Search results for: congenital heart defect(CHD)

Authors: S. Khoshemehry, M. J. Pourvaghar

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Inflammatory markers are known as the main predictors of cardiovascular diseases. This study aimed at determining the effect of 8 weeks of interval endurance training on hs-CRP level and some anthropometric parameters in overweight men. Following the call for participation in research project in Kashan, 73 volunteers participated in it and constituted the statistical population of the study. Then, 28 overweight young men from the age of 22 to 25 years old were randomly assigned into two groups of experimental and control group (n=14). Anthropometric and the blood sample was collected before and after the termination of the program for measuring hs-CRP. The interval endurance program was performed at 60 to 75% of maximum heart rate in 2 sessions per week for 8 weeks. Kolmogorov-Smirnov test was used to test whether two samples come from the same distribution and T-test was used to assess the difference of two groups which were statistically significant at the level of 0.05. The result indicated that there was a significant difference between the hs-RP, weight, BMI and W/H ratio of overweight men in posttest in the exercise group (P≤0.05) but not in the control group. Interval endurance training program causes decrease in hs-CRP level and anthropometric parameters.

Keywords: interval endurance training program, HS-CRP, overweight, anthropometric

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Authors: Leonardo Juan Ramírez López, Javier Oswaldo Rodriguez Velasquez

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We have designed a Holter that measures the heart´s activity for over 24 hours, implemented a prediction methodology, and generate alarms as well as indicators to patients and treating physicians. Various diagnostic advances have been developed in clinical cardiology thanks to Holter implementation; however, their interpretation has largely been conditioned to clinical analysis and measurements adjusted to diverse population characteristics, thus turning it into a subjective examination. This, however, requires vast population studies to be validated that, in turn, have not achieved the ultimate goal: mortality prediction. Given this context, our Insight Research Group developed a mathematical methodology that assesses cardiac dynamics through entropy and probability, creating a numerical and geometrical attractor which allows quantifying the normalcy of chronic and acute disease as well as the evolution between such states, and our Tigum Research Group developed a holter device with 12 channels and advanced computer software. This has been shown in different contexts with 100% sensitivity and specificity results.

Keywords: attractor , cardiac, entropy, holter, mathematical , prediction

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Authors: Ladan Surajo

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Nigeria as a third world country is full of people who cannot read and write, thereby constituting a stumbling block to the modern way of communication. It is a well known fact that Nigeria is a heterogeneous country with an estimated 450 or more ethnic groups communicating in divergent languages. Despite this scenario, English, Hausa, Igbo and Yoruba languages are predominantly used in the country. Apart from English language, Hausa has a wider coverage of usage among the indigenous languages in Nigeria, thereby using it in the area of social mobilization and conflict management cannot be overemphasized. Hausa Oral Singers are depicting their artistic and God endowed talents through singing to mobilize and sensitize the local communities about government programmes and the ills of other social problems of the society. It is the belief of this researcher that if used properly, the Hausa Oral Singers will assist immensely in reducing to the barest minimum some social ills of the society in Nigeria. More so that music is the food of the heart and has a resounding impact in changing the behaviour of individuals and groups.

Keywords: oral, singers, praise, social mobilization, conflict management

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Authors: Petra Hypšová, Martin Seitl

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One of the challenges of forensic psychology is to detect deception during a face-to-face interview. In addition to the classical approaches of monitoring the utterance and its components, detection is also sought by observing behavioral and physiological changes that occur as a result of the increased emotional and cognitive load caused by the production of distorted information. Typical are changes in facial temperature, eye movements and their fixation, pupil dilation, emotional micro-expression, heart rate and its variability. Expanding technological capabilities have opened the space to detect these psychophysiological changes and behavioral manifestations through non-contact technologies that do not interfere with face-to-face interaction. Non-contact deception detection methodology is still in development, and there is a lack of studies that combine multiple non-contact technologies to investigate their accuracy, as well as studies that show how different types of lies produced by different interviewers affect physiological and behavioral changes. The main objective of this study is to apply a specific non-contact technology for deception detection. The next objective is to investigate scenarios in which non-contact deception detection is possible. A series of psychophysiological experiments using infrared thermal imaging, eye tracking and behavioral analysis with FaceReader 9.0 software was used to achieve our goals. In the laboratory experiment, 16 adults (12 women, 4 men) between 18 and 35 years of age (SD = 4.42) were instructed to produce alternating prepared and spontaneous truths and lies. The baseline of each proband was also measured, and its results were compared to the experimental conditions. Because the personality of the examiner (particularly gender and facial appearance) to whom the subject is lying can influence physiological and behavioral changes, the experiment included four different interviewers. The interviewer was represented by a photograph of a face that met the required parameters in terms of gender and facial appearance (i.e., interviewer likability/antipathy) to follow standardized procedures. The subject provided all information to the simulated interviewer. During follow-up analyzes, facial temperature (main ROIs: forehead, cheeks, the tip of the nose, chin, and corners of the eyes), heart rate, emotional expression, intensity and fixation of eye movements and pupil dilation were observed. The results showed that the variables studied varied with respect to the production of prepared truths and lies versus the production of spontaneous truths and lies, as well as the variability of the simulated interviewer. The results also supported the assumption of variability in physiological and behavioural values during the subject's resting state, the so-called baseline, and the production of prepared and spontaneous truths and lies. A series of psychophysiological experiments provided evidence of variability in the areas of interest in the production of truths and lies to different interviewers. The combination of technologies used also led to a comprehensive assessment of the physiological and behavioral changes associated with false and true statements. The study presented here opens the space for further research in the field of lie detection with non-contact technologies.

Keywords: emotional expression decoding, eye-tracking, functional infrared thermal imaging, non-contact deception detection, psychophysiological experiment

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Authors: M. Markova, E. Filova, O. Kaplan, R. Matejka, L. Bacakova

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The porcine pericardium is used as a material for cardiac and aortic valves substitutes. Current biological aortic heart valve prosthesis have a limited lifetime period because they undergo degeneration. In order to make them more biocompatible and prolong their lifetime it is necessary to reseed the decellularized prostheses with endothelial cells and with valve interstitial cells. The endothelialization of the prosthesis-surface may be supported by suitable chemical surface modification of the prosthesis. The aim of this study is to prepare bioactive fibrin layers which would both support endothelialization of porcine pericardium and enhance differentiation and maturation of the endothelial cells seeded. As a material for surface adjustments we used layers of fibrin with/without heparin and some of them with adsorbed or chemically bound FGF2, VEGF or their combination. Fibrin assemblies were prepared in 24-well cell culture plate and were seeded with HSVEC (Human Saphenous Vein Endothelial Cells) at a density of 20,000 cells per well in EGM-2 medium with 0.5% FS and without heparin, without FGF2 and without VEGF; medium was supplemented with aprotinin (200 U/mL). As a control, surface polystyrene (PS) was used. Fibrin was also used as homogeneous impregnation of the decellularized porcine pericardium throughout the scaffolds. Morphology, density, and viability of the seeded endothelial cells were observed from micrographs after staining the samples by LIVE/DEAD cytotoxicity/viability assay kit on the days 1, 3, and 7. Endothelial cells were immunocytochemically stained for proteins involved in cell adhesion, i.e. alphaV integrin, vinculin, and VE-cadherin, markers of endothelial cells differentiation and maturation, i.e. von Willebrand factor and CD31, and for extracellular matrix proteins typically produced by endothelial cells, i.e. type IV collagen and laminin. The staining intensities were subsequently quantified using a software. HSVEC cells grew on each of the prepared surfaces better than on control surface. They reached confluency. The highest cell densities were obtained on the surface of fibrin with heparin and both grow factors used together. Intensity of alphaV integrins staining was highest on samples with remained fibrin layer, i.e. on layers with lower cell densities, i.e. on fibrin without heparin. Vinculin staining was apparent, but was rather diffuse, on fibrin with both FGF2 and VEGF and on control PS. Endothelial cells on all samples were positively stained for von Willebrand factor and CD31. VE-cadherin receptors clusters were best developed on fibrin with heparin and growth factors. Significantly stronger staining of type IV collagen was observed on fibrin with heparin and both growth factors. Endothelial cells on all samples produced laminin-1. Decellularized pericardium was homogeneously filled with fibrin structures. These fibrin-modified pericardium samples will be further seeded with cells and cultured in a bioreactor. Fibrin layers with/without heparin and with adsorbed or chemically bound FGF2, VEGF or their combination are good surfaces for endothelialization of cardiovascular prostheses or porcine pericardium based heart valves. Supported by the Ministry of Health, grants No15-29153A and 15-32497A, and the Grant Agency of the Czech Republic, project No. P108/12/G108.

Keywords: aortic valves prosthesis, FGF2, heparin, HSVEC cells, VEGF

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Authors: Sarah Pasala, Elizabeth Zacharias

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Vital sign monitoring is crucial for both everyday health and medical diagnosis. A significant factor in assessing a human's health is their vital signs, which include heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings. Vital sign monitoring has been the focus of many system and method innovations recently. Piezoelectrics are materials that convert mechanical energy into electrical energy and can be used for vital sign monitoring. Piezoelectric energy harvesters that are stretchable and flexible can detect very low frequencies like airflow, heartbeat, etc. Current advancements in piezoelectric materials and flexible sensors have made it possible to create wearable and implantable medical devices that can continuously monitor physiological signals in humans. But because of their non-biocompatible nature, they also produce a large amount of e-waste and require another surgery to remove the implant. This paper presents a biocompatible and flexible piezoelectric composite material for wearable and implantable devices that offers a high-performance platform for seamless and continuous monitoring of human physiological signals and tactile stimuli. It also addresses the issue of e-waste and secondary surgery. A Lead-free piezoelectric, SrBi4Ti4O15, is found to be suitable for this application because the properties can be tailored by suitable substitutions and also by varying the synthesis temperature protocols. In the present work, SrBi4Ti4O15 modified by rare-earth has been synthesized and studied. Coupling factors are calculated from resonant (fr) and anti-resonant frequencies (fa). It is observed that Samarium substitution in SBT has increased the Curie temperature, dielectric and piezoelectric properties. From impedance spectroscopy studies, relaxation, and non-Debye type behaviour are observed. The composite of bioresorbable poly(l-lactide) and Lead-free rare earth modified Bismuth Layered Ferroelectrics leads to a flexible piezoelectric device for non-invasive measurement of vital signs, such as heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings and also artery pulse signals in near-surface arteries. These composites are suitable to detect slight movement of the muscles and joints. This Lead-free rare earth modified Bismuth Layered Ferroelectrics – polymer composite is synthesized using a ball mill and the solid-state double sintering method. XRD studies indicated the two phases in the composite. SEM studies revealed the grain size to be uniform and in the range of 100 nm. The electromechanical coupling factor is improved. The elastic constants are calculated and the mechanical flexibility is found to be improved as compared to the single-phase rare earth modified Bismuth Latered piezoelectric. The results indicate that this composite is suitable for the non-invasive detection of multiple vital signs of humans.

Keywords: composites, flexible, non-invasive, piezoelectric

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Authors: Cecília M. Antão, Paulo Jorge Nogueira

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Breast cancer (BC) is the first cause of cancer mortality among Portuguese women. This retrospective observational study aimed at identifying comorbidities associated with BC female patients admitted to Portuguese public hospitals (2010-2018), investigating the effect of comorbidities on BC mortality rate, and building a predictive model using logistic regression. Results showed that the BC mortality in Portugal decreased in this period and reached 4.37% in 2018. Adjusted odds ratio indicated that secondary malignant neoplasms of liver, of bone and bone marrow, congestive heart failure, and diabetes were associated with an increased chance of dying from breast cancer. Although the Lisbon district (the most populated area) accounted for the largest percentage of BC patients, the logistic regression model showed that, besides patient’s age, being resident in Bragança, Castelo Branco, or Porto districts was directly associated with an increase of the mortality rate.

Keywords: breast cancer, comorbidities, logistic regression, adjusted odds ratio

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

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Authors: Mariam Aref Mahmoud

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After centuries of historical development, Egypt is no stranger to national identity frustrations. What may or may not be counted as this “national identity” becomes a source of contention. Today, after decades of neoliberal reform, Cairo has become the center of Egypt’s cultural debacle. At its heart, the Egyptian capital serves as Egypt’s extension into global capitalism, its flailing hope to become part of the modernized, cosmopolitan world. Yet, to converge into this image of cosmopolitanism, Cairo must silence the perceived un-modernized sounds, cultures, and spaces that arise from within its alleyways. Currently, the agitation surrounding shaabi music, particularly, that of mahraganat, places these contentions to the center of the modernization debates. This paper will discuss the process through which the conversations between modernization, space, and culture have taken place through a historical analysis of national identity formation under Egypt’s neoliberal regimes. Through this, the paper concludes that music becomes a spatial force through which public space, identity, and globalization must be contested. From these findings researchers can then analyze Cairo through not only its physical landscapes, but also its metaphysical features – such as the soundscape.

Keywords: music, space, globalization, Cairo

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Authors: Felix Gbenoba, Opeyemi Dahunsi

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Customised, self-instructional materials are at the heart of instructional delivery in Open and Distance Learning (ODL). The success of any ODL institution depends on the availability of learning materials in quality and quantity. An ODL study material is expected to imitate what the teacher does in the face-to-face learning environment. This paper evaluates these expectation based on existing data and evidence. It concludes that the reality has not matched the expectation so far in terms of pedagogic aspect of instructional delivery especially in West Africa. This does not mean that instructional materials development has not produced any significant positive results in improving the overall learning (and teaching) experience in these institutions; it implies what will help further to identify the new challenges. Obstacles and problems of instructional materials development that could have affected the open educational resource initiatives are well established. The first section of this paper recalls some of the proposed values of instructional materials. The second section compares achievements so far and suggests that instructional materials development should be consider first at an early stage to realise the aspirations of instructional delivery. The third section highlights the challenges of instructional materials development in the future.

Keywords: face-to-face learning, instructional delivery, open and distance education, self-instructional materials

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Authors: Tamam Albelwi, Robert Rogers, Hans-Peter Kubis

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Background: Exercise is widely acknowledged as a highly important health behavior, which reduces risks related to lifestyle diseases like type 2 diabetes, cardiovascular disease. However, exercise adherence is low in high-risk groups and sedentary lifestyle is more the norm than the exception. Expressed reasons for exercise participation are often based on delayed outcomes related to health threats and benefits but also enjoyment. Whether exercise is perceived as rewarding is well established in animal literature but the evidence is sparse in humans. Additionally, the question how stable any reward is perceived with time delays is an important question influencing decision-making (in favor or against a behavior). For the modality exercise, this has not been examined before. We, therefore, investigated the discounting of pre-established self-selected exercise compared with established rewards of food and money with a computer-based discounting paradigm. We hypothesized that exercise will be discounted like an established reward (food and money); however, we expect that the discounting rate is similar to a consumable reward like food. Additionally, we expected that individuals’ characteristics like preferred intensity, physical activity and body characteristics are associated with discount rates. Methods: 71 participants took part in four sessions. The sessions were designed to let participants select their preferred exercise intensity on a treadmill. Participants were asked to adjust their speed for optimizing pleasantness over an exercise period of up to 30 minutes, heart rate and pleasantness rating was measured. In further sessions, the established exercise intensity was modified and tested on perceptual validity. In the last exercise session rates of perceived exertion was measured on the preferred intensity level. Furthermore, participants filled in questionnaires related to physical activity, mood, craving, and impulsivity and answered choice questions on a bespoke computer task to establish discounting rates of their preferred exercise (kex), their favorite food (kfood) and a value-matching amount of money (kmoney). Results: Participants self-selected preferred speed was 5.5±2.24 km/h, at a heart rate of 120.7±23.5, and perceived exertion scale of 10.13±2.06. This shows that participants preferred a light exercise intensity with low to moderate cardiovascular strain based on perceived pleasantness. Computer assessment of discounting rates revealed that exercise was quickly discounted like a consumable reward, no significant difference between kfood and kex (kfood =0.322±0.263; kex=0.223±0.203). However, kmoney (kmoney=0.080±0.02) was significantly lower than the rates of exercise and food. Moreover, significant associations were found between preferred speed and kex (r=-0.302) and between physical activity levels and preferred speed (r=0.324). Outcomes show that participants perceived and discounted self-selected exercise like an established reward (food and money) but was discounted more like consumable rewards. Moreover, exercise discounting was quicker in individuals who preferred lower speeds, being less physically active. This may show that in a choice conflict between exercise and food the delay of exercise (because of distance) might disadvantage exercise as the chosen behavior particular in sedentary people. Conclusion: exercise can be perceived as a reward and is discounted quickly in time like food. Pleasant exercise experience is connected to low to moderate cardiovascular and perceptual strain.

Keywords: delay discounting, exercise, temporal discounting, time perspective

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Authors: Mbadugha Esther Ifeoma

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Soybeans, like other legumes are rich in nutrients. However, the nutrient profile of soybeans differs in some important ways from most other legumes. Among other nutrients, soy is high in protein, carbohydrates, and fibers, is rich in vitamins, minerals and unsaturated fatty acids and is low in saturated fatty acids. Because of its high nutritional value, it has been rated to be equivalent to meats, eggs and milk. Soy has many health benefits including prevention of coronary heart disease, prevention of cancer growth, improvement of cognitive function, promotion of bone health, prevention of obesity, prevention of type II diabetes and promotion of growth of normal floras in the colon. Soybean consumption is also associated with some side effects which include allergy, flatulence and abdominal discomfort. Nurses/health care providers should therefore, educate clients on the precautionary measures to be taken in preparing soy food products in order to reduce to the barest minimum the side effects, while encouraging them to include soy as part of their daily meals for optimal health and vitality.

Keywords: health benefit, health education, nutritional benefit, soybeans

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Authors: Zayd Parekh, Amish Prasad, Baraa Souman

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Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance due to an exaggerated tachycardia in response to standing upright. This exaggerated orthostatic tachycardia is defined as the heart rate (HR) rising 30 beats above a baseline value while supine or seated within ten minutes. The tachycardia can lead to symptoms of orthostatic intolerance such as palpitations, lightheadedness, exercise intolerance, fatigue, and anxiety. POTS can go undiagnosed for many years due to its similarities with other cardiac and psychiatric conditions and nonspecific presentation, making it crucial to raise awareness for it in the medical field. The following case study discusses a 30-year-old female who was evaluated in the emergency room several times before being referred to the clinic for POTS. An overview of what tests are performed with this patient is also provided, highlighting the diagnostic work-up for POTS and the process of ruling out other differentials being considered. Finally, the epidemiology, the various theories regarding its pathophysiology, the diagnostic process, and pharmacological and non-pharmacological management for POTS are reviewed.

Keywords: orthostatic intolerance, postural orthostatic tachycardia syndrome, syncope, tachycardia

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Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: V. S. S. Kumar, B. Vikram

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The development of effective decision support tools that adopted in the construction industry is vital in the world we live in today, since it can lead to substantial cost reduction and efficient resource consumption. Solving the time-cost trade off problems and its related variants is at the heart of scientific research for optimizing construction planning problems. In general, the classical optimization techniques have difficulties in dealing with TCT problems. One of the main reasons of their failure is that they can easily be entrapped in local minima. This paper presents an investigation on the application of meta-heuristic techniques to two particular variants of the time-cost trade of analysis, the time-cost trade off problem (TCT), and time-cost trade off optimization problem (TCO). In first problem, the total project cost should be minimized, and in the second problem, the total project cost and total project duration should be minimized simultaneously. Finally it is expected that, the optimization models developed in this paper will contribute significantly for efficient planning and management of construction project.

Keywords: fuzzy sets, uncertainty, optimization, time cost trade off problems

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Authors: Ahmed R. Ismail, Hatem A. El Tawil, Nevin G. Rezk

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Historic paths in today's cities are facing the pressure of the urban development due to the rapid urban growth. Every new development is tearing the old urban fabric and the socio-economic character of the historic paths. Furthermore, in some cases historic paths suffer from negligence and decay. Kom El Dekka historic path was one of those deteriorated paths in the city of Alexandria, Egypt, in spite of its high heritage and socio-economic value. Therefore, there was a need to develop urban regeneration strategies as a part of a wider sustainable development vision, to handle the situation and revitalize the path as a livable space in the heart of the city. This study aims to develop a comprehensive assessment methodology to evaluate the different values of the path and to create community-oriented and economic-based analysis methodology for its socio-economic values. These analysis and assessments provide strategies for any regeneration action plan for Kom El Dekka historic path.

Keywords: community-oriented, economic-based, syntactical analysis, urban regeneration

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Authors: Maria Christofi, George Plastiras, Rafaella Elia, Vaggelis Tsiourtis, Theocharis Theocharides, Miltiadis Katsaros

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The rapidly expanding urban areas of the world constitute a challenge of how we need to make the transition to "the next urbanization", which will be defined by new analytical tools and new sources of data. This paper is about the production of a spatial application, the ‘FUMapp’, where space and its initiative will be available literally, in meters, but also abstractly, at a sensed level. While existing spatial applications typically focus on illustrations of the urban infrastructure, the suggested application goes beyond the existing: It investigates how our environment's perception adapts to the alterations of the built environment through a dataset construction of biophysical measurements (eye-tracking, heart beating), and physical metrics (spatial characteristics, size of stimuli, rhythm of mobility). It explores the intersections between architecture, cognition, and computing where future design can be improved and identifies the flexibility and livability of the ‘available space’ of specific examined urban paths.

Keywords: biophysical data, flexibility of urban, livability, next urbanization, spatial application

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Authors: Ana Luísa Mouro

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When the financial crisis exploded in 2008 in the United States, unleashed by the collapse of Lehman Brothers, and contaminated the economies of the European periphery, Germany appeared as the anchor of the stability of all European institutions and countries in difficulty. The solutions provided by the German government have triggered a deep political debate about the key position Germany has conquered at the heart of Europe - a new “German question” has been created. Some say Germany has achieved by peaceful means what was not able to get through military conquest - the domination of Europe – and many fear Germany’s economic power. This debate about the new role of Germany in Europe has received special attention in the European media and Portugal has not been the exception. The present study has been based on the survey, selection and critical analysis of news reporting, opinion articles, interviews and editorials, published in the weekly Expresso and in the daily Público, between 2008 and 2015 (year of the 25th anniversary of Germany’s unification). The findings of this study will show the paradox of German power and its relevance for Europe’s future.

Keywords: Euro crises, German Europe, intercultural hermeneutics, Portuguese quality press

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Authors: J. Byimana, I. A. Muhire, J. E. Nzabahimana, A. Nyombayire

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Introduction: A successful cardiopulmonary resuscitation during a sudden cardiac arrest can be delayed by different components including new hospital setting, lack of adequate training, lack of pre-established resuscitation team and ineffective communication and lead to an unexpected outcome which is death. The main objective of the study was to assess the readiness of resuscitation teams during cardiac arrest and the organizational approaches that would best support their functioning in a new hospital facility, and to detect any factor that may have contributed to responses. This study analyses the readiness of Resuscitation Team (RT) during cardiac arrest. —Material and methods: A prospective Analytic design was carried out at a newly established United Nations level 2 hospital facility, on four RTM (resuscitation team member). A semi structured questionnaire was used to collect data. —Results: This study highlights indicate that the response time during cardiac arrest simulation meet both American heart association (AHA) and European resuscitation council guidelines. The study offers useful evidence about the impact of a new facility on RTM performance and provides an exposure of staff to emergency events within the Work setting.

Keywords: cardiac arrest, code blue, simulation, resuscitation team member

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Authors: Reta

Abstract:

Coffee is widely consumed not only because of its typical taste, but coffee has antioxidant properties because of its polyphenols, and it stimulates brain's performance. The main problem with the consumption of coffee is its content of caffeine. Caffeine, when consumed in excess, can increase muscle tension, stimulate the heart, and increase the secretion of gastric acid. In this research, we applied ohmic-based fermentation technology, which is specially designed to mimic the stomach. We used Arabica coffee, which although cheaper than Luwak coffee, has high acidity, which needs to be reduced. Hence, we applied the ohmic technology, varied the time and temperature of the process and measured the total acidity of the coffee to determine optimum fermentation conditions. Results revealed total acidity of the coffee varied with fermentation conditions; 0.32% at 400C and 12 hr, and 0.52% at 400C and 6 hr. The longer the fermentation, the lower was the acidity. The acidity of the mongoose-fermented (natural fermentation) beans was 2.34%, which is substantially higher than the acidity of the ohmic samples. Ohmic-based fermentation technology, therefore, offers improvements in coffee quality, and this is discussed to highlight the potential of ohmic technology in coffee processing.

Keywords: ohmic technology, fermentation, coffee quality, Arabica coffee

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Authors: Samuel A. Muyiwa

Abstract:

Religious chauvinism has attained an alarming status in Contemporary Nigerian society. Arguably, Nigeria is the largest economy and most populous nation in Africa with over 182 million people, the advantages offer by vibrant economy and high population have been sacrificed on the altar of religion. Tolerance, sacrifice, humility, compassion, love, justice, trustworthiness, dedication to the well-being of others, and unity are the universal spiritual principles that lie at the heart of any religion either Christianity or Islam even traditional. Whereas traditional religious practices foreground the beliefs, norms and ritual that are related to the sacred being God because of its quick and immediate consequence of its effect, the new-found religious sentiments have deviated from the norms, thus undermining cosmic harmony in Nigeria because of its long-time consequence of its effect. Religion, which is expected to accelerate growth and motivate people to develop spiritual nuances for the betterment of their communities, has, however occasioned conflict and violence in Nigeria socio-political cosmo. Therefore, this study examines the content of religion in the promotion of peace and unity and its contextual missing link in the promotion of conflict and violence in Nigeria.

Keywords: religion chauvinism, Nigeria, conflict, conflict resolution

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Authors: Cherifi Mehdi, Lahdir Mourad, Ameur Soltane

Abstract:

Image compression is the heart of several multimedia techniques. It is used to reduce the number of bits required to represent an image. Meteosat Second Generation (MSG) satellite allows the acquisition of 12 image files every 15 minutes and that results in a large databases sizes. In this paper, a novel image compression method based on the arithmetic coding with the sorted Run Length Coding (SRLC) for MSG images is proposed. The SRLC allows us to find the occurrence of the consecutive pixels of the original image to create a sorted run. The arithmetic coding allows the encoding of the sorted data of the previous stage to retrieve a unique code word that represents a binary code stream in the sorted order to boost the compression ratio. Through this article, we show that our method can perform the best results concerning compression ratio and bit rate unlike the method based on the Run Length Coding (RLC) and the arithmetic coding. Evaluation criteria like the compression ratio and the bit rate allow the confirmation of the efficiency of our method of image compression.

Keywords: image compression, arithmetic coding, Run Length Coding, RLC, Sorted Run Length Coding, SRLC, Meteosat Second Generation, MSG

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Authors: Sangbok Lee

Abstract:

There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

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Authors: Ekaterina Zvorykina

Abstract:

Nowadays, Arctic and Antarctic regions are distinguished to be one of the most important strategic resources for global development. Nonetheless, living conditions in Arctic regions still demand certain improvements. As soon as the region is rarely populated, one of the main points of interest is health accommodation of the people, who migrate to Arctic region for permanent and shift work. At Arctic and Antarctic latitudes, personnel face polar day and polar night conditions during the time of the year. It means that they are deprived of natural sunlight in winter season and have continuous daylight in summer. Firstly, the change in light intensity during 24-hours period due to migration affects circadian rhythms. Moreover, the controlled artificial light in winter is also an issue. The results of the recent studies on night shift medical professionals, who were exposed to permanent artificial light, have already demonstrated higher risks in cancer, depression, Alzheimer disease. Moreover, people exposed to frequent time zones change are also subjected to higher risks of heart attack and cancer. Thus, our main goals are to understand how high latitude work and living conditions can affect human health and how it can be prevented. In our study, we analyze molecular and cellular factors, which play important role in circadian rhythm change and distinguish main risk groups in people, migrating to high latitudes. The main well-studied index of circadian timing is melatonin or its metabolite 6-sulfatoxymelatonin. In low light intensity melatonin synthesis is disturbed and as a result human organism requires more time for sleep, which is still disregarded when it comes to working time organization. Lack of melatonin also causes shortage in serotonin production, which leads to higher depression risk. Melatonin is also known to inhibit oncogenes and increase apoptosis level in cells, the main factors for tumor growth, as well as circadian clock genes (for example Per2). Thus, people who work in high latitudes can be distinguished as a risk group for cancer diseases and demand more attention. Clock/Clock genes, known to be one of the main circadian clock regulators, decrease sensitivity of hypothalamus to estrogen and decrease glucose sensibility, which leads to premature aging and oestrous cycle disruption. Permanent light exposure also leads to accumulation superoxide dismutase and oxidative stress, which is one of the main factors for early dementia and Alzheimer disease. We propose a new screening system adjusted for people, migrating from middle to high latitudes and accommodation therapy. Screening is focused on melatonin and estrogen levels, sleep deprivation and neural disorders, depression level, cancer risks and heart and vascular disorders. Accommodation therapy includes different types artificial light exposure, additional melatonin and neuroprotectors. Preventive procedures can lead to increase of migration intensity to high latitudes and, as a result, the prosperity of Arctic region.

Keywords: circadian rhythm, high latitudes, melatonin, neuroprotectors

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Authors: Abu Harera Nadeem, Kingsley Donkor

Abstract:

Tea is a popular beverage due to its flavour, aroma and antioxidant properties—with the most consumed varieties being green and black tea. Antioxidants in tea can lower the risk of Alzheimer’s and heart disease and obesity. However, these teas contain heavy metals such as Hg, Cd, or Pb, which can cause autoimmune diseases like Graves disease. In this study, 11 heavy metals in various commercial green, black, and oolong tea samples were determined using inductively coupled plasma-mass spectrometry (ICP-MS). Two methods of sample preparation were compared for accuracy and precision, which were microwave-assisted digestion and ultrasonic-assisted extraction. The developed method was further validated by detection limit, precision, and accuracy. Results showed that the proposed method was highly sensitive with detection limits within parts-per-billion levels. Reasonable method accuracy was obtained by spiked experiments. The findings of this study can be used to delve into the link between tea consumption and disease and to provide information for future studies on metal determination in tea.

Keywords: ICP-MS, green tea, black tea, microwave-assisted acid digestion, ultrasound-assisted extraction

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Authors: Yaser Riki

Abstract:

There are plenty of considerations about the Third World and developing countries, but one of the main issues regarding these areas is how we can study them. This article makes attention to a fundamental way of approaching this subject through the convergence of history, philosophy, and sociology in order to understand the complexity of the Third World countries. These three disciplines are naturally connected and integrated, but they have gradually separated. While sociology has originated from philosophy, this work is an attempt to generate a sociology that incorporates philosophy as well as history at its heart. This is descriptive-analytical research that searches the history of sociology to find works and theories that provide ideas for this purpose, including the sociology of knowledge and science, The German Ideology (Karl Marx and Friedrich Engels), The Protestant Ethic (Max Weber), Ideology and Utopia (Karl Mannheim) and Dialectic of Enlightenment (Horkheimer and Adorno) provide ideas needed for this purpose. The paper offers a methodological and theoretical vision (historical-philosophical sociology) to identify a few factors, such as the system of thought, that are usually invisible and cause problems in societies, especially third-world counties. This is similar to what some of the founders of sociology did in the first world.

Keywords: the third world, methodology, sociology, philosophy, history, social change, development, social movements

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Authors: Alyona Gencheva

Abstract:

The most common way to study diagnostic results is using specialized programs at a stationary workplace. Magnetic Resonance Imaging is presented in a two-dimensional (2D) format, and Computed Tomography sometimes looks like a three-dimensional (3D) model that can be interacted with. The main idea of the research is to compare ways of displaying diagnostic results in virtual reality that can help a surgeon during or before an operation in augmented reality. During the experiment, the medical staff examined liver vessels in the abdominal area and heart boundaries. The search time and detection accuracy were measured on black-and-white and coloured scans. Usability testing in virtual reality shows convenient ways of interaction like hand input, voice activation, displaying risk to the patient, and the required number of scans. The results of the experiment will be used in the new C# program based on Magic Leap technology.

Keywords: augmented reality, computed tomography, magic leap, magnetic resonance imaging, usability testing, VTE risk

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Authors: Andres Frederic

Abstract:

We present the MindFlow system supporting the detection and the diagnosis of stresses. The heart of the system is a knowledge synthesis engine allowing occupational health stakeholders (psychologists, occupational therapists and human resource managers) to formulate queries related to stress and responding to users requests by recommending a pattern of stress if one exists. The stress pattern diagnosis is based on expert knowledge stored in the MindFlow stress ontology including stress feature vector. The query processing may involve direct access to the MindFlow system by occupational health stakeholders, online communication between the MindFlow system and the MindFlow domain experts, or direct dialog between a occupational health stakeholder and a MindFlow domain expert. The MindFlow knowledge model is generic in the sense that it supports the needs of psychologists, occupational therapists and human resource managers. The system presented in this paper is currently under development as part of a Dutch-Japanese project and aims to assist organisation in the quick diagnosis of stress patterns.

Keywords: occupational stress, stress management, physiological measurement, accident prevention

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Authors: Luciano Tarantino

Abstract:

Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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