by 33% (N=15). Of the questionnaire respondents, only 62% (N=28) had attended a perineal trauma clinic appointment. 46% (N=13) of these women reported having experienced difficulty controlling flatus or faeces in the questionnaire, however, only 23% (N=3) of these reported ongoing symptoms at the time of clinic attendance and underwent an endoanal ultrasound scan. Conclusion: Pelvic dysfunction symptoms are highly prevalent following an OASI. Perineal trauma clinic attendance alone is not sufficient for identification and follow up of symptoms. Transitional care is needed between obstetric and colorectal teams, to recognize and treat women with ongoing faecal incontinence.

Keywords: incontinence, obstetric anal sphincter, injury, repair

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Authors: Jake Tempo, Taylor Smithurst, Jen Leah, Skye Waddingham, Amanda Catlin, Richard Cetti

Abstract:

Introduction: Percutaneous nephrolithotomy (PCNL) is the gold-standard procedure for removing large or complex renal stones. Many operating positions can be used, and the debate over the ideal position continues. PCNL can be a long procedure during which patients can sustain pressure injuries. These injuries are often underreported in the literature. Interface pressure mapping records the pressure loading between a surface and the patient. High pressures with prolonged loading result in ischaemia, muscle deformation, and reperfusion which can cause skin breakdown and muscular injury. We compared the peak pressure indexes of common PCNL positions to identify positions which may be at high risk of pressure injuries. We hope the data can be used to adapt high-risk positions so that the PPI can be lessened by either adapting the positions or by using adjuncts to lower PPI. Materials and Methods: We placed a 23-year-old male subject in fourteen different PCNL positions while performing interface pressure mapping. The subject was 179 cm with a weight of 63.3 kg, BMI 19.8kg/m². Results: Supine positions had a higher mean PPI (119mmHg (41-137)) compared to prone positions (64mmHg (32-89)) (p=0.046 two tailed t-test). The supine flexed position with a bolster under the flank produced the highest PPI (194mmHg), and this was at the sacrum. Peak pressure indexes >100mmHg were recorded in eight PCNL positions. Conclusion: Supine PCNL positions produce higher PPI than prone PCNL positions. Our study shows where ‘at risk’ bony prominences are for each PCNL position. Surgeons must ensure these areas are protected during prolonged operations.

Keywords: PCNL, pressure ulcer, interface pressure mapping, surgery

Procedia PDF Downloads 70

Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata, Korczak Józef

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The object of this study was to develop recipes and technology of production of functional bread with morus alba fruit addition. There were prepared four samples of functional breads and the control sample also. Bread recipe was designed for supporting the treatment of anemia, diabetes, obesity and cardiovascular diseases. Samples of bread were baked with mixes directly after preparation and after three months' storage, each time preparing the water and methanol extracts. The sensory analysis and nutritional value were estimated. The antioxidant activity were estimated used tests such as the ability to scavenge free radical DPPH, the ability to scavenge the ABTS cation, chelating properties and the total content of polyphenols. The study results showed that the prepared sample of functional breads were characterized by a high nutritional value with high concentration of biologically active compounds which showed antioxidant activity. In addition, the profile sensory of bread samples was highly rated. However, to determine whether they can be considered as a new product preset pro-health properties require additional nutritional studies - clinical trials.

Keywords: functional food, breads, white mulberry, bioactive components

Procedia PDF Downloads 289

Authors: Temitope Francis Abiodun

Abstract:

The practice of intelligence is not limited to the machinery of a nation state alone, yet not much research or analysis has been directed towards the spy-crafts and tradecrafts engaged in by violent non-state actors (VNSAs) in the international community. The rise of 'private sector intelligence' in more recent years has only just begun to be interrogated by practitioners and academics. However, the use of intelligence by insurgents and other groups assembled to achieve varied forms of politico-military outcomes has often been overlooked. This paper examined the factors and conditions that gave rise to an increase in violent non-state actors (VNSAs), strategies aiding their deployment of insurgent intelligence, and as well the implications of their activities on global security. The failed state theory was adopted, while a descriptive research design served as the framework for the study. Data were collected from primary and secondary sources. The paper, however, revealed there were massive deployments of insurgent intelligence by violent non-state actors in contrast to a faulty pre-conception that insurgents were not as highly trained in deployment of intelligence as state actors, having assumed that the VNSAs lacked the sophistication to produce intelligence. However, the strategic objectives of insurgents (VNSAs) were revealed to depend on well-organized information gathering operations that feed into the tactical executions of their insurgency. The paper recommends, therefore, there is a need for adequate training on the part of security personnel in the states to be alive to their responsibilities; and there is also a need to ensure adequate border control and management to checkmate the influx of the various violent or deadly movements across global frontiers.

Keywords: terrorism, non-violent state actors, private sector intelligence, security

Procedia PDF Downloads 126

Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan

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Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.

Keywords: endarterectomy, eversion, femoral, vascular

Procedia PDF Downloads 181

Authors: Garima Chaudhary

Abstract:

The gender of an individual in forensic DNA analysis is normally accessed by using the STR multiplexes with the incorporated gender based marker amelogenin or in other words by presence or absence of Y-Chromosome, but it may not be true in all the cases. We hereby report an interesting case of a phenotypic female carrying a male karyotype (46XY). In the alleged murder case, the deceased female with XY genotype was noticed. The expression of 18 Y-linked genes was studied to measure the extent of expression. Expression at 4 loci was observed that might have caused the misinterpretation in forensic casework. This clinical situation of the deceased in this case was diagnosed as testicular feminization syndrome, which characterize a female phenotype with a male karyotype (46, XY). Most of these cases have SRY (testis determining factor). The genetic explanation of this phenomenon is not very clear. Here, we are discussing the impact of such situations of genetic discrepancy in forensic interpretation of results. In the presented murder case of a phenotypic female, sexual assault was also suspected. For confirmation vaginal swabs and micro slides were also sent to us for DNA examination. After DNA analysis using STR markers, Y-chromosome was detected in the samples which supporting the suspicion of sexual assault before murder. When the reference blood sample of the deceased was analyzed, it was found to be case of testicular feminization syndrome. Interesting inferences were made from the results obtained.

Keywords: DNA profiling, forensic case study, Y chromosome, females

Procedia PDF Downloads 209

Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

Procedia PDF Downloads 348

Authors: Roseline Oghogho Osaseri, Osaseri E. I.

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Lassa fever is an epidemic hemorrhagic fever caused by the Lassa virus, an extremely virulent arena virus. This highly fatal disorder kills 10% to 50% of its victims, but those who survive its early stages usually recover and acquire immunity to secondary attacks. One of the major challenges in giving proper treatment is lack of fast and accurate diagnosis of the disease due to multiplicity of symptoms associated with the disease which could be similar to other clinical conditions and makes it difficult to diagnose early. This paper proposed an Adaptive Neuro Fuzzy Inference System (ANFIS) for the prediction of Lass Fever. In the design of the diagnostic system, four main attributes were considered as the input parameters and one output parameter for the system. The input parameters are Temperature on admission (TA), White Blood Count (WBC), Proteinuria (P) and Abdominal Pain (AP). Sixty-one percent of the datasets were used in training the system while fifty-nine used in testing. Experimental results from this study gave a reliable and accurate prediction of Lassa fever when compared with clinically confirmed cases. In this study, we have proposed Lassa fever diagnostic system to aid surgeons and medical healthcare practictionals in health care facilities who do not have ready access to Polymerase Chain Reaction (PCR) diagnosis to predict possible Lassa fever infection.

Keywords: anfis, lassa fever, medical diagnosis, soft computing

Procedia PDF Downloads 247

Authors: H. Nouri, S. Chavoshi Borujeni, S. Anderson, S. Beecham, P. Sutton

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The potential risk of salt leaching through wastewater irrigation is of concern for most local governments and city councils. Despite the necessity of salinity monitoring and management in urban greenery, most attention has been on agricultural fields. This study was defined to investigate the capability and feasibility of monitoring and predicting soil salinity using near sensing and remote sensing approaches using EM38 surveys, and high-resolution multispectral image of WorldView3. Veale Gardens within the Adelaide Parklands was selected as the experimental site. The results of the near sensing investigation were validated by testing soil salinity samples in the laboratory. Over 30 band combinations forming salinity indices were tested using image processing techniques. The outcomes of the remote sensing and near sensing approaches were compared to examine whether remotely sensed salinity indicators could map and predict the spatial variation of soil salinity through a potential statistical model. Statistical analysis was undertaken using the Stata 13 statistical package on over 52,000 points. Several regression models were fitted to the data, and the mixed effect modelling was selected the most appropriate one as it takes to account the systematic observation-specific unobserved heterogeneity. Results showed that SAVI (Soil Adjusted Vegetation Index) was the only salinity index that could be considered as a predictor for soil salinity but further investigation is needed. However, near sensing was found as a rapid, practical and realistically accurate approach for salinity mapping of heterogeneous urban vegetation.

Keywords: WorldView3, remote sensing, EM38, near sensing, urban green spaces, green smart cities

Procedia PDF Downloads 148