Search results for: male external catheter

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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Authors: Tehmina Aslam

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South-Asian societies elicit a male-dominant hierarchy, socio-economically and politico-religiously. The aim of the study was to examine the contribution of gender to violent extremism in order to devise means for its control in Pakistan. A qualitative case study based on interviews was conducted of de-radicalized former militants who were affiliated to militant organizations such as Sipahe Sahaba Pakistan, Lashkare Jhangvi, Laskhare Taibah, and Jaishe Mohammad, and who resided in Sargodha and Jhang, cities of the Punjab. The study exuded three main findings: first, gender alone was insufficient to motivate a male youth to resort to violent extremism; second, gender segregation made a male youth more vulnerable to an extremist ideology; and third, male gender was more prone to the influence of an extremist misguided religious ideology that pandered to male chauvinistic (societal dogmas constructing a male identity) needs and offered a male youth an opportunity to reinforce male dominance in society. The conclusion drawn was that the confluence of societal dogmas and extremist (religious) ideologies offered the major resistance against preventing violent extremism and, without dealing with both of them simultaneously, the tendency in male youth to resorting to violent extremism could not be dissipated.

Keywords: violent extremism, countering violent extremism, preventing violent extremism, youth

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Authors: Lucia Liu, Matthew Koziol

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Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.

Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation

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Authors: Mohammad Reza Boroumand Devlagh, Seyed Mohammad Hosein Razavi, Fatemeh Ahmadi, Azam Fazli Darzi

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The issue of female presence in Iran stadiums has long been considered and debated by governmental experts and authorities, however, no conclusion is yielded yet. Thus, the present study has been done with the aim of investigating the approach of male and female spectators about the presence of female spectators in Iranian stadiums. The statistical population of the study includes all male and female spectators who have not experienced the live watching of male championship matches in stadiums. 224 subjects from the statistical population have selected through stratified random sampling as the sample of the study. For data collection, researcher-made questionnaire has been used whose validity has been confirmed by the university professors and its reliability has been studied and confirmed through an preliminary study. (r= 0.81). Data analysis has been done using descriptive and referential statistics in P< 0.05. The results of the study showed that male and female were meaningfully agreed with the female presence in stadiums and there is no meaningful difference between male and female approaches concerning the female spectators’ presence in sport stadiums of Iran (sig= 0.867).

Keywords: male, female spectators, Iran, sport stadiums, population

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Authors: Hari Om Kashyap, Rohit Gurudas Maulingkar

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The aim of the study was to compare sports competition anxiety levels between male and female college athletes of Ponda City. A total number of 50 athletes were selected as a subject for this research, where 25 male athletes and 25 female athletes of age between 18 to 22 years were selected. The purposive method was used for the selection of samples from Ponda city. Sports Competitive Anxiety Test (SCAT) by R. Martin, 1990, was used for data collection. For comparing Sports Competitive Anxiety between male and female college athletes independent “t” test was applied at a 0.05 level of significance. The result of the study indicates that the p-value is .013178, and the result is significant at p<.05, which means there was a significant difference found in sports competitive anxiety between male athletes and female athletes who are taking part in various intercollegiate sports competitions.

Keywords: competitive anxiety, athlete, male, female

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Authors: Adel M. Qatawneh

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This paper aimed to determine the importance of knowledge innovation for external audit on anti-corruption in the entire Jordanian bank companies are listed in Amman Stock Exchange (ASE). The study importance arises from the need to recognize the Knowledge innovation for external audit and anti-corruption as the development in the world of business, the variables that will be affected by external audit innovation are: reliability of financial data, relevantly of financial data, consistency of the financial data, Full disclosure of financial data and protecting the rights of investors to achieve the objectives of the study a questionnaire was designed and distributed to the society of the Jordanian bank are listed in Amman Stock Exchange. The data analysis found out that the banks in Jordan have a positive importance of Knowledge innovation for external audit on anti-corruption. They agree on the benefit of Knowledge innovation for external audit on anti-corruption. The statistical analysis showed that Knowledge innovation for external audit had a positive impact on the anti-corruption and that external audit has a significantly statistical relationship with anti-corruption, reliability of financial data, consistency of the financial data, a full disclosure of financial data and protecting the rights of investors.

Keywords: knowledge innovation, external audit, anti-corruption, Amman Stock Exchange

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Authors: Ikpechukwu Njoku

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The study examined appraisal of shipping trade influence on the economic growth in Nigeria from 1981-2016 by the use of secondary data collected from the Central Bank of Nigeria. The main objectives are to examine the trend of shipping trade in Nigeria as well as determine the influence of economic growth on gross domestic product (GDP). The study employed both descriptive and influential tools. The study adopted cointegration regression method for the analysis of each of the variables (shipping trade, external reserves and external debts). The results show that there is a statistically significant relationship between GDP and external reserves with p-value 0.0190. Also the result revealed that there is a statistically significant relationship between GDP and shipping trade with p-value 0.000. However, shipping trade and external reserves contributed positively at 1% and 5% level of significance respectively while external debts impacted negatively to GDP at 5% level of significance with a long run variance of cointegration regression. Therefore, the study suggests that government should do all it can to curtail foreign dominance and repatriation of profit for a more sustainable economy as well as upgrade port facilities, prevent unnecessary delays and encourage exportable goods for maximum deployment of ships.

Keywords: external debts, external reserve, GDP, shipping trade

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Authors: Morteza Pourazar, Fatemeh Mirakhori, Fazlolah Bagherzadeh, Rasool Hemayattalab

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The purpose of study was to examine the effects of external and internal focus of attention in the motor learning of children with cerebral palsy. The study involved 30 boys (7 to 12 years old) with CP type 1 who practiced throwing beanbags. The participants were randomly assigned to the internal focus, external focus, and control groups, and performed six blocks of 10-trial with attentional focus reminders during a practice phase and no reminders during retention and transfer tests. Analysis of variance (ANOVA) with repeated measures on the last factor was used. The results show that significant main effects were found for time and group. However, the interaction of time and group was not significant. Retention scores were significantly higher for the external focus group. The external focus group performed better than other groups; however, the internal focus and control groups’ performance did not differ. The study concluded that motor skills in Spastic Hemiparetic Cerebral Palsy (SHCP) children could be enhanced by external attention.

Keywords: cerebral palsy, external attention, internal attention, throwing task

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Authors: Hadi O. Tohme

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This study is a review on the effectiveness of new physiotherapy techniques with external sensory stimulus compared to standard physiotherapy in the daily activities of patients with Parkinson's disease. Twenty studies from 1996 to 2015 were analyzed and discussed in this review, using the rehabilitation strategy with external sensory stimulus evaluating walking, freezing episodes, balance, transfers, and daily activities of parkinsonian patients. The study highlights the effectiveness of the variety of rehabilitation with cueing strategy used in the treatment of Parkinson's disease. Based on the literature review completed, there is a need for more specific trials with better treatment strategies to support the most appropriate choice of physiotherapy intervention using external sensory stimulus to the type and frequency of this stimulus. In addition, no trials examined the long-term benefits of the physiotherapy intervention with the external sensory stimulus. In order to determine if, or how long the improvements due to the external sensory stimulus physiotherapy intervention can last, long-term follow-up should be performed.

Keywords: cueing strategy, external sensory stimulus, parkinson disease, rehabilitation for parkinson, sensory attention focused exercises, sensory strategy reeducation

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Authors: Douglas F. Prawitt, Nathan Y. Sharp, David A. Wood

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Consistent with prior experimental and survey studies, we find that IAFs that spend more time directly assisting the external auditor is associated with lower external audit fees. Interestingly, we do not find evidence that external auditors reduce fees based on work previously performed by the IAF. We also find that the time spent assisting the external auditor has a greater negative effect on external audit fees than the time spent performing tasks upon which the auditor may rely but that are not performed as direct assistance to the external audit. Our results also show that previous proxies used to measure this relation is either not associated with or are negatively associated with our direct measures of how the IAF can contribute to the external audit and are highly positively associated with the size and the complexity of the organization. Thus, we conclude the disparate experimental and archival results may be attributable to issues surrounding the construct validity of measures used in previous archival studies and that when measures similar to those used in experimental studies are employed in archival tests, the archival results are consistent with experimental findings. Our research makes four primary contributions to the literature. First, we provide evidence that internal auditing contributes to a reduction in external audit fees. Second, we replicate and provide an explanation for why previous archival studies find that internal auditing has either no association with external audit fees or is associated with an increase in those fees: prior studies generally use proxies of internal audit contribution that do not adequately capture the intended construct. Third, our research expands on survey-based research (e.g., Oil Libya sh.co.) by separately examining the impact on the audit fee of the internal auditors’ work, indirectly assisting external auditors and internal auditors’ prior work upon which external auditors can rely. Finally, we extend prior research by using a new, independent data source to validate and extend prior studies. This data set also allows for a sample of examining the impact of internal auditing on the external audit fee and the use of a more comprehensive external audit fee model that better controls for determinants of the external audit fee.

Keywords: internal audit, contribution, external audit, function

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Authors: Artur Siqueira Nóbrega de Freitas

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The Autonomous Underwater Vehicles (AUV), as well the Remotely Operated Vehicles (ROV), are unmanned technologies used in oceanographic investigations, offshore oil extraction, military applications, among others. Differently from AUVs, ROVs uses a physical connection with the surface for energy supply e data traffic. The AUVs use batteries and embedded data acquisition systems. These technologies have progressed, supported by studies in the areas of robotics, embedded systems, naval engineering, etc. This work presents a methodology for external pressure vessel design, responsible for contain and keep the internal components of the vehicle, such as on-board electronics and sensors, isolated from contact with water, creating a pressure differential between the inner and external regions.

Keywords: vessel, external pressure, AUV, buckling

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Authors: Marc Angelo C. Balon, Maxine Joy A. Yongoyong

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Female masturbation has been an age-old controversy. In fact, it is not widely talked about specifically in the Philippines since the Filipino culture still preserves the space for conservativeness. Although, considering the numerous and emerging studies on female masturbation, this study will focus on the perspectives of secular and non-secular male groups with regard to female masturbation. The objectives of this study is to identify the perceptions of these male groups and their taking on considering women who masturbate as their sexual partner, as a sexual object, and as a life partner and lastly, to have a comparative analysis of the perceptions of these male groups drawing out their sense of meaning on the masturbation of women. The researchers made use of purposive sampling technique and interview guide questionnaire. The secular male group were psychology students while the non-secular male group was drawn from a Catholic Church seminary in Tagaytay City, Cavite. Results showed that the secular male group had scientific perspectives such as exploring the genitals, contradicting moral perspectives on masturbation as a regular practice, while the non-secular male groups had theological perspectives in accordance with the fundamental moral theology, moral perspectives and perspectives on masturbation as a regular practice. Moreover, men who came from the non-secular group highly believe that masturbation is immoral. Otherwise, men who came from the secular group noted that masturbation is primary physiological need.

Keywords: secular, non-secular, masturbation, comparative analysis

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Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho

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The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.

Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool

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Authors: Mukesh R. Goswami

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Sports Competition Anxiety test (SCAT) constructed and standardized by Martens was Administrated on 30 National level (15 male, 15 female) Volleyball players of Gujarat. The age of subjects ranged between 19 to 22 years. The purpose of the study was to compare the level of Anxiety between male and female national level Volleyball players of Gujarat. Statistical analysis has been done by T-test and the significance of the result was seen on 0.05 level. The t-test showed that there was no significant difference found in mean difference among the male and the female National level Volleyball players in relation to sports competition anxiety.

Keywords: competition, anxiety, male and female volleyball players, sports

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Authors: Thanduxolo Nomngcoyiya, Simon M. Kang’ethe

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The paper aimed to critically analyse gaps pertaining to the cultural policy environments governing traditional male circumcision in the Eastern Cape as exemplified by an empirical case study. The original study which this paper is derived from utilized qualitative paradigm; and encompassed 28 participants. It used in-depth one-on-one interviews complemented by focus group discussions and key informants as a method of data collection. It also adopted interview guide as a data collection instrument. The original study was cross-sectional in nature, and the data was audio recorded and transcribed later during the data analysis and coding process. The study data analysis was content thematic analysis and identified the following key major findings on the culture of male circumcision policy: Lack of clarity on culture of male circumcision policy operations; Myths surrounding procedures on culture of male circumcision; Divergent views on cultural policies between government and male circumcision custodians; Unclear cultural policies on selection criteria of practitioners; and Lack of policy enforcement and implementation on transgressors of culture of male circumcision. It recommended: a stringent selection criteria of practitioners; a need to carry out death-free male circumcision; a need for male circumcision stakeholders to work with other culture and tradition-friendly stakeholders.

Keywords: human rights, policy enforcement, traditional male circumcision, traditional surgeons and nurses

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Authors: F. Kantaş, D. Boyacı, C. Dinç

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Exhaust systems plays an important role in thermal heat management. Exhaust manifold picks burned gas from engine and exhaust pipes transmit exhaust gas to muffler, exhaust gas is reacted chemically to avoid noxious gas and sound is reduced in muffler then gas is threw out with tail pipe from muffler. Exhaust gas flows out from tail pipe and this hot gas flows to many parts that available around tail pipe and muffler, like spare tire, transmission, pipes etc. These parts are heated by hot exhaust gas. Also vehicle on ride, external flow effects exhaust gas flow and exhaust gas behavior is changed. It's impossible to understand which parts are heated by hot exhaust gas in tests. To understand this phenomena, exhaust gas flow is solved in CFD also external flow due to vehicle movement must be solved with exhaust gas flow. Because external flow effects exhaust gas flow behavior with many parameters. This paper investigates external flow effects exhaust gas flow behavior and other critical parameters effect exhaust gas flow behavior, like different tail pipe design, exhaust gas mass flow in critic vehicle driving situations.

Keywords: exhaust, gas flow, vehicle, external flow

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Authors: Puneet Goyal, Aarti Agarwal

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Background and Objective: Nutritional support is an integral part of palliative care of advanced non-resectable abdominal malignancy patients, though is frequently neglected aspect. Non-Healing high output Entero-cutaneous fistulas sometimes require long term parenteral nutrition, to take care of catabolism and replacement of nutrients. We present a case of inoperable pancreatic malignancy with high output entero-cutaneous fistula, which was provided parenteral nutritional support with the use of Totally Implantable Venous Access Device (TIVAD). Method and Results: 55 year old man diagnosed with carcinoma pancreas had developed high entero-cutaneous fistula. His tumor was found to be inoperable and was on total parenteral nutrition through routine central line. This line was difficult to maintain as he required it for a long term TPN. He was planned to undergo Totally Implantable Venous Access Device (TIVAD) implantation. 8Fr single lumen catheter with Groshong non-return Valve (Bard Access Systems, Inc. USA) was inserted through right internal jugular vein, under fluoroscopic guidance. The catheter was tunneled subcutaneously and brought towards infraclavicular pocket, cut at appropriate length and connected to port and locked. Port was sutured in floor of pocket. Free flow of blood aspirated, flushed with heparinized saline. There was no kink observed in entire length of catheter under fluoroscopy. Skin over infraclavicular pocket was sutured. Long term catheter care and associated risks were explained to patient and relatives. Patient continued to receive total parenteral nutrition as well as other supportive therapy though TIVAD for next 6 weeks, till his demise. Conclusion: TIVADs are standard of care for long term venous access solutions in cancer patients requiring chemotherapy. In this case, we extended its use for providing parenteral nutrition and other supportive therapy. TIVADs can be implanted in advanced cancer patients for providing venous access solution required for various palliative treatments and medications. This will help in improving quality of life and satisfaction amongst terminally ill cancer patients.

Keywords: parenteral nutrition, totally implantable venous access device, long term venous access, interventions in anesthesiology

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Mohamed Shafi Mahboob Ali

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Male breast cancer (MBC) is a rare entity with overall cases reported less than 1%. However, the incidence of MBC is regularly rising every year. Due to the lack of data on MBC, diagnosis and treatment are tailored to female breast cancer. MBC risk increases with age and is usually diagnosed ten years late as the disease progression is slow compared to female breast cancer (FBC). The most common feature of MBC is an intra-ductal variant, and often, upon diagnosis, the stage of the disease is already advanced. The Prognosis of MBC is often flawed, but new treatment modalities are emerging with the current knowledge and advancement. We presented a series of male breast cancer in our center, highlighting the clinicopathological, radiological and treatment options.

Keywords: male, breast, cancer, clinicopathology, ultrasound, CT scan

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Authors: Ana Beatriz C. G. Silva, Luiz Carlos Wrobel, Fernando Luiz B. Ribeiro

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This paper presents a thermoregulation model using the finite element method to perform numerical analyses of brain cooling procedures as a contribution to the investigation on the use of therapeutic hypothermia after ischemia in adults. The use of computational methods can aid clinicians to observe body temperature using different cooling methods without the need of invasive techniques, and can thus be a valuable tool to assist clinical trials simulating different cooling options that can be used for treatment. In this work, we developed a FEM package applied to the solution of the continuum bioheat Pennes equation. Blood temperature changes were considered using a blood pool approach and a lumped analysis for intravascular catheter method of blood cooling. Some analyses are performed using a three-dimensional mesh based on a complex geometry obtained from computed tomography medical images, considering a cooling blanket and a intravascular catheter. A comparison is made between the results obtained and the effects of each case in brain temperature reduction in a required time, maintenance of body temperature at moderate hypothermia levels and gradual rewarming.

Keywords: brain cooling, finite element method, hypothermia treatment, thermoregulation

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Authors: Abouzar Kaboudian, Ravi Chaithanya Mysa, Boo Cheong Khoo, Rajeev Kumar Jaiman

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Vortex induced vibrations can significantly affect the effectiveness of structures in aerospace as well as offshore marine industries. The oscillatory nature of the forces resulting from the vortex shedding around bluff bodies can result in undesirable effects such as increased loading, stresses, deflections, vibrations and noise in the structures, and also reduced fatigue life of the structures. To date, most studies concentrate on either the free oscillations or the prescribed motion of the bluff bodies. However, the structures in operation are usually subject to the external oscillatory forces (e.g. due to the platform motions in offshore industries). In this work, we present the effects of the external cross-flow forces on the vortex-induced vibrations of an oscillating cylinder. The effects of the amplitude, as well as the frequency of the external force on the fluid-forces on the oscillating cylinder are carefully studied and presented. Moreover, we present the transition of the response to be dominated by the vortex-induced-vibrations to the range where it is mostly dictated by the external oscillatory forces. Furthermore, we will discuss how the external forces can affect the flow structures around a cylinder. All results are compared against free oscillations of the cylinder.

Keywords: circular cylinder, external force, vortex-shedding, VIV

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Authors: Zohreh Bang Tavakoli, Shuktika Chatterjee

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This study investigates the fiscal policy impact on countries’ economic growth in developing countries with a different external debt level. The fiscal policy effectiveness has been re-emphasized in the global financial crisis of 2008 with the external debt as its new contemporary driver (Ruščáková and Semančíková, 2016). According to Bouakez, (2014 ) different theories have proposed the economic consequence of fiscal policy, specifically for developing countries. However, fiscal policy literature is lacking research regarding the fiscal policy’s effectiveness with the external debt’s contributions through comprehensive study (Canh, 2018). Also, according to scholars, high levels of external debt will influence economic growth. First, through foreign resources and channel of investment in which high level of debt decreases the amount of foreign investment in the developing countries. Second, through the deterioration of foreign investors and fiscal policies related to a high level of debt (Cordella, et.al., 2010). Therefore, this study proposed that only countries with a low external debt level and appropriate fiscal policies and good quality institutions can gain the proper quantity and quality of foreign investors, which will help the economic growth. For this, this research is examining the impact of fiscal policy on developing countries' economic growth in the situation of different external debt levels.

Keywords: fiscal policy, external debt, gross domestic product, developing countries

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Authors: Jared Cheves, Amanda DeChent, Joyce Pan

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Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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Authors: Eunjoo Lee

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Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.

Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors

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Authors: Amanat Ali, Muhammad S. Al-Siyabi, Mostafa I. Waly, Hashem Al-Kilani

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In a cross-sectional research design, we assessed the nutrient intake, nutritional status, nutritional knowledge and dietary habits of Sultan Qaboos University (SQU) student athletes. A total of 71 (49 male and 22 female) student athletes with a mean age of 21.0 ± 1.81 and 19.32 ± 0.72 years and body mass index (BMI) of 22.51 ± 1.98 and 20.34 ± 2.97 kg/m2 for male and female respectively, participated in this study. A study questionnaire consisting of 2 sections was distributed to the participants. Section I included 18 questions regarding the demographic information, whereas the Section II consisted of 20 questions regarding the nutrition knowledge. The dietary intake of participants was collected by using a 7-days food diary identifying the frequency as well as the variety of food consumption. Significant differences (P < 0.05) were observed in the main sources of nutrition information used by the male and female athletes. Male athletes mainly had most of the nutrition information from friends (17%) whereas female athletes relied mainly on the family (20%). More female athletes (20%) were using TV as a source of nutrition information as compared to male athletes (15%). Both male and female athletes had the minimum nutrition information from dietitians and physicians. Significant (P < 0.05) differences were also observed in the nutritional knowledge and dietary habits scores of male and female athletes, which were 57 % and 49 %, respectively. Male athletes were classified to have fair nutritional knowledge and dietary habits, whereas the female athletes had poor nutritional knowledge and dietary habits. The average daily energy intake of male athletes was 2595 ± 358 kcal/day. Carbohydrate, fat, and protein contributed 64%, 22%, and 14%, of the total energy intake for the male athletes, respectively. The energy and macronutrients intake of male athletes was within the recommended dietary intake. The results indicated some gaps in the nutritional knowledge of SQU student athletes and suggest that there is a need for developing strategies in counseling and teaching the athletes to improve their nutritional knowledge and dietary habits.

Keywords: nutrient assessment, nutritional knowledge, dietary habits, Omani University athletes

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Authors: Seyed Hossein Alavi, Farshad Ghazalian, Soghra Jamshidi

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The present study was done with the purpose of considering mental health and general purpose of describing and comparing depression level of athlete and non-athlete male students educational year of 2012 Research method in this study in proportion to the selective title, descriptive method is causative – comparative. Research samples were selected randomly from B.A students of different fields including 500 students. Average mean of research samples was between 20 to 25 years. Data collection tool is questionnaire of depression measurement of Aroun Beck (B.D.I) that analyzes and measures 21 aspects of depression in 6 ranges. Operation related to analysis of statistical data to extraction of results was done by SPSS software. To extraction of research obtained by comparison of depression level mean, show that the hypothesis of the research (H_1) based on the existence of the significance scientific difference was supported and showed that there’s a significance difference between depression level of athlete male students in comparison with depression level of non-athlete male students. Thus, depression level of athlete male students was lower in comparison with depression level of non-athlete male students.

Keywords: depression, athlete students, non-athlete students

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Authors: Nguyen Ngoc Que Tran

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Purpose: The purpose of this paper is to investigate the relationship between internal market orientation, external market orientation, employee commitment and job satisfaction. Design/methodology/approach: This study collected data through a survey and utilized simple linear regression and multiple regression analysis to determine if there was any support for the research hypotheses as presented in the previous chapter. Findings: Using data from 256 employees of four leading joint stock banks in Vietnam, the empirical results indicates that employee commitment is positively related with external market orientation, job satisfaction is positively related to employee commitment, and employee commitment and job satisfaction are positively related to external market orientation. However, job satisfaction has no significant positive effect on external market orientation. Theoretical contribution: The primary contribution to marketing theory arising from this study is the integration of job satisfaction, employee commitment, and external market orientation in a single research model. Practical implications: The major contribution to practice is an external market oriented bank has to respond rapidly to the future needs and preferences of its customers. This could result in high levels of commitment to the service process and in doing so provide Vietnamese joint-stock commercial banks with a competitive advantage. The finding is important for the banking service sector in general and the Vietnamese banking industry in particular.

Keywords: employee commitment, job satisfaction and external market orientation, vietnam, bank

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Authors: Keivan Jamshidi, Afshin Zahedi

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Reactive amyloidosis is a condition that complicates a long list of chronic inflammation, chronic infectious, malignant, and hereditary disorders. In the present study the propensity for amyloidogenesis in male and female rats on spatio-temporal pattern was evaluated. For this purpose a total of 40 male and female Swiss mice, obtained from Pasteur Institute Tehran, after being weighted were randomly divided into 4 groups including 2 treatment groups [ 10 male (Group A1) and 10 female (Group B1) each], and 2 control groups [10 male (Group A2) and 10 female (Group B2) each]. At the end of 3rd, 5th and 7th weeks of experiment 3 mice were randomly selected and euthnised. Spleen samples of each animal were obtained and preserved in 10% neutral buffer formalin. Sample were then processed through different stages of dehydration, clearing and impregnation and finally embedded in paraffin blocks. Sections of 5µm thickness then cut and stained by alkaline Congo red techniques. The data obtained from polarized microscopic quantitative analysis did show significant differences between groups A1 and B1. A preferential expression of reactive amyloidosis is concluded in male, indicating sex differences in amyloidosis.

Keywords: amyloidosis, amyloidogenesis, mice, gender

Procedia PDF Downloads 574

Authors: Shih-Chieh Liao, Jen-Ying Ma

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Dual protagonists game always bring a unique experience compared to the other games. This research wants to discuss whether the dual protagonists have the moving ability and special ability or not; it will affect the preference of the players. This research will focus on the single-player dual protagonists game. After the observation, we found that when players control the dual protagonists, the moving ability and special ability are a great point defining the preference of players. When players control the character, which is lack of moving ability, they often feel impatient with the inconvenient mechanism and then reduce the will to play with the character or even the game. Furthermore, the special ability is also important in the situation that there is another character to compare with. When the character is too powerful, players tend not to use the weaker one. In addition, gender is a big deal in the games. It surprisingly controls the will of play occasionally. In view of these, this research makes a single-player dual protagonists game and the dual protagonists are limited to male and female. The experiment content detected with Electrodermal Activity (EDA) includes seven different situations. (1) male and females both have the moving ability and special ability. (2) male and female both have a special ability, but female does not have the moving ability. (3) male and females both have a special ability, but the male does not have the moving ability. (4) male and female both have the moving ability, but the male does not have special ability (5) male and female both have the moving ability, but female does not have a special ability (6) male-only has the moving ability and female-only has a special ability (7) male-only has a special ability and female only has the moving ability. The experiment will evaluate the emotional changes of the subjects in those situations. The result sorted by the significance of player preference is (6)>(4)>(1)>(2)>(5)>(3)>(7). The result demonstrates that players prefer females with special abilities or males with moving abilities. The game developer could design the ability of dual protagonists based on this research. Therefore, players may have a better experience.

Keywords: biofeedback, dual protagonists, emotional responses, psychology, user experience

Procedia PDF Downloads 162

Authors: Tsungming Wu

Abstract:

The present paper investigates the use of linking adverbials between native male speakers and female speakers in their presentation. From previous studies, overuse of linking adverbials may be an indicator of the low proficiency level in English. In this study, female speakers are found to use more linking adverbials in general. However, the overuse of linking adverbials found in female speakers’ speeches does not imply female speakers’ lower English proficiency, but imply different approaches that male and female speakers adopt in dealing with their presentation tasks. Female speakers are found to be more interactional, leading to their more uses of interactive devices in the presenting process. On the other hand, male speakers take different approaches in dealing with their tasks. Male speakers try to be authoritative and amicable at the same time, resulting in the uses of both interactive devices and distancing devices in their speeches. The paper specifically presents and compares the use of the linking adverbial items, actually and so, in male speakers’ and female speakers’ speeches.

Keywords: LAs, linking adverbial, low proficiency, overuse

Procedia PDF Downloads 288