Search results for: post cancer maxillary reconstruction

Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

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Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

Procedia PDF Downloads 109

Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

Procedia PDF Downloads 173

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background & aims: Reading is a receptive skill whose importance could involve abilities' variance from linguistic standard. Several evidences support the hypothesis stating that the more you read the better you write, with a different impact for speech language therapists (SLTs) who use audio-visual aids and computer-assisted language instruction (CALI) and those who do not. Methods: Here we made use of audio-visual aids and CALI for teaching reading skill to a group of 40 students of special needs of both sexes (range between 8 and 18 years old) at al-Malādh school for teaching students of special needs in Dhamar (Yemen) while another group of the same number is taught using ordinary teaching methods. Pre-and-posttests have been administered at the beginning and the end of the semester (Before and after teaching the reading course). The purpose was to understand the differences between the levels of the students of special needs to see to what extent audio-visual aids and CALI are useful for them. The two groups were taught by the same instructor under the same circumstances in the same school. Both quantitative and qualitative procedures were used to analyze the data. Results: The overall findings revealed that audio-visual aids and CALI are very useful for teaching reading to students of special needs and this can be seen in the scores of the treatment group’s subjects (7.0%, in post-test vs.2.5% in pre-test). In comparison to the scores of the second group’s subjects (where audio-visual aids and CALI were not used) (2.2% in both pre-and-posttests), the first group subjects have overcome reading tasks and this can be observed in their performance in the posttest. Compared with males, females’ performance was better (1466 scores (7.3%) vs. 1371 scores (6.8%). Qualitative and statistical analyses showed that such comprehension is absolutely due to the use of audio-visual aids and CALI and nothing else. These outcomes confirm the evidence of the significance of using audio-visual aids and CALI as effective means for teaching receptive skills in general and reading skill in particular.

Keywords: reading, receptive skills, audio-visual aids, CALI, students, special needs, SLTs

Procedia PDF Downloads 49

Authors: L. Sun, C. Hardacre, A. Garforth, N. Zhang

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Higher Education (HE) degrees in the UK are attractive for international students. The recognized reputation of the HE and the world-leading researchers in some areas in the UK imply that the HE degree from the UK might be a passport to a successful career for abroad students. However, it is a challenge to inspire outstanding students applying for the universities in the UK. The incentives should be country-specific for undergraduates and postgraduates. The potential obstacles to stop students applying for the study in the UK mainly lie in these aspects: different HE systems between the UK and other countries, such as China; less information for the application procedures; worries for the study in English for those non-native speakers; and expensive international tuition fees. The hybrid incentives have been proposed by the efforts from the institutions, stuffs, and students themselves. For example, excellent students from top universities would join us based on the abroad exchange programs or ‘2+2 programme’ with discount tuition. They are potential PhD candidates in the further study in the UK. Diversity promotions are implemented to share information and answer queries for potential students and their guardians. Face to face presentations, workshops, and seminars deliver chances for students to admire teaching and learning in the UK, and give students direct answers for their confusions. WeChat official account and Twitter as the online information platform are set up to post messages of recruitment, the guidance for the application procedures, and international collaboration in teaching and research as well. Students who are studying in the UK and the alumni would share their experiences in the study and lives in the UK and their careers after obtaining the HE degree would play as a positive stimulus to our potential students. Short term modules in the UK with exchangeable credits in summer holidays would give abroad students firsthand experiences of the study in the reputable schools with excellent academics, different cultures and the network with international students. Successful cases at the University of Manchester illustrated the effectiveness of these presented methodologies.

Keywords: abroad students, degree study, high education, hybrid incentives

Procedia PDF Downloads 166

Authors: Paul Lemarignier, Olivier Fiquet, Vincent Pateloup

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In line with the strong desire of nuclear energy players to have ever more effective products in terms of safety, research programs on E-ATF (Enhanced-Accident Tolerant Fuels) that are more resilient, particularly to the loss of coolant, have been launched in all countries with nuclear power plants. Among the multitude of solutions being developed internationally, carcinoembryonic antigen (CEA) and its partners are investigating a promising solution, which is the realization of CERMET (CERamic-METal) type fuel pellets made of a matrix of fissile material, uranium dioxide UO2, which has a low thermal conductivity, and a metallic phase with a high thermal conductivity to improve heat evacuation. Work has focused on the development by powder metallurgy of micro-structured CERMETs, characterized by networks of metallic phase embedded in the UO₂ matrix. Other types of macro-structured CERMETs, based on concepts proposed by thermal simulation studies, have been developed with a metallic phase with a specific geometry to optimize heat evacuation. This solution could not be developed using traditional processes, so additive manufacturing, which revolutionizes traditional design principles, is used to produce these innovative prototype concepts. At CEA Cadarache, work is first carried out on a non-radioactive surrogate material, alumina, in order to acquire skills and to develop the equipment, in particular the robocasting machine, an additive manufacturing technique selected for its simplicity and the possibility of optimizing the paste formulations. A manufacturing chain was set up, with the pastes production, the 3D printing of pellets, and the associated thermal post-treatment. The work leading to the first elaborations of macro-structured alumina/molybdenum CERMETs will be presented. This work was carried out with the support of Framatome and EdF.

Keywords: additive manufacturing, alumina, CERMET, molybdenum, nuclear safety

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Authors: Charles Iledun Oyewole

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The daunting challenge that the ‘man with the hoe’ is going to face in the coming decades will be complex and interwoven. With global population already above 7 billion people, it has been estimated that food (crop) production must more than double by 2050 to meet up with the world’s food requirements. Nigeria population is also expected to reach over 240 million people by 2050, at the current annual population growth of 2.61 per cent. The country’s farming population is estimated at over 65 per cent, but the country still depends on food importation to complement production. The small scale farmer, who depends on simple hand tools: hoes and cutlasses, remains the centre of agricultural production, accounting for 90 per cent of the total agricultural output and 80 per cent of the market flow. While the hoe may have been a tool for sustainable development at a time in human history, this role has been smothered by population growth, which has brought too many mouths to be fed (over 170 million), as well as many industries to fuel with raw materials. It may then be argued that the hoe is unfortunately not a tool for the coming challenges and that agricultural mechanization should be the focus. However, agriculture as an enterprise is a ‘complete wheel’ which does not work when broken, particularly, in respect to mechanization. Generally, mechanization will prompt increase production, where land is readily available; increase production, will require post-harvest handling mechanisms, crop processing and subsequent storage. An important aspect of this is readily available and favourable markets for such produce; fuel by good agricultural policies. A break in this wheel will lead to the process of mechanization crashing back to subsistence production, and probably reversal to the hoe. The focus of any agricultural policy should be to chart a course for sustainable mechanization that is environmentally friendly, that may ameliorate Nigeria’s food and raw material gaps. This is the focal point of this article.

Keywords: Crop production, Farmer, Hoes, Mechanization, Policy framework, Population, Growth, Rural areas

Procedia PDF Downloads 221

Authors: David Whitehouse

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Some of the strengths of online teaching include flexibility, creativity, and comprehensiveness. A challenge can be motivation. How can an instructor repeating the same lessons over and over, day in and day out, year after year, maintain motivation? Enthusiasm? Does motivating the student and creating enthusiasm in class build the same things inside the instructor? The answers lie in the adoption of what I label EUQ—The Empathy and Understanding Quotient. In the online environment, students who are adults have many demands on their time: civilian careers, families (spouse, children, older parents), and sometimes even military service. Empathetic responses on the part of the instructor will lead to open and honest communication on the part of the student, which will lead to understanding on the part of the instructor and a rise in motivation in both parties. Understanding the demands can inform an instructor’s relationship with the student throughout the temporal parameters of classwork. In practicing EUQ, instructors can build motivation in their students and find internal motivation in an enhanced classroom dynamic. The presentation will look at what motivates a student to accomplish more than the minimum required and how that can lead to excellent results for an instructor’s own motivation. Through direct experience of having students give high marks on post-class surveys and via direct messaging, the presentation will focus on how applying EUQ in granting extra time, searching for intent while grading, communicating with students via Quick Notes, responses in Forums, comments in Assignments, and comments in grading areas - - - how applying these things infuses enthusiasm and energy in the instructor which drive creativity in teaching. Three primary ways of communicating with students will be given as examples. The positive response and negative response each for a Forum, an Assignment, and a Message will be explored. If there is time, participants will be invited to craft their own EUQ responses in a role playing exercise involving two common classroom scenarios—late work and plagiarism.

Keywords: education, instruction, motivation, online, teaching

Procedia PDF Downloads 171

Authors: Ratna Kuswardani

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This paper aims to study the impact of recent Global Financial Crisis (GFC) on 6 selected emerging Asian economies (Indonesia, Malaysia, Thailand, Philippines, Singapore, and South Korea). We first figure out the contagion of GFC from the US and Europe to the selected emerging Asian countries by studying the tail dependence of market stock returns between those countries. We apply the concept of Extreme Value Theory (EVT) to model the dependence between multiple returns series of variables under examination. We explore the factors causing the contagion between the regions. We find dependencies between markets that are influenced by their size, especially for large markets in emerging Asian countries that tend to have a higher dependency to the market in the more advanced country such as the U.S. and some countries in Europe. The results also suggest that the dependencies between market returns and bank stock returns in the same region tend to be higher than dependencies between these returns across two different regions. We extend our analysis by studying the impact of GFC on the systemic in the banking system. We also find that larger institution has more dependencies with the market stock, suggesting that larger size bank can cause disruption in the market. Further, the higher probability of extreme loss can be seen during the crisis period, which is shown by the non-linear dependency between the pre-crisis and the post-crisis period. Finally, our analysis suggests that systemic risk appears in the domestic banking systems in emerging Asia, as shown by the extreme dependencies within banks in the system. Overall, our results provide caution to policy makers and investors alike on the possible contagion of the impact of global financial crisis across different markets.

Keywords: contagion, extreme value theory, global financial crisis, systemic risk

Procedia PDF Downloads 151

Authors: B. Vijay Antony Raj, Umarani Gunasekaran, R. Thiru Kumara Raja Vallaban

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Fibrous autoclaved aerated concrete (FAAC) is concrete containing fibrous material in it which helps to increase its structural integrity when compared to that of convention autoclaved aerated concrete (CAAC). These short discrete fibers are uniformly distributed and randomly oriented, which enhances the bond strength within the aerated concrete matrix. Conventional red-clay bricks create larger impact to the environment due to red soil depletion and it also consumes large amount to time for construction. Whereas, AAC are larger in size, lighter in weight and it is environmentally friendly in nature and hence it is a viable replacement for red-clay bricks. Internal micro cracks and corner cracks are the only disadvantages of conventional autoclaved aerated concrete, to resolve this particular issue it is preferable to make use of fibers in it.These fibers are bonded together within the matrix and they induce the aerated concrete to withstand considerable stresses, especially during the post cracking stage. Hence, FAAC has the capability of enhancing the mechanical properties and energy absorption capacity of CAAC. In this research work, individual fibers like glass, nylon, polyester and polypropylene are used they generally reduce the brittle fracture of AAC.To study the fibre’s surface topography and composition, SEM analysis is performed and then to determine the composition of a specimen as a whole as well as the composition of individual components EDAX mapping is carried out and then an experimental approach was performed to determine the effect of hybrid (multiple) fibres at various dosage (0.5%, 1%, 1.5%) and curing temperature of 180-2000 C is maintained to determine the mechanical properties of autoclaved aerated concrete. As an analytical part, the outcome experimental results is compared with fuzzy logic using MATLAB.

Keywords: fiberous AAC, crack control, energy absorption, mechanical properies, SEM, EDAX, MATLAB

Procedia PDF Downloads 269

Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

Procedia PDF Downloads 102

Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

Procedia PDF Downloads 136

Authors: V. Suganya, V. Balasuriya

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The functioning of Micro and Small Scale (MSS) businesses in the northern part of Sri Lanka was vulnerable due to three decades of internal conflict and the subsequent post-war economic openings has resulted new market prospects for MSS businesses. MSS businesses survive and operate with limited resources and struggle to access finance, raw material, markets, and technology. This study attempts to identify the manner in which entrepreneurial orientation puts into practice by the business operators to overcome these business challenges. Business operators in the traditional food processing sector are taken for this study as this sub-sector of the food industry is developing at a rapid pace. A review of the literature was done to recognize the concepts of entrepreneurial orientation, defining MMS businesses and the manner in which business performance is measured. Direct interview method supported by a structured questionnaire is used to collect data from 80 respondents; based on a fixed interval random sampling technique. This study reveals that more than half of the business operators have opted to commence their business ventures as a result of identifying a market opportunity. 41 per cent of the business operators are highly entrepreneurial oriented in a scale of 1 to 5. Entrepreneurial orientation shows significant relationship and strongly correlated with business performance. Pro-activeness, innovativeness and competitive aggressiveness shows a significant relationship with business performance while risk taking is negative and autonomy is not significantly related to business performance. It is evident that entrepreneurial oriented business practices contribute to better business performance even though 70 per cent prefer the ideas/views of the support agencies than the stakeholders when making business decisions. It is recommended that appropriate training should be introduced to develop entrepreneurial skills focusing to improve business networks so that new business opportunities and innovative business practices are identified.

Keywords: Micro and Small Scale (MMS) businesses, entrepreneurial orientation (EO), food processing, business operators

Procedia PDF Downloads 494

Authors: Kyung Jin Kim, Jiwon Kwak, Jae-Hoon Lee, Soo Suk Lee

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MicroRNAs (miRNA) are a class of endogenous, single-stranded, small, and non-protein coding RNA molecules typically 20-25 nucleotides long. They are thought to regulate the expression of other genes in a broad range by binding to 3’- untranslated regions (3’-UTRs) of specific mRNAs. The detection of miRNAs is very important for understanding of the function of these molecules and in the diagnosis of variety of human diseases. However, detection of miRNAs is very challenging because of their short length and high sequence similarities within miRNA families. So, a simple-to-use, low-cost, and highly sensitive method for the detection of miRNAs is desirable. In this study, we demonstrate a novel bi-directional extension (BDE) assay. In the first step, a specific linear RT primer is hybridized to 6-10 base pairs from the 3’-end of a target miRNA molecule and then reverse transcribed to generate a cDNA strand. After reverse transcription, the cDNA was hybridized to the 3’-end which is BDE sequence; it played role as the PCR template. The PCR template was amplified in an SYBR green-based quantitative real-time PCR. To prove the concept, we used human brain total RNA. It could be detected quantitatively in the range of seven orders of magnitude with excellent linearity and reproducibility. To evaluate the performance of BDE assay, we contrasted sensitivity and specificity of the BDE assay against a commercially available poly (A) tailing method using miRNAs for let-7e extracted from A549 human epithelial lung cancer cells. The BDE assay displayed good performance compared with a poly (A) tailing method in terms of specificity and sensitivity; the CT values differed by 2.5 and the melting curve showed a sharper than poly (A) tailing methods. We have demonstrated an innovative, cost-effective BDE assay that allows improved sensitivity and specificity in detection of miRNAs. Dynamic range of the SYBR green-based RT-qPCR for miR-145 could be represented quantitatively over a range of 7 orders of magnitude from 0.1 pg to 1.0 μg of human brain total RNA. Finally, the BDE assay for detection of miRNA species such as let-7e shows good performance compared with a poly (A) tailing method in terms of specificity and sensitivity. Thus BDE proves a simple, low cost, and highly sensitive assay for various miRNAs and should provide significant contributions in research on miRNA biology and application of disease diagnostics with miRNAs as targets.

Keywords: bi-directional extension (BDE), microRNA (miRNA), poly (A) tailing assay, reverse transcription, RT-qPCR

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Authors: Patricia Chinyere Oranefo

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This study examined the effect of sustainability accounting disclosure on financial performance of listed Brewery firms in Nigeria. The dearth of empirical evidence and literature on “governance disclosure” as one of the explanatory variables of sustainability accounting reporting were the major motivation for this study. The main objective was to ascertain the effect of sustainability accounting disclosure on financial performance of listed Brewery firms in Nigeria. An ex–post facto research design approach was adopted for the study. The population of this study comprises of five (5) Brewery firms quoted on the floor of the Nigeria exchange group (NSX) and the sample size of four (4) listed firms was drawn using purposive sampling method. Secondary data were carefully sourced from the financial statement/annual reports and sustainability reports from 2012 to 2021 of the Brewery firms quoted on the Nigeria exchange group (NSX). Panel regression analysis by aid of E-views 10.0 software was used to test for statistical significance of the effect of sustainability accounting disclosure on financial performance of listed Brewery firms in Nigeria. The results showed that economic sustainability disclosure indexes do not significantly affect return on asset of listed Brewery firms in Nigeria. The findings further revealed that environmental sustainability disclosure indexes do not significantly affect return on equity of listed Brewery firms in Nigeria. More so, results showed that Social Sustainability disclosure indexes significantly affect Net Profit Margin of listed Brewery firms in Nigeria. Finally, the result established also that governance sustainability disclosure indexes do not significantly affect Earnings per share of listed Brewery firms in Nigeria. Consequent upon the findings, this study recommended among others; that managers of Brewers in Nigeria should improve and sustain full disclosure practices on economic, environmental, social and governance disclosures following the guidelines of the Global Reporting Index (GRI) as they are capable of exerting significant effect on financial performance of firms in Nigeria.

Keywords: sustainability, accounting, disclosure, financial performance

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Authors: Vidhi Chandra, Arshpreet Singh Grewal

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A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

Procedia PDF Downloads 105

Authors: Catherine Harrison

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Faced with arrest, imprisonment and the denazification process in 1945, Tübingen University’s Professor of Theology, Gerhard Kittel, refused to abandon the “Christian” antisemitism which he had first expounded in his Die Judenfrage [The Jewish Question] (1933 and 1934). At the heart of this paper is a critical engagement with Die Judenfrage, the first in English. Putting Die Judenfrage into dialogue with Kittel’s 1946, Meine Verteidigung [My Defence] (1945-6) exposes the remarkable consistency of Kittel’s idiosyncratic but closely argued Christian theology of antisemitism. Girdling his career as a foremost theologian, antisemite and enthusiastic supporter of Hitler and the NSDAP, the consistency between Die Judenfrage and Meine Verteidigung attests Kittel’s consistent and authentic, intellectual position. In both texts, he claims to be advancing Christian, as opposed to “vulgar” or racial, antisemitism. Yet, in the thirteen years which divide them, Kittel had mediated contact with Nazi illuminati Rudolph Hess, Alfred Rosenberg, Winnifred Wagner, Josef Goebbels and Baldur von Schirach, through his publications in various antisemitic journals. The paper argues: Die Judenfrage, as both a text and as a theme, is axiomatic to Kittel’s defence statement; and that Die Judenfrage constitutes the template of Kittel’s arcane, personal “Christian” antisemitism of which Meine Verteidigung is a faithful impression. Both are constructed on the same theologically chimeric and abstruse hypotheses regarding Volk, Spätjudentum [late Judaism] and Heilgeschichte [salvation history]. Problematising these and other definitional vagaries that make up Kittel’s “Christian” antisemitism highlight the remarkable theoretical consistency between Die Judenfrage and Meine Verteidigung. It is concluded that a deadly synergy of Nazi racial antisemitism and the New Testament antisemitism shaped Kittel’s judgement to the degree that, despite the slipstream of concentration camp footage which was shaking the foundations of post-war German academia, Meine Verteidigung is a simple restatement of the antisemitsm conveyed in Die Judenfrage.

Keywords: Gerhard Kittel, Third Reich theology, the Jewish Question, Nazi antisemitism

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Authors: Lesley Northrop, Justin DeGrazia, Jessica Greenwood

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ASPIRA Labs now offers an en-suit and ready-to-implement technology transfer solution to enable labs and hospitals that lack the resources to build it themselves to offer in-house genetic testing. This unique platform employs a patented Molecular Inversion Probe (MIP) technology that combines the specificity of a hybrid capture protocol with the ease of an amplicon-based protocol and utilizes an advanced bioinformatics analysis pipeline based on machine learning. To demonstrate its efficacy, two independent genetic tests were validated on this technology transfer platform: expanded carrier screening (ECS) and hereditary cancer testing (HC). The analytical performance of ECS and HC was validated separately in a blinded manner for calling three different types of variants: SNVs, short indels (typically, <50 bp), and large indels/CNVs defined as multi-exonic del/dup events. The reference set was constructed using samples from Coriell Institute, an external clinical genetic testing laboratory, Maine Molecular Quality Controls Inc. (MMQCI), SeraCare and GIAB Consortium. Overall, the analytical performance showed a sensitivity and specificity of >99.4% for both ECS and HC in detecting SNVs. For indels, both tests reported specificity of 100%, and ECS demonstrated a sensitivity of 100%, whereas HC exhibited a sensitivity of 96.5%. The bioinformatics pipeline also correctly called all reference CNV events resulting in a sensitivity of 100% for both tests. No additional calls were made in the HC panel, leading to a perfect performance (specificity and F-measure of 100%). In the carrier panel, however, three additional positive calls were made outside the reference set. Two of these calls were confirmed using an orthogonal method and were re-classified as true positives leaving only one false positive. The pipeline also correctly identified all challenging carrier statuses, such as positive cases for spinal muscular atrophy and alpha-thalassemia, resulting in 100% sensitivity. After confirmation of additional positive calls via long-range PCR and MLPA, specificity for such cases was estimated at 99%. These performance metrics demonstrate that this tech-transfer solution can be confidently internalized by clinical labs and hospitals to offer mainstream ECS and HC as part of their test catalog, substantially increasing access to quality germline genetic testing for labs of all sizes and resources levels.

Keywords: clinical genetics, genetic testing, molecular genetics, technology transfer

Procedia PDF Downloads 178

Authors: Huixuan Xu

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The present study was set out to investigate the extent to which and how service-learning fostered a sample of 138 Hong Kong undergraduates’ interpersonal competence and cooperative orientation development. Interpersonal competence is presented when an individual shows empathy with others, provides intelligent advice to others and has practical judgment. Cooperative orientation reflects individuals’ willingness to work with others to achieve common goals. A quality service-learning programme may exhibit the features of provision of meaningful service, close link to curriculum, continuous reflection, youth voice, and diversity. Mixed methods were employed in the present study. Pre-posttest survey was administered to capture individual undergraduates’ development of interpersonal competence and cooperative orientation over a period of four months. The respondents’ evaluation of service-learning elements was administered in the post-test survey. Focus groups were conducted after the end of the service-learning to further explore how the certain service-learning elements promoted individual undergraduates’ development of interpersonal competence and cooperative orientation. Three main findings were reported from the study. (1) The scores of interpersonal competence increased significantly from the pretest to the posttest, while the change of cooperative orientation was not significant. (2) Cooperative orientation and interpersonal competence were correlated positively with the overall course quality respectively, which suggested that the more a service-learning course complied with quality practice, the students became more competent in interpersonal competence and cooperative orientation. (3) The following service-learning elements showed higher impacts: (a) direct contact with service recipients, which engaged students in practicing interpersonal skills; (b) individual participants’ being exposed to a situation that required communication and dialogue with people from diverse backgrounds with different views; (c) experiencing interpersonal conflicts among team members and having the conflicts solved; (d) students’ taking a leading role in a project-based service. The present study provides compelling evidence about what elements in a service-learning program may foster undergraduates’ development of cooperative orientation and interpersonal competence. Implications for the design of service-learning programmes are provided.

Keywords: undergraduates, interpersonal competence, cooperation orientation, service-learning

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Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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Authors: Duy Nguyen Do, Bart Julien Dewancker

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Many Soviet-style collective housing complexes (also known as KTT) were built since the 1960s in Hanoi to support the post-war population growth. Those low-rise buildings have created well-knitted, robust communities, so much to the point that in most complexes, all families in one housing block would know each other, occasionally interact and provide supports in need. To understand how the community of collective housing complexes have developed and maintained in order to adapt their advantages into modern housing designs, the study is executed on the site of Nguyen Cong Tru KTT. This is one of the oldest KTT in Hanoi, completed in 1954. The complex also has an unique characteristic that is closely related to its community: the symbiotic relationship with Hom – a flea market that has been co-developing with Nguyen Cong Tru KTT since its beginning. The research consists of three phases: the first phase is a sociological investigation with Nguyen Cong Tru KTT’s current residents and a site survey on the complex’s economic and architectural characteristics. In the second phase, the collected data is analyzed to find out people’s opinions with the KTT’s concerning their satisfaction with the current housing status, floor plan organization, community, the relationship between the KTT’s dedicated public spaces with the flea market and their usage. Simultaneously, the master plan and gathered information regarding current architectural characteristics of the complex are also inspected. On the third phase, the analyses’ results will provide information regarding the issues, positive trends and significant historical features of the complex’s architecture in order to generate suitable proposals for the redesigning project of Nguyen Cong Tru KTT, a design focused on vitalizing modern apartments’ communities.

Keywords: collective house community, collective house public space, community-focused, redesigning Nguyen Cong Tru KTT, sociological investigation

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Authors: Maierhaba Mijiti

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Objective：The aim is to understand the relationship between the expression level of the long-non-coding RNA LINC AC008063 and the clinicopathological parameters of patients with head and neck squamous cell carcinoma (HNSCC), and to clarify the biological function of LINC AC008063 in HNSCC cells. Moreover, it provides a potential biomarker for the diagnosis, treatment, and prognosis evaluation of HNSCC. Methods: The expression level of LINC AC008063 in the HNSCC was analyzed using transcriptome sequencing data from the TCGA (The cancer genome atlas) database. The expression levels of LINC AC008063 in human embryonic lung diploid cells 2BS, human immortalized keratinocytes HACAT, HNSCC cell lines CAL-27, Detroit562, AMC-HN-8, FD-LSC-1, FaDu and WSU-HN30 were determined by real-time quantitative PCR (qPCR). RNAi (RNA interference) was introduced for LINC AC008063 knockdown in HNSCC cell lines, the localization and abundance analysis of LINC AC008063 was determined by RT-qPCR, and the biological functions were examined by CCK-8, clone formation, flow cytometry, transwell invasion and migration assays, Seahorse assay. Results: LINC AC008063 was upregulated in HNSCC tissue (P<0.001), and verified b CCK-8, clone formation, flow cytometry, transwell invasion and migration assays, Seahorse assayy qPCR in HNSCC cell lines. The survival analysis revealed that the overall survival rate (OS) of patients with high LINC AC008063 expression group was significantly lower than that in the LINC AC008063 expression group, the median survival times for the two groups were 33.10 months and 61.27 months, respectively (P=0.002). The clinical correlation analysis revealed that its expression was positively correlated with the age of patients with HNSCC (P<0.001) and positively correlated with pathological state (T3+T4＞T1+T2, P=0.03). The RT-qPCR results showed that LINC AC008063 was mainly enriched in cytoplasm (P=0.01). Knockdown of LINC AC008063 inhibited proliferation, colony formation, migration and invasion; the glycolytic capacity was significantly decreased in HNSCC cell lines (P＜0.05). Conclusion: High level of LINC AC008063 was associated with the malignant progression of HNSCC as well as promoting the important biological functions of proliferation, colony formation, migration and invasion; in particular, the glycolytic capacity was decreased in HNSCC cells. Therefore, LINC AC008063 may serve as a potential biomarker for HNSCC and a distinct molecular target to inhibit glycolysis.

Keywords: head and neck squamous cell carcinoma, oncogene, long non-coding RNA, LINC AC008063, invasion and metastasis

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Authors: Mohammad Emran, Colton Wayne, Shannon M Koehler, P. Stephen Almond, Haroon Patel

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Purpose: Assessment of anastomotic perfusion in Hirschsprung disease using Indocyanine Green (ICG)-near-infrared (NIR) fluorescence angiography. Introduction: Anastomotic stricture and leak are well-known complications of Hirschsprung pull-through procedures. Complications are due to tension, infection, and/or poor perfusion. While a surgeon can visually determine and control the amount of tension and contamination, assessment of perfusion is subject to surgeon determination. Intraoperative use of ICG-NIR enhances this decision-making process by illustrating perfusion intensity and adequacy in the pulled-through bowel segment. This technique, proven to reduce anastomotic stricture and leak in adults, has not been studied in children to our knowledge. ICG, an FDA approved, nontoxic, non-immunogenic, intravascular (IV) dye, has been used in adults and children for over 60 years, with few side effects. ICG-NIR was used in this report to demonstrate the adequacy of perfusion during transanal pullthrough for Hirschsprung’s disease. Method: 8 patients with Hirschsprung disease were evaluated with ICG-NIR technology. Levels of affected area ranged from sigmoid to total colonic Hirschsprung disease. After leveling, but prior to anastomosis, ICG was administered at 1.25 mg (< 2 mg/kg) and perfusion visualized using an NIR camera, before and during anastomosis. Video and photo imaging was performed and perfusion of the bowel was compared to surrounding tissues. This showed the degree of perfusion and demarcation of perfused and non-perfused bowel. The anastomosis was completed uneventfully and the patients all did well. Results: There were no complications of stricture or leak. 5 of 8 patients (62.5%) had modification of the plan based on ICG-NIR imaging. Conclusion: Technologies that enhance surgeons’ ability to visualize bowel perfusion prior to anastomosis in Hirschsprung’s patients may help reduce post-operative complications. Further studies are needed to assess the potential benefits.

Keywords: colonic anastomosis, fluorescence angiography, Hirschsprung disease, pediatric surgery, SPY

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Authors: Natividad Natalia Angeles Manuel

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In the Dominican Republic, American-Dominican veterans face unique challenges due to their dual identities and wartime experiences. This case study examines an 85-year-old veteran with memory impairments and emotional distress linked to military service. A neuropsychological assessment using standardized tools evaluated cognitive domains and functional abilities. Significant deficits in memory, orientation, semantic memory, and executive functions, alongside symptoms of Post-Traumatic Stress Disorder and depression, were identified. A six-month cognitive stimulation program included tailored interventions to enhance memory, attention, and executive skills through weekly sessions and group activities. Medical and physical therapy support aimed to improve overall cognitive, functional, and emotional outcomes. Follow-up evaluations showed improvements in memory retention, attention, task proficiency, and reduced depressive symptoms, highlighting the program's effectiveness in promoting emotional well-being and quality of life. Despite ongoing memory challenges and military-related nightmares, the veteran responded positively to interventions, demonstrating resilience and motivation. This study emphasizes the importance of personalized neuropsychological interventions for American-Dominican veterans in the Dominican Republic. Through assessment tools and focused cognitive stimulation strategies, healthcare providers can successfully alleviate cognitive and emotional challenges stemming from traumatic experiences in elderly veterans. Overall, integrated neuropsychological assessment and stimulation programs are shown to enhance cognitive resilience and emotional well-being, thus contributing to an enhanced quality of life for aging American-Dominican veterans.

Keywords: neuropsychology, cognitive stimulation, American-Dominican veterans, Dominican Republic, PTSD, memory deficits

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Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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Authors: Yavuz Erdoğan, Hidayet Çiftçi

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Cyberbullying, a phenomenon among adolescents, is defined as actions that use information and communication technologies such as social media to support deliberate, repeated, and hostile behaviour by an individual or group. With the advancement in communication and information technology, cyberbullying has expanded its boundaries among students in schools. Thus, parents, psychologists, educators, and lawmakers must become aware of the potential risks of this phenomenon. In the light of these perspectives, this study aims to investigate the relationships between cyberbullying perception and Facebook attitudes of Turkish students. A survey method was used for the study and the data were collected by “Cyberbullying Perception Scale”, “Facebook Attitude Scale” and “Personal Information Form”. For this purpose, study has been conducted during 2014-2015 academic year, with a total of 748 students with 493 male (%65.9) and 255 female (%34.1) from randomly selected high schools. In the analysis of data Pearson correlation and multiple regression analysis, multivariate analysis of variance (MANOVA) and Scheffe post hoc test has been used. At the end of the study, the results displayed a negative correlation between Turkish students’ Facebook attitudes and cyberbullying perception (r=-.210; p<0.05). In order to identify the predictors of students’ cyberbullying perception, multiple regression analysis was used. As a result, significant relations were detected between cyberbullying perception and independent variables (F=5.102; p<0.05). Independent variables together explain 11.0% of the total variance in cyberbullying scores. The variables that significantly predict the students’ cyberbullying perception are Facebook attitudes (t=-5.875; p<0.05), and gender (t=3.035; p<0.05). In order to calculate the effects of independent variables on students’ Facebook attitudes and cyberbullying perception MANOVA was conducted. The results of the MANOVA indicate that the Facebook attitudes and cyberbullying perception were significantly differed according to students’ gender, age, educational attainment of the mother, educational attainment of the father, income of the family and daily usage of internet.

Keywords: facebook, cyberbullying, attitude, internet usage

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: Rasoul Eslami, Reza Gharakhanlou

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NT-4/5 and TrkB have been proposed to be involved in the coordinated adaptations of the neuromuscular system to elevated level of activity. Despite the persistence of this neurotrophin and its receptor expression in adult skeletal muscle, little attention has been paid to the functional significance of this complex in the mature neuromuscular system. Therefore, the purpose of this research was to study the effect of one session of resistance exercise on mRNA expression of NT4/5 and TrkB proteins in slow and fast muscles of Wistar Rats. Male Wistar rats (10 mo of age, preparation of Pasteur Institute) were housed under similar living conditions in cages (in groups of four) at room temperature under a controlled light/dark (12-h) cycle with ad libitum access to food and water. A number of sixteen rats were randomly divided to two groups (resistance exercise (T) and control (C); n=8 for each group). The resistance training protocol consisted of climbing a 1-meter–long ladder, with a weight attached to a tail sleeve. Twenty-four hours following the main training session, rats of T and C groups were anaesthetized and the right soleus and flexor hallucis longus (FHL) muscles were removed under sterile conditions via an incision on the dorsolateral aspect of the hind limb. For NT-4/5 and TrkB expression, quantitative real time RT-PCR was used. SPSS software and independent-samples t-test were used for data analysis. The level of significance was set at P < 0.05. Data indicate that resistance training significantly (P<0.05) decreased mRNA expression of NT4/5 in soleus muscle. However, no significant alteration was detected in FHL muscle (P>0.05). Our results also indicate that no significant alterations were detected for TrkB mRNA expression in soleus and FHL muscles (P>0.05). Decrease in mRNA expression of NT4/5 in soleus muscle may be as result of post-translation regulation following resistance training. Also, non-alteration in TrkB mRNA expression was indicated in probable roll of P75 receptor.

Keywords: neurotrophin-4/5 (NT-4/5), TrkB receptor, resistance training, slow and fast muscles

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Authors: Kwok W. Mui, Ling T. Wong, Tsz W. Tsang

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Many Hong Kong people nowadays spend most of their lifetime working indoor. Since poor Indoor Air Quality (IAQ) potentially leads to discomfort, ill health, low productivity and even absenteeism in workplaces, a call for establishing statutory IAQ control to safeguard the well-being of residents is urgently required. Although policies, strategies, and guidelines for workplace IAQ diagnosis have been developed elsewhere and followed with remedial works, some of those workplaces or buildings have relatively late stage of the IAQ problems when the investigation or remedial work started. Screening for IAQ problems should be initiated as it will provide information as a minimum provision of IAQ baseline requisite to the resolution of the problems. It is not practical to sample all air pollutants that exit. Nevertheless, as a statutory control, reliable, rapid screening is essential in accordance with a compromise strategy, which balances costs against detection of key pollutants. This study investigates the feasibility of using an IAQ index as a parameter of IAQ control in Hong Kong. The index is a screening parameter to identify the unsatisfactory workplace IAQ and will highlight where a fully effective IAQ monitoring and assessment is needed for an intensive diagnosis. There already exist a number of representative common indoor pollutants based on some extensive IAQ assessments. The selection of pollutants is surrogate to IAQ control consists of dilution, mitigation, and emission control. The IAQ Index and assessment will look at high fractional quantities of these common measurement parameters. With the support of the existing comprehensive regional IAQ database and the IAQ Index by the research team as the pre-assessment probability, and the unsatisfactory IAQ prevalence as the post-assessment probability from this study, thresholds of maintaining the current measures and performing a further IAQ test or IAQ remedial measures will be proposed. With justified resources, the proposed IAQ Index and assessment protocol might be a useful tool for setting up a practical public IAQ surveillance programme and policy in Hong Kong.

Keywords: assessment, index, indoor air quality, surveillance programme

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Authors: Kajal Attri

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Introduction: Transgender people are considered third gender in India, although they still face identification issues and alienated from society. Furthermore, they face several challenges, including discrimination in employment, resources, education, and property as a result, most transgender people make a living through begging at traffic lights, trains, and buses; attending auspicious occasions such as childbirth and weddings; and engaging in sex work, which includes both home-based and street-based sex work. During COVID-19, maintaining social distance exacerbates transgender people's circumstances and prevents them from accessing health care services, sexual reassignment surgery, identity-based resources, government security, and financial stability. Nonetheless, the pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. This study focuses on how we missed transgender people during COVID-19 to provide better facilities to cope with this situation when they are already the most vulnerable segment of the society. Methodology: The research was conducted using secondary data from published publications and grey literature obtained from four databases: Pubmed, Psychinfo, Science direct, and Google scholar. The literature included total 25 articles that met the inclusion criteria for a review. Result and Discussion: Transgender people, who are considered the most vulnerable sector of society, have already faced several obstacles as a result of the outbreak. The analysis underscores the difficulties that transgender persons faced during COVID-19, such as, They had trouble accessing the government's social security programmes during the lockdown, which provide rations and pensions since they lack the necessary identifying cards. The impact of COVID-19 leaves transgender people at heightened risk of poverty and ill health because they exist on the margins of society, those livelihood base on sex work, begging, and participation on auspicious occasions. They had a significant risk of contracting SARS-CoV2 because they lived in congested areas or did not have permanent shelter, and they were predominantly infected with HIV, cancer, and other non-communicable illnesses. The pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. Conclusion: The study comes forward with useful suggestions based on content analysis and information to reduce the existing woes of transgenders during any pandemic like COVID-19.

Keywords: COVID-19, transgender, lockdown, transwomen, stigmatization

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Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

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Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

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