Search results for: difference mean opinion score (DMOS)

Authors: Happy Zulu

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Neuropsychological examination is an important way of formally assessing brain function. While there is so much documentation about the influence that some factors, such as age and education, have on neuropsychological tests (NP), not so much has been done to assess the influence that residency (rural/urban) may have. The specific objectives of this study were to establish if there is a significant difference in mean test scores on NP tests between rural and urban participants and to assess which tests on the Zambia Neurobehavioural Test Battery (ZNTB) are more affected by the participants‘ residency (rural/urban) and to determine the extent to which education, gender, and age predict test performance on NP tests for rural and urban participants. The participants (324) were drawn from both urban and rural areas of Zambia (Rural = 152 and Urban = 172). However, only 234 participants (Rural = 152 and Urban 82) were used for all the analyses in this particular study. The 234 participants were used as the actual proportion of the rural vs urban population in Zambia was 65% : 35%, respectively (CSO, 2003). The rural-urban ratio for the participants that were captured during the data collection process was 152 : 172, respectively. Thus, all the rural participants (152) were included and 90 of the 172 urban participants were randomly excluded so that the rural/urban ratio reached the desired 65% : 35 % which was the required ideal statistic for appropriate representation of the actual population in Zambia. Data on NP tests were analyzed from 234 participants, rural (N=152) reflecting 65% and urban (N=82) reflecting 35%. T-tests indicated that urban participants had superior performances in all the seven NP test domains, and all the mean differences in all these domains were found to be statistically significant. Residency had a large or moderate effect in five domains, while its effect size was small only in two of the domains. A standard multiple regression revealed that education, age and residency as predictor variables made a significant contribution to variance in performance on various domains of the ZNTB. However, the gender of participants was not a major factor in determining one‘s performance on neuropsychological tests. This particular report is part of an ongoing, larger, cutting-edge study aimed at formulating the normative data for Zambia with regard to performance on neuropsychological tests. This is necessary for appropriate, effective, and efficient assessment or diagnosis of various neurocognitive and neurobehavioural deficits that a number of people may currently be suffering from. It has been shown in this study that it is vital to make careful analyses of the variables that may be associated with one‘s performance on neuropsychological tests.

Keywords: neuropsychology, neurobehavioural, residency, Zambia

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Authors: Lemuel David

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The importance of the Micro, Small, and Medium Enterprises sector is well recognized for its legitimate contribution to the Macroeconomic objectives of the Republic of Liberia, like generation of employment, input t, exports, and enhancing entrepreneurship. Right now, Medium and Small enterprises accounts for about 99 percent of the industrial units in the country, contributing 60 percent of the manufacturing sector output and approximately one-third of the nation’s exports. The role of various financial institutions like ECO bank and Non-financial Institutions like Bearch Limited support promoting the growth of Micro, Small, and Medium Enterprises is unique. A small enterprise or entrepreneur gets many types of assistance from different institutions for varied purposes in the course of his entrepreneurial journey. This paper focuses on the factors related to financial institutional support and non-financial institutional support entrepreneurs to the growth of Medium and Small enterprises in the Republic of Liberia. The significance of this paper is to support Policy and Institutional Support for Medium and Small enterprises to know the views of entrepreneurs about financial and non-financial support systems in the Republic of Liberia. This study was carried out through a survey method, with the use of questionnaires. The population for this study consisted of all registered Medium and Small enterprises which have been registered during the years 2004-2014 in the republic of Liberia. The sampling method employed for this study was a simple random technique and determined a sample size of 400. Data for the study was collected using a standard questionnaire. The questionnaire consisted of two parts: the first part consisted of questions on the profile of the respondents. The second part covers (1) financial, promotional factors and (2) non-financial promotional factors. The results of the study are based on financial and non-financial supporting activities provided by institutions to Medium and Small enterprises. After investigation, it has been found that there is no difference in the support given by Financial Institutions and non-financial Institutions. Entrepreneurs perceived “collateral-free schemes and physical infrastructure support factors are highest contributing to entry and growth of Medium and Small enterprises.

Keywords: micro, small, and medium enterprises financial institutions, entrepreneurship

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Authors: Ahmed Ghachem, Denis Prud’homme, Rémi-Rabasa-Lhoret, M. Brochu

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Objective: To compare the effects of a CR on body composition, lipid profile and glucose homeostasis in obese postmenopausal women with and without MetS. Methods: Secondary analyses were performed on seventy-three inactive obese postmenopausal women (age: 57.7 ± 4.8 yrs; body mass index: 32.4 ± 4.6 kg/m2) who participated in the 6-month caloric restriction arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorized participants with MetS [n = 20, 27.39%] and without MetS [n = 53, 72.61%]. Variables of interest were: body composition (DXA), body fat distribution (CT scan), glucose homeostasis at the fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids and resting blood pressure. Results: By design, the MetS group had a worse cardiometabolic profile; while both groups were comparable for age. Fifty-five patients out of seventy-three displayed no change in MetS status after the intervention. Twelve participants out of twenty (or 60.0%) in the MetS group had no more MetS after weight loss (P= NS); while six participants out of fifty three (or 11.3%) in the other group developed the MetS after the intervention (P= NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/HDL-C ratio, which decrease significantly more in the MetS group (P ≤ 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile. Conclusion: Despite no overall significant effects on MetS, heterogeneous results were obtained in response to weight loss in the present study; with some improving the MetS while other displaying deteriorations. Further studies are needed in order to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.

Keywords: menopause, obesity, physical inactivity, metabolic syndrome, caloric restriction, weight loss

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Authors: Dawit Thomas

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Feeding and weaning practices vary from culture to culture and depend on different child-rearing values. The socio-cultural dimensions that influence the acceptable infant feeding practices are varied and complex. Understanding cultural differences in beliefs and practices relating to infant feeding is important to enhance designing programs for delivering successful psychological, social, physiological and economic well-being of mothers and infants. The main purpose of this study was exploring mothers infant feeding practices in the context of Hadiyya culture. After purposively selecting Harche Huyaya Uyaya Kebele eight infant feeding mothers were selected using snowball sampling technique. The study employed interviews and focus group discussion. The study found out early initiation and prolonged breastfeeding and early complementary feeding in some instances immediately after birth. In addition, infants were not forced to wean unless the mothers encounter pressing issues like pregnancy and health related problems. Furthermore, the main weaning techniques were putting unpleasant materials on the tip of nipples and sending infants to grandparents home. The study also found out gender difference in weaning, i.e., early initiation of weaning for girls. This can be indicative of gender-based bias on weaning practice. Finally, health extension workers, office of women and children affairs and Hadiyya Zone Tourism office should organize awareness raising programs to preserve vital infant feeding practices like prolonged breastfeeding and length of weaning. In addition, the offices should raise awareness among communities on negative side effects of sending infant to grandparents home that may weaken infant-mothers attachment and create favorable ground for the development of phobia.

Keywords: feeding, infant, practices, weaning

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Authors: Deepti Mishra, K. K Pant, Xiu Song Zhao, Muxina Konarova

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Catalytic transformation of simplest hydrocarbon methane into benzene and valuable chemicals over Mo/HZSM-5 has a great economic potential, however, it suffers serious hurdles due to the blockage in the micropores because of extensive coking at high temperature during methane dehydroaromatization (MDA). Under such conditions, it necessitates the design of micro/mesoporous ZSM-5, which has the advantages viz. uniform dispersibility of MoOx species, consequently the formation of active Mo sites in the micro/mesoporous channel and lower carbon deposition because of improved mass transfer rate within the hierarchical pores. In this study, we report a unique strategy to control the porous structures of ZSM-5 through a dual templating approach, utilizing C6 and C12 -surfactants as porogen. DFT studies were carried out to correlate the ZSM-5 framework development using the C6 and C12 surfactants with structure directing agent. The structural and morphological parameters of the synthesized ZSM-5 were explored in detail to determine the crystallinity, porosity, Si/Al ratio, particle shape, size, and acidic strength, which were further correlated with the physicochemical and catalytic properties of Mo modified HZSM-5 catalysts. After Mo incorporation, all the catalysts were tested for MDA reaction. From the activity test, it was observed that C6 surfactant-modified hierarchically porous Mo/HZSM-5(H) showed the highest benzene formation rate (1.5 μmol/gcat. s) and longer catalytic stability up to 270 min of reaction as compared to the conventional microporous Mo/HZSM-5(C). In contrary, C12 surfactant modified Mo/HZSM-5(D) is inferior towards MDA reaction (benzene formation rate: 0.5 μmol/gcat. s). We ascribed that the difference in MDA activity could be due to the hierarchically interconnected meso/microporous feature of Mo/HZSM-5(H) that precludes secondary reaction of coking from benzene and hence contributing substantial stability towards MDA reaction.

Keywords: hierarchical pores, Mo/HZSM-5, methane dehydroaromatization, coke deposition

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Authors: Tatiana A. Pozdniakova, Maria A. P. Cechinel, Luciana P. Mazur, Rui A. R. Boaventura, Vitor J. P. Vilar.

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Two brown macroalgae, Laminaria hyperborea and Pelvetia canaliculata, were employed as natural cation exchangers in a fixed-bed column for Zn(II) removal from a galvanization wastewater. The column (4.8 cm internal diameter) was packed with 30-59 g of previously hydrated algae up to a bed height of 17-27 cm. The wastewater or eluent was percolated using a peristaltic pump at a flow rate of 10 mL/min. The effluent used in each experiment presented similar characteristics: pH of 6.7, 55 mg/L of chemical oxygen demand and about 300, 44, 186 and 244 mg/L of sodium, calcium, chloride and sulphate ions, respectively. The main difference was nitrate concentration: 20 mg/L for the effluent used with L. hyperborean and 341 mg/L for the effluent used with P. canaliculata. The inlet zinc concentration also differed slightly: 11.2 mg/L for L. hyperborean and 8.9 mg/L for P. canaliculata experiments. The breakthrough time was approximately 22.5 hours for both macroalgae, corresponding to a service capacity of 43 bed volumes. This indicates that 30 g of biomass is able to treat 13.5 L of the galvanization wastewater. The uptake capacities at the saturation point were similar to that obtained in batch studies (unpublished data) for both algae. After column exhaustion, desorption with 0.1 M HNO3 was performed. Desorption using 9 and 8 bed volumes of eluent achieved an efficiency of 100 and 91%, respectively for L. hyperborean and P. canaliculata. After elution with nitric acid, the column was regenerated using different strategies: i) convert all the binding sites in the sodium form, by passing a solution of 0.5 M NaCl, until achieve a final pH of 6.0; ii) passing only tap water in order to increase the solution pH inside the column until pH 3.0, and in this case the second sorption cycle was performed using protonated algae. In the first approach, in order to remove the excess of salt inside the column, distilled water was passed through the column, leading to the algae structure destruction and the column collapsed. Using the second approach, the algae remained intact during three consecutive sorption/desorption cycles without loss of performance.

Keywords: biosorption, zinc, galvanization wastewater, packed-bed column

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Authors: Bumjo Kim, Hyun Jin Kim, Joon Ha Kim

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The separate sewer system is that collects the wastewater as a sewer pipe and rainfall as a stormwater pipe separately, and then sewage is treated in the wastewater treatment plant, the stormwater is discharged to rivers or lakes through stormwater drainage pipes. Unfortunately, even for separate sewer systems, it is not possible to prevent Rainfall Driven Inflow/Infiltration(RDII) completely to the sewer pipe. Even if the sewerage line is renovated, there is an ineluctable RDII due to the combined sewer system in the house or the difficulty of sewage maintenance in private areas. The basic statistical analysis was performed using environmental data including rainfall, sewage, water qualities and groundwater level in the strict of Gwangju in ​South Korea. During rainfall in the target area, RDII showed an increased rate of 13.4 ~ 53.0% compared to that of a clear day and showed a rapid hydrograph response of 0.3 ~ 3.0 hr. As a result of water quality analysis, BOD5 concentration decreased by 17.3 % and salinity concentration decreased by 8.8 % at the representative spot in the project area compared to the sunny day during rainfall. In contrast to the seasonal fluctuation range of 0.38 m ~ 0.55 m in groundwater in Gwangju area and 0.58 m ~ 0.78 m in monthly fluctuation range, while the difference between groundwater level and the depth of sewer pipe laying was 2.70 m on average, which is larger than the range of fluctuation. Comprehensively, it can be concluded that the increasing of flowrate at sewer line is due to not infiltration water caused by groundwater level rise, construction failure, cracking due to joint failure or conduit deterioration, rainfall was directly inflowed into the sewer line rapidly. Acknowledgements: This work was supported by the 'Climate Technology Development and Application' research project (#K07731) through a grant provided by GIST in 2017.

Keywords: ground water, rainfall, rainfall driven inflow/infiltration, separate sewer system

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Authors: Kylie Mueller, Nijole Bernaitis, Shailendra Anoopkumar-Dukie

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Background: Vitamin K antagonists particularly warfarin is the most frequently used oral medication for deep vein thrombosis (DVT) treatment and prophylaxis. Time in therapeutic range (TITR) of the international normalised ratio (INR) is widely accepted as a measure to assess the quality of warfarin therapy. Multiple factors can affect warfarin control and the subsequent adverse outcomes including thromboembolic and bleeding events. Predictor models have been developed to assess potential contributing factors and measure the individual risk of these adverse events. These predictive models have been validated in atrial fibrillation (AF) patients, however, there is a lack of literature on whether these can be successfully applied to other warfarin users including DVT patients. Therefore, the aim of the study was to assess the ability of these risk models (HAS BLED and CHADS2) to predict haemorrhagic and ischaemic incidences in DVT patients treated with warfarin. Methods: A retrospective analysis of DVT patients receiving warfarin management by a private pathology clinic was conducted. Data was collected from November 2007 to September 2014 and included demographics, medical and drug history, INR targets and test results. Patients receiving continuous warfarin therapy with an INR reference range between 2.0 and 3.0 were included in the study with mean TITR calculated using the Rosendaal method. Bleeding and thromboembolic events were recorded and reported as incidences per patient. The haemorrhagic risk model HAS BLED and ischaemic risk model CHADS2 were applied to the data. Patients were then stratified into either the low, moderate, or high-risk categories. The analysis was conducted to determine if a correlation existed between risk assessment tool and patient outcomes. Data was analysed using GraphPad Instat Version 3 with a p value of <0.05 considered to be statistically significant. Patient characteristics were reported as mean and standard deviation for continuous data and categorical data reported as number and percentage. Results: Of the 533 patients included in the study, there were 268 (50.2%) female and 265 (49.8%) male patients with a mean age of 62.5 years (±16.4). The overall mean TITR was 78.3% (±12.7) with an overall haemorrhagic incidence of 0.41 events per patient. For the HAS BLED model, there was a haemorrhagic incidence of 0.08, 0.53, and 0.54 per patient in the low, moderate and high-risk categories respectively showing a statistically significant increase in incidence with increasing risk category. The CHADS2 model showed an increase in ischaemic events according to risk category with no ischaemic events in the low category, and an ischaemic incidence of 0.03 in the moderate category and 0.47 high-risk categories. Conclusion: An increasing haemorrhagic incidence correlated to an increase in the HAS BLED risk score in DVT patients treated with warfarin. Furthermore, a greater incidence of ischaemic events occurred in patients with an increase in CHADS2 category. In an Australian population of DVT patients, the HAS BLED and CHADS2 accurately predicts incidences of haemorrhage and ischaemic events respectively.

Keywords: anticoagulant agent, deep vein thrombosis, risk assessment, warfarin

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Authors: Hemanth K. Balaga, Prakash Nanthagopalan

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Every year a huge amount of paper gets discarded of which only a minute fraction is being recycled and the rest gets dumped as landfills. Paper fibres can be recycled only a limited number of times before they become too short or weak to make high quality recycled paper. This eventually adds to the already big figures of waste paper that is being generated and not recycled. It would be advantageous if this prodigious amount of waste can be utilized as a low-cost sustainable construction material and make it as a value added product. The generic term for the material under investigation is paper-concrete. This is a fibrous mix made of Portland cement, water and pulped paper and/or other aggregates. The advantages of this material include light weight, good heat and sound insulation capability and resistance to flame. The disadvantages include low strength compared to conventional concrete and its hydrophilic nature. The properties vary with the variation of cement and paper content in the mix. In the present study, Portland Pozzolona Cement and news print paper were used for the preparation of paper concrete cubes. Initially, investigations were performed to determine the minimum soaking period required for the softening of the paper fibres. Further different methodologies were explored for proper blending of the pulp with cement paste. The properties of paper concrete vary with the variation of cement to paper to water ratio. The study mainly addresses the parameters of strength and weight loss of the concrete cubes with age and the time that is required for the dry paper fibres to become soft enough in water to bond with the cement. The variation of compressive strength with cement content, water content, and time was studied. The water loss of the cubes with time and the minimum time required for the softening of paper fibres were investigated .Results indicate that the material loses 25-50 percent of the initial weight at the end of 28 days, and a maximum 28 day compressive strength (cubes) of 5.4 Mpa was obtained.

Keywords: soaking time, difference water, minimum water content, maximum water content

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Authors: E. Farg, M. M. El-Sharkawy, M. S. Mostafa, S. M. Arafat

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Mapping water stress provides important baseline data for sustainable agriculture. Recent developments in the new Sentinel-1 data which allow the acquisition of high resolution images and varied polarization capabilities. This study was conducted to detect and quantify vegetation water content from canopy backscatter for extracting spatial information to encourage drought mapping activities throughout new reclaimed sandy soils in western Nile delta, Egypt. The performance of radar imagery in agriculture strongly depends on the sensor polarization capability. The dual mode capabilities of Sentinel-1 improve the ability to detect water stress and the backscatter from the structure components improves the identification and separation of vegetation types with various canopy structures from other features. The fieldwork data allowed identifying of water stress zones based on land cover structure; those classes were used for producing harmonious water stress map. The used analysis techniques and results show high capability of active sensors data in water stress mapping and monitoring especially when integrated with multi-spectral medium resolution images. Also sub soil drip irrigation systems cropped areas have lower drought and water stress than center pivot sprinkler irrigation systems. That refers to high level of evaporation from soil surface in initial growth stages. Results show that high relationship between vegetation indices such as Normalized Difference Vegetation Index NDVI the observed radar backscattering. In addition to observational evidence showed that the radar backscatter is highly sensitive to vegetation water stress, and essentially potential to monitor and detect vegetative cover drought.

Keywords: canopy backscatter, drought, polarization, NDVI

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Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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Authors: Natalia A. Salazar, Erika K. Méndez, Catalina Álvarez, Carlos E. Orrego

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Lyophilization, also called freeze-drying, is an important dehydration technique mainly used for pharmaceuticals. Food industry also uses lyophilization when it is important to retain most of the nutritional quality, taste, shape and size of dried products and to extend their shelf life. Vacuum-Induced during freezing cycle (VI) has been used in order to control ice nucleation and, consequently, to reduce the time of primary drying cycle of pharmaceuticals preserving quality properties of the final product. This procedure has not been applied in freeze drying of foods. The present work aims to investigate the effect of VI on the lyophilization drying time, final moisture content, density and reconstitutional properties of mango (Mangifera indica L.) slices (MS) and mango pulp-maltodextrin dispersions (MPM) (30% concentration of total solids). Control samples were run at each freezing rate without using induced vacuum. The lyophilization endpoint was the same for all treatments (constant difference between capacitance and Pirani vacuum gauges). From the experimental results it can be concluded that at the high freezing rate (0.4°C/min) reduced the overall process time up to 30% comparing process time required for the control and VI of the lower freeze rate (0.1°C/min) without affecting the quality characteristics of the dried product, which yields a reduction in costs and energy consumption for MS and MPM freeze drying. Controls and samples treated with VI at freezing rate of 0.4°C/min in MS showed similar results in moisture and density parameters. Furthermore, results from MPM dispersion showed favorable values when VI was applied because dried product with low moisture content and low density was obtained at shorter process time compared with the control. There were not found significant differences between reconstitutional properties (rehydration for MS and solubility for MPM) of freeze dried mango resulting from controls, and VI treatments.

Keywords: drying time, lyophilization, mango, vacuum induced freezing

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Authors: Tyler Palma, Praveen Damasus, Michael Munther, Mehrdad Mohsenizadeh, Keivan Davami

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The advancement of additive manufacturing, in both research and commercial realms, is highly dependent upon continuing innovations and creativity in materials and designs. Additive manufacturing shows great promise towards revolutionizing various industries, due largely to the fact that design data can be used to create complex products and components, on demand and from the raw materials, for the end user at the point of use. However, it will be critical that the material properties of additively-made parts for engineering purposes be fully understood. As it is a relatively new additive manufacturing method, the response of properties of Multi Jet Fusion (MJF) produced parts to different printing parameters has not been well studied. In this work, testing of mechanical and tribological properties MJF-printed Polyamide 12 parts was performed to determine whether printing orientation in this method results in significantly different part performances. Material properties were studied at macro- and nanoscales. Tensile tests, in combination with tribology tests including steady-state wear, were performed. Results showed a significant difference in resultant part characteristics based on whether they were printed in a vertical or horizontal orientation. Tensile performance of vertically and horizontally printed samples varied, both in ultimate strength and strain. Tribology tests showed that printing orientation has notable effects on the resulting mechanical and wear properties of tested surfaces, due largely to layer orientation and the presence of unfused fused powder grain inclusions. This research advances the understanding of how print orientation affects the mechanical properties of additively manufactured structures, and also how print orientation can be exploited in future engineering design.

Keywords: additive manufacturing, indentation, nano mechanical characterization, print orientation

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Authors: Shangqing Song, Bin Xu, Yajun Cheng, Zhong Wang

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miRNAs derived from exosomes exist in a body fluid such as urine were regarded as potential biomarkers for various human cancers diagnosis and prognosis, as mature miRNAs can be steadily preserved by exosomes. However, its potential value in clear cell renal cell carcinoma (ccRCC) diagnosis and prognosis remains unclear. In the present study, differentially expressed miRNAs from urinal exosomes were identified by next-generation sequencing (NGS) technology. The 16 differentially expressed miRNAs were identified between ccRCC patients and healthy donors. To explore the specific diagnosis biomarker of ccRCC, we validated these urinary exosomes from 70 early-stage renal cancer patients, 30 healthy people and other urinary system cancers, including 30 early-stage prostate cancer patients and 30 early-stage bladder cancer patients by qRT-PCR. The results showed that urinary exosome miR-30c-5p could be stably amplified and meanwhile the expression of miR-30c-5p has no significant difference between other urinary system cancers and healthy control, however, expression level of miR-30c-5p in urinary exosomal of ccRCC patients was lower than healthy people and receiver operation characterization (ROC) curve showed that the area under the curve (AUC) values was 0.8192 (95% confidence interval was 0.7388-0.8996, P= 0.0000). In addition, up-regulating miR-30c-5p expression could inhibit renal cell carcinoma cells growth. Lastly, HSP5A was found as a direct target gene of miR-30c-5p. HSP5A depletion reversed the promoting effect of ccRCC growth casued by miR-30c-5p inhibitor, respectively. In conclusion, this study demonstrated that urinary exosomal miR-30c-5p is readily accessible as diagnosis biomarker of early-stage ccRCC, and miR-30c-5p might modulate the expression of HSPA5, which correlated with the progression of ccRCC.

Keywords: clear cell renal cell carcinoma, exosome, HSP5A, miR-30c-5p

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Authors: Amar F. Siddique

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The Guwahati city is one of the fastest growing cities of the north-eastern region of India, situated on the South Bank of the Brahmaputra River falls in the highest seismic zone level V. The city has witnessed many high magnitude earthquakes in the past decades. The Assam earthquake occurred on August 15, 1950, of moment magnitude 8.7 epicentered near Rima, Tibet was one of the major earthquakes which caused a serious structural damage and widespread soil liquefaction in and around the region. Hence the study of ground motion characteristics of Guwahati city is very essential. In this present work 1D equivalent linear ground response analysis (GRA) has been adopted using Deep soil software. The analysis has been done for two typical sites namely, Panbazar and Azara comprising total four boreholes location in Guwahati city of India. GRA of the sites is carried out by using an input motion recorded at Nongpoh station (recorded PGA 0.048g) and Nongstoin station (recorded PGA 0.047g) of 1997 Indo-Burma earthquake. In comparison to motion recorded at Nongpoh, different amplifications of bedrock peak ground acceleration (PGA) are obtained for all the boreholes by the motion recorded at Nongstoin station; although, the Fourier amplitude ratios (FAR) and fundamental frequencies remain almost same. The difference in recorded duration and frequency content of the two motions mainly influence the amplification of motions thus getting different surface PGA and amplification factor keeping a constant bedrock PGA. From the results of response spectra, it is found that at the period of less than 0.2 sec the ground motion recorded at Nongpoh station will give a high spectral acceleration (SA) on the structures than at Nongstoin station. Again for a period greater than 0.2 sec the ground motion recorded at Nongstoin station will give a high SA on the structures than at Nongpoh station.

Keywords: fourier amplitude ratio, ground response analysis, peak ground acceleration, spectral acceleration

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Authors: Vinay Suhalka

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In India, the official nomenclature used by the State for persons with disability is divyang (literally, the one with a divine limb), a word coming from the Sanskrit language. Disability thus gets portrayed as divine, at least in the welfare sector from where it flows down even to the popular imagination where it gets equated to divinity. This paper looks at reference to persons with disabilities as divyangs and goes on to discusses what such usage for an already marginalized group achieves and misses out. The issue of nomenclature and language has always been a contested one when it comes to disability. At the same time, there is also an issue of who determines these labels for the persons with disability. Nomenclature and language used for disability can have real consequences for the population of persons with disability as it may empower or disempower them. Thus, this paper looks at the issue of what it means for persons with disabilities as ‘exceptionally gifted’ and hence divyang. Language can be a powerful tool to communicate meanings and messages associated with a term. When the persons with disabilities as a group are described as ‘exceptionally gifted, talented and the source of inspiration’, it essentially stereotypes and marginalizes them by putting a burden of performance that all of them ought to be achievers, and it is only then that they would be assimilated in the larger society. This paper also argues that such a situation creates a ‘double bind’ where the person is always trying to match up to the labels (the disabled as ‘achiever, overcomer, inspirational’) created by somebody else and looks at self through the eyes of others. This conceptual paper also presents an overview of disability labels while simultaneously looking at projecting disability as divinity which has the potential to wrongly portray the lives of persons with disability in India due to the official usage of the term. It also explores the question of visibility of disability since the idea of divyang implicitly assumes that all disabilities are visible. In reality, however, it may not be the case simply because all forms of disabilities are not visible, people may choose not to visibilize their disabilities if they can and pass as able-bodied, fearing the stigma that surrounds disability. Finally, it argues for an increased focus on understanding the everyday lived realities of those with disability in order to regard it as an important form of difference which could be a potential resource for the society.

Keywords: persons with disability, labels, language use, divinity

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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Authors: Muhammad Isa Khan, Jalil Ur Rehman, Muhammad Afzal Khan Rao, James Chow

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Purpose: This study investigates the dose-volume variations in planning target volume (PTV) and organs-at-risk (OARs) using different collimator angles for smart arc prostate volumetric modulated arc therapy (VMAT). Awareness of the collimator angle for PTV and OARs sparing is essential for the planner because optimization contains numerous treatment constraints producing a complex, unstable and computationally challenging problem throughout its examination of an optimal plan in a rational time. Materials and Methods: Single arc VMAT plans at different collimator angles varied systematically (0°-90°) were performed on a Harold phantom and a new treatment plan is optimized for each collimator angle. We analyzed the conformity index (CI), homogeneity index (HI), gradient index (GI), monitor units (MUs), dose-volume histogram, mean and maximum doses to PTV. We also explored OARs (e.g. bladder, rectum and femoral heads), dose-volume criteria in the treatment plan (e.g. D30%, D50%, V30Gy and V38Gy of bladder and rectum; D5%,V14Gy and V22Gy of femoral heads), dose-volume histogram, mean and maximum doses for smart arc VMAT at different collimator angles. Results: There was no significance difference found in VMAT optimization at all studied collimator angles. However, if 0.5% accuracy is concerned then collimator angle = 45° provides higher CI and lower HI. Collimator angle = 15° also provides lower HI values like collimator angle 45°. It is seen that collimator angle = 75° is established as a good for rectum and right femur sparing. Collimator angle = 90° and collimator angle = 30° were found good for rectum and left femur sparing respectively. The PTV dose coverage statistics for each plan are comparatively independent of the collimator angles. Conclusion: It is concluded that this study will help the planner to have freedom to choose any collimator angle from (0°-90°) for PTV coverage and select a suitable collimator angle to spare OARs.

Keywords: VMAT, dose-volume histogram, collimator angle, organs-at-risk

Procedia PDF Downloads 509

Authors: Chung Danbi, Linton Oliver, Whang Yoon-Jae

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Supermodularity, or complementarity, is a popular concept in economics which can characterize many objective functions such as utility, social welfare, and production functions. Further, supermodular dominance captures a preference for greater interdependence among inputs of those functions, and it can be applied to examine which input set would produce higher expected utility, social welfare, or production. Therefore, we propose and justify a consistent testing for a useful implication of supermodular dominance. We also conduct Monte Carlo simulations to explore the finite sample performance of our test, with critical values obtained from the recentered bootstrap method, with and without the selective recentering, and the subsampling method. Under various parameter settings, we confirmed that our test has reasonably good size and power performance. Finally, we apply our test to compare the geographic and distant knowledge spillover in terms of their effects on social welfare using the National Bureau of Economic Research (NBER) patent data. We expect localized citing to supermodularly dominate distant citing if the geographic knowledge spillover engenders greater social welfare than distant knowledge spillover. Taking subgroups based on firm and patent characteristics, we found that there is industry-wise and patent subclass-wise difference in the pattern of supermodular dominance between localized and distant citing. We also compare the results from analyzing different time periods to see if the development of Internet and communication technology has changed the pattern of the dominance. In addition, to appropriately deal with the sparse nature of the data, we apply high-dimensional methods to efficiently select relevant data.

Keywords: supermodularity, supermodular dominance, stochastic dominance, Monte Carlo simulation, bootstrap, subsampling

Procedia PDF Downloads 126

Authors: A. Kabir, D. Boulainine, I. Bouanane, N. Benslim, B. Boudjema, C. Sedrati

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SnO₂ is an n-type semiconductor with a direct gap of about 3.6 eV. It is largely used in several domains such as nanocrystalline photovoltaic cells. Due to its interesting physic-chemical properties, this material was elaborated in thin film forms using different deposition techniques. It was found that SnO₂ properties were directly affected by the deposition method parameters. In this work, the RGTO method (Rheotaxial Growth and Thermal Oxidation) was used to deposit elaborate SnO₂ thin films. This technique consists on thermal oxidation of the Sn films deposited onto a substrate heated to a temperature close to Sn melting point (232°C). Such process allows the preparation of high porosity tin oxide films which are very suitable for the gas sensing. The films structural, morphological and optical properties pre and post thermal oxidation were studied using X-ray diffraction (XRD), scanning electron microscopy (SEM), UV-Visible spectroscopy and Fourier transform infrared spectroscopy (FTIR) respectively. XRD patterns showed a polycrystalline structure of the cassiterite phase of SnO₂. The grain growth was found affected by the oxidation temperature. This grain size evolution was confronted to existing grain growth models in order to understand the growth mechanism. From SEM images, the as deposited Sn film was formed of difference diameter spherical agglomerations. As a function of the oxidation temperature, these spherical agglomerations shape changed due to the introduction of oxygen ions. The deformed spheres started to interconnect by forming bridges between them. The volume porosity, determined from the UV-Visible reflexion spectra, Changes as a function of the oxidation temperature. The variation of the crystalline fraction, determined from FTIR spectra, correlated with the variation of both the grain size and the volume porosity.

Keywords: tin oxide, RGTO, grain growth, volume porosity, crystalline fraction

Procedia PDF Downloads 255

Authors: Kushaal Selvarajah, Geetha Annavi, Mohd Noor Hisham Mohd Nadzir

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Sambar deer (Rusa unicolor) was uplisted from Least Concern to Vulnerable by the International Union for Conservation of Nature Red list in 2015 due to drastic population decline in the wild throughout its geographical range. Sambar deer is a valued prey for the highly endangered species such as the Malayan tiger. Ex-situ conservation efforts, i.e., captive breeding, initiated by local government to boost sambar deer numbers in captivity and to reintroduce into the wild to support a higher number of tigers, consistent with the goal of our National Tiger Conservation Action Plan. The reproductive success of sambar deer and their welfare management practices in captivity are important components for effective captive breeding programs. However, there is a lack of study carried out on sambar deer in recent years and their behavior in captivity. Three captive sites (Zoo Negara, Zoo Taiping, and Sungkai Conservation Centre) were selected and observed for an average of 40 days each site (6 hours/day). A Generalized Linear Model (GLM) was used to determine the correlation between social behavior and extrinsic parameters. A comparison between all three captive sites showed the strongest correlation in behavioral variability, followed by a time of observation. This proves that there is a difference between in behavioral consistency and frequency between herds across captive sites rising to the possibility of external factors that are influential. Time of day of observation also had significant influence on certain extrinsic parameters being skewed to morning observations and this could be due to an adaptive behavior to the feeding time in the captive sites being in the morning which caused the deer to be resting towards the afternoon. Extensive study need to be done on sambar deer to pinpoint the specifics and better understanding of these possible influential factors in their behavior.

Keywords: behaviour ecology, captivity, ex-situ conservation, husbandry

Procedia PDF Downloads 154

Authors: Nuray Baltaci, Kursat Cagiltay

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University rankings which can be seen as nouveau topic are at the center of focus and followed closely by different parties. Students are interested in university rankings in order to make informed decisions about the selection of their candidate future universities. University administrators and academicians can utilize them to see and evaluate their universities’ relative performance compared to other institutions in terms of including but not limited to academic, economic, and international outlook issues. Local institutions may use those ranking systems, as TUBITAK (The Scientific and Technological Research Council of Turkey) and YOK (Council of Higher Education) do in Turkey, to support students and give scholarships when they want to apply for undergraduate and graduate studies abroad. When it is considered that the ranking systems are concerned by this many different parties, the importance of having clear, easy to use and well-designed websites by ranking institutions will be apprehended. In this paper, a usability study for the websites of four different global university ranking institutions, namely Academic Ranking of World Universities (ARWU), Times Higher Education, QS and University Ranking by Academic Performance (URAP), was conducted. User-based approach was adopted and usability tests were conducted with 10 graduate students at Middle East Technical University in Ankara, Turkey. Before performing the formal usability tests, a pilot study had been completed to reflect the necessary changes to the settings of the study. Participants’ demographics, task completion times, paths traced to complete tasks, and their satisfaction levels on each task and website were collected. According to the analyses of the collected data, those ranking websites were compared in terms of efficiency, effectiveness and satisfaction dimensions of usability as pointed in ISO 9241-11. Results showed that none of the selected ranking websites is superior to other ones in terms of overall effectiveness and efficiency of the website. However the only remarkable result was that the highest average task completion times for two of the designed tasks belong to the Times Higher Education Rankings website. Evaluation of the user satisfaction on each task and each website produced slightly different but rather similar results. When the satisfaction levels of the participants on each task are examined, it was seen that the highest scores belong to ARWU and URAP websites. The overall satisfaction levels of the participants for each website showed that the URAP website has highest score followed by ARWU website. In addition, design problems and powerful design features of those websites reported by the participants are presented in the paper. Since the study mainly tackles about the design problems of the URAP website, the focus is on this website. Participants reported 3 main design problems about the website which are unaesthetic and unprofessional design style of the website, improper map location on ranking pages, and improper listing of the field names on field ranking page.

Keywords: university ranking, user-based approach, website usability, design

Procedia PDF Downloads 396

Authors: B. Makoudi, R. Ghanimi, A. Bargaz, M. Mouradi, M. Farissi, A. Kabbaj, J. J. Drevon, C. Ghoulam

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Legume species are able to establish a nitrogen fixing symbiosis with soil rhizobia that allows them, when it operates normally, to ensure their necessary nitrogen nutrition. This biological process needs high phosphorus (P) supply and consequently it is limited under low phosphorus availability. To overcome this constraint, legume-rhizobia symbiosis develops many mechanisms to increase P availability in the rhizosphere and also the efficiency of P fertilizers. The objectives of our research works are to understand the physiological and biochemical mechanisms implemented by legume-rhizobia symbiosis to increase its P use efficiency (PUE) in order to select legume genotypes-rhizobia strains combination more performing for BNF under P deficiency. Our studies were carried out on two grain legume species, common bean (Phaseolus vulgaris) and faba bean (Vicia faba) tested in farmers’ fields and in experimental station fewer than two soil phosphorus levels. Under field conditions, the P deficiency caused a significant decrease of Plant and nodule biomasses in all of the tested varieties with a difference between them. This P limitation increased the contents of available P in the rhizospheric soils that was positively correlated with the increase of phosphatases activities in the nodules and the rhizospheric soil. Some legume genotypes showed a significant increase of their P use efficiency under P deficiency. The P solubilization test showed that some rhizobia strains isolated from Haouz region presented an important capacity to grow on solid and liquid media with tricalcium phosphate as the only P source and their P solubilizing activity was confirmed by the assay of the released P in the liquid medium. Also, this P solubilizing activity was correlated with medium acidification and the excretion of acid phosphatases and phytases in the medium. Thus, we concluded that medium acidification and excretion of phosphatases in the rhizosphere are the prominent reactions for legume-rhizobia symbiosis to improve its P nutrition.

Keywords: legume, phosphorus deficiency, rhizobia, rhizospheric soil

Procedia PDF Downloads 308

Authors: Salimah Hasnah, Namratha Radhakrishnan

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Communities play a vital role in mobilizing people and resources for the benefit of all. Since time immemorial, communities have been spear heading different activities ranging from disaster management, palliative care, local economic development and many more with laudable success. Urban agriculture is one such activity where communities can prove to make a real difference. Farming activities in cities across different developed countries have proved to have favorable outcomes in the form of increased food security, neighborhood revitalization, health benefits and local economic growth. However, urban agriculture in the developing nations have never been prioritized as an important planning tool to cater to the basic needs of the public. Urban agricultural practices are being carried out in a fragmented fashion without a formal backing. The urban dwellers rely heavily on their far-off rural counterparts for daily food requirements. With the onset of the pandemic and the recurring lockdowns, the significance of geographic proximity and its impact on the availability of food to the public are gradually being realized around the globe. This warrants a need for localized food systems by shortening the distance between production and consumption of food. The significance of communities in realizing these urban farming benefits is explored in this paper. A case-study approach is adopted to understand how different communities have overcome barriers to urban farming in cities. The applicability of these practices is validated against the state of Kerala in India wherein different community centered approaches have been successful in the past. The existing barriers are assessed and way forward to achieve a self-sufficient localized food systems is formulated with the key lessons from the case studies. These recommendations will be helpful to successfully establish and sustain farming activities in urban areas by leveraging the power of communities.

Keywords: community-centric, COVID-19, drivers and barriers, local food system, urban agriculture

Procedia PDF Downloads 134

Authors: Michael Ryan, Rosemary E. Borgerding, Kimberly L. Oliver

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The objective of this study was to assess the effectiveness of a sports nutrition intervention on body composition in high-school athletes. The study aimed to improve the food and water intake of high-school athletes, evaluate the cost-effectiveness of the intervention, and assess changes in body fat. Data were collected through observations, questionnaires, and interviews. Additionally, bioelectrical impedance analysis was performed to assess the body composition of athletes both before and after the intervention. Athletes (n=25) participated in researcher-monitored training sessions three times a week over the course of 12 weeks. During these sessions, in addition to completing their auxiliary sports training, participants were exposed to educational interventions aimed at improving their nutrition. These included discussions regarding current eating habits, nutritional guidelines for athletes, and individualized recommendations. Food was also made available to athletes for consumption before and after practice. Meals of balanced macronutrient composition were prepared and provided to athletes on four separate occasions throughout the intervention, either prior to or following a competitive event such as a tournament or game. A paired t-test was used to determine the statistical significance of the changes in body fat percentage. The results showed that there was a statistically significant difference between pre and post-intervention body fat percentage (p= .006). Cohen's d of 0.603 was calculated, indicating a moderate effect size. In conclusion, this study provides evidence that a sports nutrition intervention that combines food availability, explicit prescription, and education can be effective in improving the body composition of high-school athletes. However, it's worth noting that this study had a small sample size, and the conclusions cannot be generalized to a larger population. Further research is needed to assess the scalability of this study. This preliminary study demonstrated the feasibility of this type of nutritional intervention and laid the groundwork for a larger, more extensive study to be conducted in the future.

Keywords: bioelectrical impedance, body composition, high-school athletes, sports nutrition, sports pedagogy

Procedia PDF Downloads 90

Authors: Dwi Arisandi Wijaya, Ernawati Arifin Giri-Rachman, Neni Nurainy

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Typhoid fever disease can be prevented by using a polysaccharide-based vaccine Vi which is a virulence factor of S.typhi. To produce high yield Vi polysaccharide from bacteria, it is important to know the biosynthesis of Vi polysaccharide and the regulators involved. In the In vivo condition, S. typhi faces different osmolarity, and the bacterial two-component system OmpR-EnvZ, regulate by up and down Capsular Vi polysaccharide biosynthesis. A high yielded Vi Polysaccharide strain, S. typhi strain C6524 used to study the effect of media osmolarity on Vi polysaccharide biosynthesis and the osmoregulation pattern of S. typhi strain C6524. The methods were performed by grown S. typhi strain C6524 grown on medium with 50 mM, 100 mM, and 150 mM osmolarity with the batch system. Vi polysaccharide concentration was measured by ELISA method. For further investigation of the osmoregulation pattern of strain C6524, the osmoregulator gene, OmpR, has been isolated and sequenced using the specific primer of the OmpR gene. Nucleotide sequence analysis is done with BLAST and Lallign. Amino Acid sequence analysis is done with Prosite and Multiple Sequence Alignment. The results of cultivation showed the average content of polysaccharide Vi for 50 mM, 100 mM, and 150 mM osmolarities 11.49 μg/mL, 12.06 μg/mL, and 14.53 μg/mL respectively. Analysis using Anova stated that the osmolarity treatment of 150 mM significantly affects Vi content. Analysis of nucleotide sequences shows 100% identity between S. typhi strain C6524 and Ty2. Analysis of amino acid sequences shows that the OmpR response regulator protein of the C6524 strain also has a α4-β5-α5 motif which is important for the regulatory activation system when phosphorylation occurs by domain kinase. This indicates that the regulator osmolarity response of S. typhi strain C6524 has no difference with the response regulator owned by S. typhi strain Ty2. A high Vi response rate in the 150 mM osmolarity treatment requires further research for RcsB-RcsC, another two-component system involved in Vi Biosynthesis.

Keywords: osmoregulator, OmpR, Salmonella, Vi polysaccharide

Procedia PDF Downloads 193

Authors: Sibel Karacaoglu, Fatma Ç. Kayapinar

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The aim of the study is to investigate the effect of the core training program on physical fitness characteristics and body composition in male volleyball players. 26 male university volleyball team players aged between 19 to 24 years who had no health problems and injury participated in the study. Subjects were divided into training (TG) and control groups (CG) as randomly. Data from twenty-one players who completed all training sessions were used for statistical analysis (TG,n=11; CG,n=10). A core training program was applied to the training group three days a week for 10 weeks. On the other hand, the control group did not receive any training. Before and after the 10-week training program, pre- and post-testing comprised of body composition measurements (weight, BMI, bioelectrical impedance analysis) and physical fitness measurements including flexibility (sit and reach test), muscle strength (back, leg and grip strength by dynamometer), muscle endurance (sit-ups and push-ups tests), power (one-legged jump and vertical jump tests), speed (20m sprint, 30m sprint) and balance tests (one-legged standing test) were performed. Changes of pre- and post- test values of the groups were determined by using dependent t test. According to the statistical analysis of data, no significant difference was found in terms of body composition in the both groups for pre- and post- test values. In the training group, all physical fitness measurements improved significantly after core training program (p<0.05) except 30m speed and handgrip strength (p>0.05). On the hand, only 20m speed test values improved after post-test period (p<0.05), but the other physical fitness tests values did not differ (p>0.05) between pre- and post- test measurement in the control group. The results of the study suggest that the core training program has positive effect on physical fitness characteristics in male volleyball players.

Keywords: body composition, core training, physical fitness, volleyball

Procedia PDF Downloads 344

Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

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Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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Authors: Neo Mohlabane

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-- Feminists across various contexts have written extensively on the subject of ‘Woman.’ Recently the question of difference; to account for the cultural, ethnic, and racial diversity among women themselves has become a highly contested issue in feminist theories. Tensions have ensued where ‘western feminisms’ have been criticized for bias that is embedded in the objectification of ‘different’ women often regarded as ‘other’; traditional, therefore inferior. Thus, it is argued that womanhood; a set of socially defined attributes appropriate for women, holds different meanings depending on the context in which it is defined. Drawing on decolonial feminist approaches, this qualitative study explored the constructions of ‘womanhood’ from the perspective of unmarried Basotho women in Lesotho, where womanhood is predominantly defined in marital terms. Through the narrated life-stories of twenty unmarried Basotho women, the study revealed that as opposed to the ‘traditional’ definition that accounts for a single attribute woman as ‘wife,’ unmarried Basotho women defined ‘womanhood’ in different ways that deconstructed fixed gendered categories. The women drew meaning from their past personal experiences of childhood to construct and re-construct womanhood in adulthood. By transforming their embodied experiences of hardship and sorrow into valuable constructs with which they self-evaluated as resilient and perseverant, the women constructed a base for self-affirmation as woman. In addition, the women anchored their constructions and reconstructions of woman by transforming the meanings attached to the realms of respectability, sexuality and motherhood. Thus, to the question; what is a Woman? In part, the study concluded that there is no such thing as a ‘unitary’ definition of womanhood, instead Mosotho womanhood has always been and will always be in a state of flux; bearing multiplicity and complexity. This study highlights the need to exercise caution when using western concepts to understand the experiences of women in local African contexts. In order to decolonize feminist scholarship, African feminisms need to re-construct conceptual and theoretical frameworks appropriate for analyzing and understanding gender issues in African contexts.

Keywords: decoloniality, feminism, Lesotho, womanhood

Procedia PDF Downloads 103