Search results for: case studies

Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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Authors: Jae-Yong Park, Yeo-Kyeong Lee, Hee-Sun Kim

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Purpose: This study aims at investigating the mechanical behaviors of mastication, according to various teeth movement. There are three masticatory cases which are general case and 2 cases of teeth movement. General case includes the common arrange of all teeth and 2 cases of teeth movement are that one is the half movement location case of molar teeth in no. 14 tooth seat after extraction of no. 14 tooth and the other is no. 14 tooth seat location case of molar teeth after extraction in the same case before. Materials and Methods: In order to analyze these cases, 3 dimensional finite element (FE) model of the skull were generated based on computed tomography images, 964 dicom files of 38 year old male having normal occlusion status. An FE model in general occlusal case was used to develop CAE procedure. This procedure was applied to FE models in other occlusal cases. The displacement controls according to loading condition were applied effectively to simulate occlusal behaviors in all cases. From the FE analyses, von Mises stress distribution of skull and teeth was observed. The von Mises stress, effective stress, had been widely used to determine the absolute stress value, regardless of stress direction and yield characteristics of materials. Results: High stress was distributed over the periodontal area of mandible under molar teeth when the mandible was transmitted to the coronal-apical direction in the general occlusal case. According to the stress propagation from teeth to cranium, stress distribution decreased as the distribution propagated from molar teeth to infratemporal crest of the greater wing of the sphenoid bone and lateral pterygoid plate in general case. In 2 cases of teeth movement, there were observed that high stresses were distributed over the periodontal area of mandible under teeth where they are located under the moved molar teeth in cranium. Conclusion: The predictions of the mechanical behaviors of general case and 2 cases of teeth movement during the masticatory process were investigated including qualitative validation. The displacement controls as the loading condition were applied effectively to simulate occlusal behaviors in 2 cases of teeth movement of molar teeth.

Keywords: cranium, finite element analysis, mandible, masticatory action, occlusal force

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Authors: Nkechi V. Osuji

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The use of blockchain to address the issue of climate change is increasingly a discourse among countries, industries, and stakeholders. For a long time, the European Union (EU) has been combating the issue of climate action in industries through sustainability programs. One of such programs is the EU monitoring reporting and verification (MRV) program of the EU ETS. However, the system has some key challenges and areas for improvement, which makes it inefficient. The main objective of the research is to look at how blockchain can be used to improve the inefficiency of the EU ETS program for the Danish energy industry with a focus on its monitoring and reporting framework. Applying empirical data from 13 semi-structured expert interviews, three case studies, and literature reviews, three outcomes are presented in the study. The first is on the current conditions and challenges of monitoring and reporting CO₂ emission trading. The second is putting into consideration if blockchain is the right fit to solve these challenges and how. The third stage looks at the factors that might affect the implementation of such a system and provides recommendations to mitigate these challenges. The first stage of the findings reveals that the monitoring and reporting of CO₂ emissions is a mandatory requirement by law for all energy operators under the EU ETS program. However, most energy operators are non-compliant with the program in reality, which creates a gap and causes challenges in the monitoring and reporting of CO₂ emission trading. Other challenges the study found out are the lack of transparency, lack of standardization in CO₂ accounting, and the issue of double-counting in the current system. The second stage of the research was guided by three case studies and requirement engineering (RE) to explore these identified challenges and if blockchain is the right fit to address them. This stage of the research addressed the main research question: how can blockchain be used for monitoring and reporting CO₂ emission trading in the energy industry. Through analysis of the study data, the researcher developed a conceptual private permissioned Hyperledger blockchain and elucidated on how it can address the identified challenges. Particularly, the smart contract of blockchain was highlighted as a key feature. This is because of its ability to automate, be immutable, and digitally enforce negotiations without a middleman. These characteristics are unique in solving the issue of compliance, transparency, standardization, and double counting identified. The third stage of the research presents technological constraints and a high level of stakeholder collaboration as major factors that might affect the implementation of the proposed system. The proposed conceptual model requires high-level integration with other technologies such as the Internet of Things (IoT) and machine learning. Therefore, the study encourages future research in these areas. This is because blockchain is continually evolving its technology capabilities. As such, it remains a topic of interest in research and development for addressing climate change. Such a study is a good contribution to creating sustainable practices to solve the global climate issue.

Keywords: blockchain, carbon emission trading, European Union emission trading system, monitoring and reporting

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Authors: Palash Dutta

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More frequently uncertainties are encountered in medical diagnosis and therefore it is the most important and interesting area of applications of fuzzy set theory. In this present study, an attempt has been made to extend Sanchez’s approach for medical diagnosis via interval valued picture fuzzy sets and exhibit the technique with suitable case studies. In this article, it is observed that a refusal can be expressed in the databases concerning the examined objects. The technique is performing diagnosis on the basis of distance measures and as a result, this approach makes it possible to introduce weights of all symptoms and consequently patient can be diagnosed directly.

Keywords: medical diagnosis, uncertainty, fuzzy set, picture fuzzy set, interval valued picture fuzzy set

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Authors: Andrew Adjah Sai, Portia Opoku Boadi

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Explaining change is an abstract endeavor. Many management scholars have adopted metaphors to explain change. In this paper, we deal with the drivers of technological change. We use a historical and theoretical approach to review and elaborate on the concepts and context about a specific case. We discuss the limitations of each approach proffered and the implications as a consequence on technological change. We present plurality and multiplicity of perspectives using a socio-technical approach to explain technological change contextually on an organizational level. We show by using our model how technology absorption and diffusion can be accelerated through artefactual institutions to enable social change. The multiplicity of perspectives and plurality of our arguments creates a fine explanation of the e-Estonia case as an example.

Keywords: artefactual institutions, e-Estonia, social change, technological trajectories

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Authors: A. Shahsavar, Z. Jakub

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Due to the outstanding properties of the 2D metal-organic frameworks (MOF), intensive computational and experimental studies have been done. However, the lack of fundamental studies of MOFs on the graphene backbone is observed. This work studies Fe and Ni as metal and tetracyanoquinodimethane (TCNQ) with a high electron affinity as an organic linker functionalized on graphene. Here we present DFT calculations results to unveil the electronic and magnetic properties of iron and nickel-TCNQ physisorbed on graphene. Adsorption and Fermi energies, structural, and magnetic properties will be reported. Our experimental observations prove Fe- and NiTCNQ@Gr/Ir(111) are thermally highly stable up to 500 and 250°C, respectively, making them promising materials for single-atom catalysts or high-density storage media.

Keywords: DFT, graphene, MTCNQ, self-assembly

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Authors: Micael Sousa

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Board games (BGs) are thriving as new designs emerge from the hobby community to greater audiences all around the world. Although digital games are gathering most of the attention in game studies and serious games research fields, the post-digital movement helps to explain why in the world dominated by digital technologies, the analog experiences are still unique and irreplaceable to users, allowing innovation in new hybrid environments. The BG’s new designs are part of these post-digital and hybrid movements because they result from the use of powerful digital tools that enable the production and knowledge sharing about the BGs and their face-to-face unique social experiences. These new BGs, defined as modern by many authors, are providing innovative designs and unique game mechanics that are still not yet fully explored by the main serious games (SG) approaches. Even the most established frameworks settled to address SG, as fun games implemented to achieve predefined goals need more development, especially when considering modern BGs. Despite the many anecdotic perceptions, researchers are only now starting to rediscover BGs and demonstrating their potentials. They are proving that BGs are easy to adapt and to grasp by non-expert players in experimental approaches, with the possibility of easy-going adaptation to players’ profiles and serious objectives even during gameplay. Although there are many design thinking (DT) models and practices, their relations with SG frameworks are also underdeveloped, mostly because this is a new research field, lacking theoretical development and the systematization of the experimental practices. Using BG as case studies promise to help develop these frameworks. Departing from the Design, Experience, and Play (DPE) framework and considering the Common Design Think Tools (CDST), this paper proposes a new experimental framework for the adaptation and development of modern BG design for DT: the Design, Experience, and Play for Think (DPET) experimental framework. This is done through the systematization of the DPE and CDST approaches applied in two case studies, where two different sequences of adapted BG were employed to establish a DT collaborative process. These two sessions occurred with different participants and in different contexts, also using different sequences of games for the same DT approach. The first session took place at the Faculty of Economics at the University of Coimbra in a training session of serious games for project development. The second session took place in the Casa do Impacto through The Great Village Design Jam light. Both sessions had the same duration and were designed to progressively achieve DT goals, using BGs as SGs in a collaborative process. The results from the sessions show that a sequence of BGs, when properly adapted to address the DPET framework, can generate a viable and innovative process of collaborative DT that is productive, fun, and engaging. The DPET proposed framework intents to help establish how new SG solutions could be defined for new goals through flexible DT. Applications in other areas of research and development can also benefit from these findings.

Keywords: board games, design thinking, methodology, serious games

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Authors: Doua AlSaad, Ahmed Awaisu, Samah Elsalem, Palli Valapila Abdulrouf, Binny Thomas, Moza AlHail

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Background: It has been suggested that pyridoxine has an anti-lactogenic effect. Studies of the efficacy of pyridoxine in suppressing lactation have reported conflicting results. The aim of this review is to evaluate the effectiveness and safety of high-dose pyridoxine in postpartum lactation inhibition. Methods: This systematic review included published trials that compared the efficacy and/or safety of pyridoxine to placebo or to other pharmacological agents for the inhibition of postpartum lactation. We searched PubMed, Embase, ScienceDirect, CINAHL, AMED, the Cochrane library, and the clinical trials registry to identify relevant literature. No limit was imposed on the year of publication of the studies, and the review included studies published until 15 January 2016. Two reviewers independently extracted data and assessed the risk of bias. Results: Seven studies were included, with a total of 1155 women, of which 471 women received pyridoxine. Three studies were randomized controlled trials, while the remaining four studies were non-randomized controlled trials. All of the included studies were relatively small (n = 18 – 482). The studies compared pyridoxine with placebo, bromocriptine, and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450 – 600 mg for 5 to 7 days. Two trials (n = 349 participants) indicated that pyridoxine was effective in inhibiting lactation in approximately 95% of the enrolled patients. All other studies failed to demonstrate pyridoxine efficacy through either clinical assessment or prolactin level measurements. Pyridoxine safety was assessed by two trials in which no serious untoward side-effects were reported. Overall, the risk of bias for most of the studies was low to moderate. Conclusion: Current evidence supporting the effectiveness of high dose pyridoxine in the inhibition of postpartum lactation is inconsistent and insufficient. Larger randomized trials are needed to confirm the efficacy of pyridoxine in postpartum lactation inhibition. Acknowledgment: This review received a grant from the Medical Research Center of Hamad Medical Corporation in Qatar (grant number: 15100/15).

Keywords: pyridoxine, safety, effectiveness, lactation inhibition

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Authors: Lynn Mcquarrie, Charlotte Enns

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The goal of this project was to develop a visually-based, signed language phonological awareness training program and to pilot the intervention with signing deaf children (ages 6 -10 years/ grades 1 - 4) who were beginning readers to assess the effects of systematic explicit American Sign Language (ASL) phonological instruction on both ASL vocabulary and English print vocabulary learning. Growing evidence that signing learners utilize visually-based signed language phonological knowledge (homologous to the sound-based phonological level of spoken language processing) when reading underscore the critical need for further research on the innovation of reading instructional practices for visual language learners. Multiple single-case studies using a multiple probe design across content (i.e., sign and print targets incorporating specific ASL phonological parameters – handshapes) was implemented to examine if a functional relationship existed between instruction and acquisition of these skills. The results indicated that for all cases, representing a variety of language abilities, the visually-based phonological teaching approach was exceptionally powerful in helping children to build their sign and print vocabularies. Although intervention/teaching studies have been essential in testing hypotheses about spoken language phonological processes supporting non-deaf children’s reading development, there are no parallel intervention/teaching studies exploring hypotheses about signed language phonological processes in supporting deaf children’s reading development. This study begins to provide the needed evidence to pursue innovative teaching strategies that incorporate the strengths of visual learners.

Keywords: American sign language phonological awareness, dual language strategies, vocabulary learning, word reading

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Authors: Mohammed Saad Alanazi

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Satisfaction of travelers with services provided in the airports is a sign of competitiveness and the corporate image of the airport. This study conducted a systematic literature review of recent studies published after 2017 regarding the factors that positively influence travelers’ satisfaction and encourage them to report positive reviews online. This study found variations among the studies found. They used several research methodologies, and datasets and focused on different airports, yet, they commonly categorized airport services into seven categories that should receive high intention because their qualities were found increasing review rate and positivity. It was found that studies targeting travelers’ satisfaction and intention of revisiting tended to use primary sources of data (survey); meanwhile, studies concerned positivity and negativity of comments towards airport services often used online reviews provided by travelers.

Keywords: business Intelligence, airport service quality, passenger satisfaction, thorough analysis

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Authors: Godfrey Nsereko, Daniel Kadobera, Denis Okethwangu, Joyce Nguna, Alex Riolexus Ario

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Background: Malaria is a leading cause of morbidity and mortality in Uganda. In April 2018, malaria cases surged in Nwoya District, northern Uganda, exceeding the action thresholds. We investigated to assess the outbreak’s magnitude, identify transmission risk factors, and recommend evidence-based control measures. Methods: We defined a malaria case as onset of fever in a resident of Nwoya District with a positive Rapid Diagnostic Test or microscopy for malaria P. falciparum from 1 February to 22 May 2018. We reviewed medical records in all health facilities of affected sub-counties to find cases. In a case-control study, we compared exposure risk factors between 107 case-persons and 107 asymptomatic controls matched by age and village. We conducted entomological assessment on vector-density and behavior. Results: We identified 3,879 case-persons (attack rate [AR]=6.5%) and 2 deaths (case-fatality rate=5.2/10,000). Females (AR=8.1%) were more affected than males (AR=4.7%). Of all age groups, the 5-18 year age group (AR=8.4%) was most affected. Heavy rain started on 4 March; a propagated outbreak began during the week of 2 April. In the case-control study, 55% (59/107) of case-patients and 18% (19/107) of controls had stagnant water around households for several days following rainfall (ORM-H=5.6, 95%CI=3.0-11); 25% (27/107) of case-patients and 51% (55/107) of controls wore long-sleeve cloths during evening hours (ORM-H=0.30, 95%CI=0.20-0.60); 29% (31/107) of case-patients and 15% (16/107) of controls did not sleep under a long-lasting insecticide-treated net (LLIN) (ORM-H=2.3, 95%CI=1.1-4.9); 37% (40/107) of case-patients and 52% (56/107) of controls had ≥1 LLIN per 2 household members (ORM-H=0.54, 95%CI=0.30-0.97). Entomological assessment indicated active breeding sites; Anopheles gambiae sensu lato species were the predominant vector. Conclusion: Increased vector breeding sites after heavy rainfall, together with inadequate malaria preventive measures caused this outbreak. We recommended increasing coverage for LLINs and larviciding breeding sites.

Keywords: malaria outbreak, Plasmodium falciparum, global health security, Uganda

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Authors: Flavia Magliacani

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The urbanization of the last decades and its resulting urban growth entail problems both for environmental and economic sustainability. From this perspective, sustainable settlement development requires a horizontal decrease in the existing urban structure in order to enhance its greater concentration. Hence, new stratifications of the city fabric and architectural strategies ensuring high-density settlement models are possible solutions. However, although increasing housing density is necessary, it is not sufficient. Guaranteeing the quality of living is, indeed, equally essential. In order to meet this objective, many other factors come to light, namely the relationship between private and public spaces, the proximity to services, the accessibility of public transport, the local lifestyle habits, and the social needs. Therefore, how to safeguard both quality and density in human habitats? The present paper attempts to answer the previous main research question by addressing several sub-questions: Which architectural types meet the dual need for urban density and housing quality? Which project criteria should be taken into consideration by good design practices? What principles are desirable for future planning? The research will analyse different architectural responses adopted in four European cities: Paris, Lion, Rotterdam, and Amsterdam. In particular, it will develop a qualitative and comparative study of two specific architectural solutions which integrate housing density and quality living. On the one hand, the so-called 'self-contained city' model, on the other hand, the French 'Habitat Dense Individualisé' one. The structure of the paper will be as follows: the first part will develop a qualitative evaluation of some case studies, emblematic examples of the two above said architectural models. The second part will focus on the comparison among the chosen case studies. Finally, some conclusions will be drawn. The methodological approach, therefore, combines qualitative and comparative research. Parameters will be defined in order to highlight potential and criticality of each model in light of an interdisciplinary view. In conclusion, the present paper aims at shading light on design approaches which ensure a right balance between density and quality of the urban living in contemporary European cities.

Keywords: density, future design, housing quality, human habitat

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Authors: Dorra Kallel, Ines Kanoun, Diala Dhouib

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This paper elaborates a Systematic Literature Review SLR) to select the most outstanding studies that address the Menu Planning Problem (MPP) and to classify them according to the to the three following criteria: the used methods, types of patients and the required constraints. At first, a set of 4165 studies was selected. After applying the SLR’s guidelines, this collection was filtered to 13 studies using specific inclusion and exclusion criteria as well as an accurate analysis of each study. Second, the selected papers were invested to answer the proposed research questions. Finally, data synthesis and new perspectives for future works are incorporated in the closing section.

Keywords: Menu Planning Problem (MPP), Systematic Literature Review (SLR), classification, exact and approaches methods

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Authors: Qin Dai

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The renovation of existing interior space is big issue for architects in today’s China. However the traditional way of space renovation in China mostly focuses on the object itself, and the method also focuses on subjective level without the support of specific data. This research focuses the application of renovation of existing interior space based on post occupancy evaluation by a case study of a typical interior space. The research hopes to give a more scientific method of interior space renovation for architects and help promoting and guiding renovation practice. This research studies the post occupancy evaluation of the atrium space of Zhejiang University Library including subjective satisfaction and physical environmental satisfaction. The result provides necessary data support to conclude the design principles and strategies of renovation. Then the research uses simulation software to verify the availability of the strategy given based on the study. In conclusion, the research summarizes the application process of design methods of renovation of existing interior space based on the post-occupancy evaluation, and testifies to the practical significance of the renovation of existing interior space.

Keywords: existing interior space, physical environmental satisfaction, post occupancy evaluation, renovation of space, subjective satisfaction of space

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Authors: Anna-Maria Saarela

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At the Savonia University of Applied Sciences (UAS), curriculum and studies have been improved by applying an Open Innovation Space approach (OIS). It is based on multidisciplinary action learning. The key elements of OIS-ideology are work-life orientation, and student-centric communal learning. In this approach, every participant can learn from each other and innovations will be created. In this social innovation educational approach, all practices are carried out in close collaboration with enterprises in real-life settings, not in classrooms. As an example, in this paper, Savonia UAS’s Future Food RDI hub (FF) shows how OIS practices are implemented by providing food product development and consumer research services for enterprises in close collaboration with academicians, students and consumers. In particular one example of OIS experimentation in the field is provided by a consumer research carried out utilizing verbal analysis protocol combined with audio-visual observation (VAP-WAVO). In this case, all co-learners were acting together in supermarket settings to collect the relevant data for a product development and the marketing department of a company. The company benefitted from the results obtained, students were more satisfied with their studies, educators and academicians were able to obtain good evidence for further collaboration as well as renewing curriculum contents based on the requirements of working life. In addition, society will benefit over time as young university adults find careers more easily through their OIS related food science studies. Also this knowledge interaction model re-news education practices and brings working-life closer to educational research institutes.

Keywords: collaboration, education, food science, industry, knowledge transfer, RDI, student

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Authors: Sadia Munir

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Preeclampsia is the contributor to the worldwide maternal mortality of approximately 100,000 deaths a year. It complicates about 10% of all pregnancies and is the first cause of maternal admission to intensive care units. Predicting preeclampsia is a major challenge in obstetrics. More importantly, no major progress has been achieved in the treatment of preeclampsia. As placenta is the main cause of the disease, the only way to treat the disease is to extract placental and deliver the baby. In developed countries, the cost of an average case of preeclampsia is estimated at £9000. Interestingly, preeclampsia may have an impact on the health of mother or infant, beyond the pregnancy. We performed a systematic search of PubMed including the combination of terms such as preeclampsia, biomarkers, treatment, hypoxia, inflammation, oxidative stress, vascular endothelial growth factor A, activin A, inhibin A, placental growth factor, transforming growth factor β-1, Nodal, placenta, trophoblast cells, microRNAs. In this review, we have summarized current knowledge on the identification of potential biomarkers for the diagnosis of preeclampsia. Although these studies show promising data in early diagnosis of preeclampsia, the current value of these factors as biomarkers, for the precise prediction of preeclampsia, has its limitation. Therefore, future studies need to be done to support some of the very promising and interesting data to develop affordable and widely available tests for early detection and treatment of preeclampsia.

Keywords: activin, biomarkers, growth factors, miroRNA

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Authors: Yrfet Shkreli

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To determine the content of human rights norms in national constitutions, international law - in the form of treaties, declarations and case law from international monitoring bodies, and comparative case law from other countries - is often discussed in the judgments of domestic courts. This paper explores the extent to which international law has influenced domestic human rights case law in Africa. The paper first explores how the human rights provisions of African constitutions came into being before turning to the role played by international law in the constitutional order of various African states and how treaties, declarations and findings of international monitoring bodies have been used in African countries to interpret and expand on constitutional human rights provisions.

Keywords: European Union, global governance, globalization, normative power

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Authors: Ranjana Dani

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Brand communication narratives in India has evolved today to reflect the vibrant and intriguing tone of voice inspired by a rich cultural heritage while addressing the culturally alert attitude of the contemporary global Indian. Brands are strongly associated with the organization's values, vision, and mission and portray this through specific ‘look and feel’ and ‘tone of voice’. It is within the brand’s visual language that COLOUR has evolved to become a most powerful weapon in the designer’s arsenal. Color is big business in Brand Design! A brand is a ‘collection of perceptions’, meaningful brand connect is about striving to occupy head and heart space in consumers. The persona of the young Indian reflects a deep attachment to cultural roots as seen through the characteristic of ‘Indie Pride,’ blended with the ambitious, aspirational traits of a modern ‘global citizen’.Studies on ‘Color Perceptions’ indicate a trend that amplifies this, and hence brands reflect a GLOCAL palette, a Global and Local Blend. This paper establishes this through case studies that expand the inspirations, selection processes, and use of innovative color palettes crafted by some dynamic brand designers. This throws light on the role of color as it generates visual impact and recall for successful brands.

Keywords: colour palettes, brand design and business, cultural context, colour perceptions, glocal, contemporaneity

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Authors: Farah Al Zaabi, Sarah Amrani

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Complex regional pain syndrome (CRPS) is a chronic pain condition that develops in an extremity following a fracture, soft tissue injury, or surgery. It is a neuropathic pain disorder that is accompanied by the characteristic skin manifestations that are needed for the diagnosis. We report the case of a 30 year old male, who has findings consistent with CRPS and has been followed for over two years by multiple specialties within the healthcare system without obtaining a diagnosis. The symptoms he presented with were treated based on the specialty he was seeing, rather than unified and recognized as a single disease process. Our case highlights the complexity of chronic pain, which can sometimes present with skin manifestations, and the importance of involving a pain specialist early for both the medical and physical recovery of CRPS patients.

Keywords: complex regional pain syndrome, chronic pain, skin changes of CRPS, dermatological manifestions of CRPS

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Authors: Kate Duggan

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Introduction: Functional Communication Training (FCT) is an approach which aims to reduce behaviours of concern by teaching more effective ways to communicate. It requires identification of the function of the behaviour of concern, through gathering information from key stakeholders and completing observations of the individual’s behaviour including antecedents to, and consequences of the behaviour. Appropriate communicative alternatives are then identified and taught to the individual using systematic instruction techniques. Behaviours of concern demonstrated by individuals with autism spectrum conditions (ASC) frequently have a communication function. When contributing to positive behavior support plans, speech and language therapists and other professionals working with individuals with ASC need to identify alternative communicative behaviours which are equally reinforcing as the existing behaviours of concern. Successful implementation of FCT is dependent on an effective ‘response match’. The new way of communicating must be equally as effective as the behaviour previously used and require the same amount or less effort from the individual. It must also be understood by the communication partners the individual encounters and be appropriate to their communicative contexts. Method: Four case studies within a non-maintained special school environment were described and analysed. A response match framework was used to identify the effectiveness of functional communication training delivered by the student’s speech and language therapist, teacher and learning support assistants. The success of systematic instruction techniques used to develop new communicative behaviours was evaluated using the CODES framework. Findings: Functional communication training can be used as part of a positive behaviour support approach for students within this setting. All case studies reviewed demonstrated ‘response success’, in that the desired response was gained from the new communicative behaviour. Barriers to the successful embedding of new communicative behaviours were encountered. In some instances, the new communicative behaviour could not be consistently understood across all communication partners which reduced ‘response recognisability’. There was also evidence of increased physical or cognitive difficulty in employing the new communicative behaviour which reduced the ‘response effectivity’. Successful use of ‘thinning schedules of reinforcement’, taught students to tolerate a delay to reinforcement once the new communication behaviour was learned.

Keywords: augmentative and alternative communication, autism spectrum conditions, behaviours of concern, functional communication training

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Authors: Bakr Gomaa

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Wind driven Cross ventilation is achieved when air moves indoors due to the pressure difference on the building envelope. This is especially important in breezy moderate to humid settings in which fast air flow can promote thermal comfort. Studies have shown that the use of simple building forms or ignoring the urban context when studying natural ventilation can lead to inaccurate results. In this paper, the impact of the urban form of a regular array of buildings is investigated to define the impact of this urban setting on cross ventilation potential. The objective of this paper is to provide the necessary tools to achieve natural ventilation for cooling purposes in an array of building blocks context. The array urban form has been studied before for natural ventilation purposes yet to the best of our knowledge no study has considered the relationship between the urban form and the pressure patterns that develop on the buildings envelope for cross ventilation. For this we use detailed weather data for a case study city of Alexandria (Egypt), as well as a validated CFD simulations to investigate the cross ventilation potential in terms of pressure patterns in waterfront as well as in-city wind flows perpendicular to the buildings array. it was found that for both waterfront and in-city wind speeds the windows needed for cross ventilation in rear raws of the array are significantly larger than those needed for front raw.

Keywords: Alexandria, CFD, cross ventilation, pressure coefficient

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Authors: Betzabet García-Mendoza, Rocío Abascal-Mena

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Breast and cervical cancer are among the leading causes of death of women in Mexico. The mortality rate for these diseases is alarming, even though there have been many campaigns for making people self-aware of the importance of conducting gynecological studies for a timely prevention and detection, these have not been enough. This paper presents a mobile application for organizing and controlling gynecological studies in order to help and boost women to take care of their bodies and health. The process of analyzing and designing the mobile application is presented, along with all the steps carried out by following a user-centered design methodology.

Keywords: breast cancer, cervical cancer, gynecological mobile application, paper prototyping, storyboard, women health

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Authors: Gajanan M. Sonwane

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Nowadays, the entire pharmaceutical industry is facing the challenge of increasing efficiency and innovation. The major hurdles are the growing cost of research and development and a concurrent stagnating number of new chemical entities (NCEs). Hence, the challenge is to select the most druggable targets and to search the equivalent drug-like compounds, which also possess specific pharmacokinetic and toxicological properties that allow them to be developed as drugs. The present research work includes the studies of developing new anticancer heterocycles by using molecular modeling techniques. The heterocycles synthesized through such methodology are much effective as various physicochemical parameters have been already studied and the structure has been optimized for its best fit in the receptor. Hence, on the basis of the literature survey and considering the need to develop newer anticancer agents, new phenazinamine derivatives were designed by subjecting the nucleus to molecular modeling, viz., GQSAR analysis and docking studies. Simultaneously, these designed derivatives were subjected to in silico prediction of biological activity through PASS studies and then in silico toxicity risk assessment studies. In PASS studies, it was found that all the derivatives exhibited a good spectrum of biological activities confirming its anticancer potential. The toxicity risk assessment studies revealed that all the derivatives obey Lipinski’s rule. Amongst these series, compounds 4c, 5b and 6c were found to possess logP and drug-likeness values comparable with the standard Imatinib (used for anticancer activity studies) and also with the standard drug methotrexate (used for antimitotic activity studies). One of the most notable mutations is the threonine to isoleucine mutation at codon 315 (T315I), which is known to be resistant to all currently available TKI. Enzyme assay planned for confirmation of target selective activity.

Keywords: drug design, tyrosine kinases, anticancer, Phenazinamine

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Authors: Achutha Raman

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Today's brave new world features a bonanza of digitally interconnected products, or ‘things,’ that improve convenience, possibilities, and in some cases efficiency for consumers. Nonetheless, even as the market accelerates, this Internet of ‘things’ is subject to substantial leakage of consumer personal data. First defining the fluid concept of ‘things,’ this paper subsequently uses case studies taken from the EU, Asia, and the US, to highlight large gaps and comprehensively evaluate the state of security for consumer ‘things.’ Ultimately, this paper offers several ways of improving the present status quo, and especially focuses on an evaluative approach that augments the standard mechanism of Firmware Over the Air Updates, and ought to be easily implementable.

Keywords: cybersecurity, FOTA, Internet of Things, transnational privacy

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Authors: Halimah Al Hifzi, Waseem Al-Talalwah, Shorok Al Dorazi, Hassan Al Mousa, Zainab Al-Hashim, Roger Soames

Abstract:

The obturator artery is one branches of anterior division of the internal iliac artery. It passes on the lateral wall of pelvis to escape into thigh region via obturator foremen. Based on previous research studies, it found to be extremely variable in origin and course. It may arise from internal or external iliac artery. The current study includes 82 dissected specimens to investigate the origin of the obturator artery and explain the clinical importance. The obturator artery arises from the internal iliac artery in 75% either from its anterior or posterior division in 46.9% or 25% respectively. Further, it arises neither from the anterior nor posterior division of the internal iliac artery but it arises between them in 3.1%. In 25%, the obturator artery arises from the external iliac artery. In case of aneurysmectomy of posterior division, carries a high risk of insufficient of vascular supply for demand structures such as proximal adductors attachment and hip joint. Therefore, vascular surgeons have to pay attention to the posterior division being an origin of the obturator artery beside its usual three classical branches: superior gluteal, iliolumbar and lateral sacral arteries. Further, the obturator artery arising from the external iliac system is in great dangerous of laceration in case of anterior pelvic fracture. Therefore, it may lead to haemorrhagic shock threatening life.

Keywords: obturator artery, external iliac, internal iliac artery, anterior division, posterior division, superior gluteal, iliolumbar and lateral sacral, pubic fracture, aneurysm, shock

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Authors: Tan Bee Piang

Abstract:

The family is always seen as the most important agent of socialization, therefore, abusive parents and broken family have often been highlighted as two main factors contributing to juvenile delinquency. However, several studies have indicated that the peer group is one of the most powerful socialization agents in adolescent development, the influences of family are insignificant after peer influences are taken. This study aimed to investigate the relative influence of parents and peers on juvenile delinquency in Malaysia. Malaysia is a multicultural society, so different types of traditional values and religions permeate all aspects of Malaysian society, and the influences of family and parents are always seen as the most important agents of socialization. 80 juveniles from a reform school in Malaysia have been selected to participate in this study. Based on the experiences of juveniles in this study, it found that peer groups play an important role when the adolescents try to create their own identities. Adolescents merely make friends with those who have similar life experiences, so adolescents are easily influenced by their friends and the juvenile delinquency is mostly group behavior. This research found that there is no significant relationship between family factors and delinquency. The data shows that a significant percentage of juveniles come from middle-class family and most of them are not from broken family. However, most of them have strained family relationship. This research suggests that we should take a look into other causes, like peer influence, of juvenile delinquency in Malaysia.

Keywords: juvenile delinquency, peer influence, group behaviour, family relationship

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Authors: May Zaw, Amber Latif, William Lim

Abstract:

Postpartum dyspnea can be due to many causes, such as pulmonary embolism, amniotic fluid embolism, and peripartum cardiomyopathy, but less frequently due to acute pulmonary edema. The incidence of acute pulmonary edema during pregnancy and in the postpartum period has been estimated to be around 0.08%. About half of the cases are attributed to tocolytic therapy. Herein, we present a case of a young woman presenting with acute hypoxia after induction of labor with oxytocin and found to have acute pulmonary edema. This case aims to illustrate and add to a growing body of literature regarding oxytocin-induced acute pulmonary edema and highlights the importance of recognizing the rare complication of oxytocin and necessary interventions to avoid complications. Oxytocin-induced pulmonary edema is a relatively uncommon condition, but physicians should have a high index of suspicion to initiate timely intervention and avoid fetal complications.

Keywords: pulmonary, pregnancy, oxytocin, postpartum

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Authors: Sandeep Nath

Abstract:

There are good stresses and bad stresses. To tell the difference, recognize early signs of stress, and label stress conditions correctly, we need to understand stress triggers and the mechanism of stress as it arises. By understanding this in our teenage years, we can be prepared to prevent harmful stress from escalating and ruining health, physical, mental, and emotional. We can also prepare others/peers to be stress-free. The understanding of this is available in a form closest to our natural being, in ancient oriental wisdom, and is brought together as actionable habits in the movement called RENEWALism. The constructs of RENEWALism Habits are detailed in this paper, and case studies are presented of teenagers who have been equipped with both capability and capacity to handle their situations and environments independently.

Keywords: habits, renewalism, stress, teenagers

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Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti

Abstract:

Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.

Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology

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Authors: Sharon Jackson White

Abstract:

Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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