Search results for: background modeling

Authors: Dmitry Aron

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Major radiation accidents carry not only the potential risks of negative consequences for public health due to exposure but also because of large-scale emergency measures were taken by authorities to protect the population, which can lead to unreasonable social and economic damage. It is technically difficult, as a rule, to assess the possible costs and damages from decisions on evacuation or resettlement of residents in the shortest possible time, since it requires specially prepared information systems containing relevant information on demographic, economic parameters and incoming data on radiation conditions. Foreign observers also face the difficulties in assessing the consequences of an accident in a foreign territory, since they usually do not have official and detailed statistical data on the territory of foreign state beforehand. Also, they can suppose the application of unofficial data from open Internet sources is an unreliable and overly labor-consuming procedure. This paper describes an approach to prompt creation of relational database that contains detailed actual data on economics, demographics and radiation situation at the Fukushima Prefecture during the Fukushima Daiichi NPP accident, received by the author from open Internet sources. This database was developed and used to assess the number of evacuated population, radiation doses, expected financial losses and other parameters of the affected areas. The costs for the areas with temporarily evacuated and long-term resettled population were investigated, and the radiological and economic effectiveness of the measures taken to protect the population was estimated. Some of the results are presented in the article. The study showed that such a tool for analyzing the consequences of radiation accidents can be prepared in a short space of time for the entire territory of Japan, and it can serve for the modeling of social and economic consequences for hypothetical accidents for any nuclear power plant in its territory.

Keywords: Fukushima, radiation accident, emergency measures, database

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Irsa Ejaz, Siyang He, Wei Li, Naiyue Hu, Chaochen Tang, Songbo Li, Meng Li, Boubacar Diallo, Guanghui Xie, Kang Yu

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Background: Near-infrared spectroscopy (NIR) is a non-destructive, fast, and low-cost method to measure the grain quality of different cereals. Previously reported NIR model calibrations using the whole grain spectra had moderate accuracy. Improved predictions are achievable by using the spectra of whole grains, when compared with the use of spectra collected from the flour samples. However, the feasibility for determining the critical biochemicals, related to the classifications for food, feed, and fuel products are not adequately investigated. Objectives: To evaluate the feasibility of using NIRS and the influence of four sample types (whole grains, flours, hulled grain flours, and hull-less grain flours) on the prediction of chemical components to improve the grain sorting efficiency for human food, animal feed, and biofuel. Methods: NIR was applied in this study to determine the eight biochemicals in four types of sorghum samples: hulled grain flours, hull-less grain flours, whole grains, and grain flours. A total of 20 hybrids of sorghum grains were selected from the two locations in China. Followed by NIR spectral and wet-chemically measured biochemical data, partial least squares regression (PLSR) was used to construct the prediction models. Results: The results showed that sorghum grain morphology and sample format affected the prediction of biochemicals. Using NIR data of grain flours generally improved the prediction compared with the use of NIR data of whole grains. In addition, using the spectra of whole grains enabled comparable predictions, which are recommended when a non-destructive and rapid analysis is required. Compared with the hulled grain flours, hull-less grain flours allowed for improved predictions for tannin, cellulose, and hemicellulose using NIR data. Conclusion: The established PLSR models could enable food, feed, and fuel producers to efficiently evaluate a large number of samples by predicting the required biochemical components in sorghum grains without destruction.

Keywords: FT-NIR, sorghum grains, biochemical composition, food, feed, fuel, PLSR

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Authors: Daeung Jung

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Background: In case of patients with missing teeth, multiple implant restoration has been widely used and is inevitable. To increase its survival rate, it is important to understand the influence of different implant designs on inter-implant crestal bone resorption. There are several implant systems designed to minimize loss of crestal bone, and the Astra Tech and Brånemark Implant are two of them. Aim/Hypothesis: The aim of this 10-year study was to compare the height of inter-implant bone crest in two implant systems; the Astra Tech and the Brånemark implant system. Material and Methods: In this retrospective study, 40 consecutively treated patients were utilized; 23 patients with 30 sites for Astra Tech system and 17 patients with 20 sites for Brånemark system. The implant restoration was comprised of splinted crown in partially edentulous patients. Radiographs were taken immediately after 1st surgery, at impression making, at prosthetics setting, and annually after loading. Lateral distance from implant to bone crest, inter-implant distance was gauged, and crestal bone height was measured from the implant shoulder to the first bone contact. Calibrations were performed with known length of thread pitch distance for vertical measurement, and known diameter of abutment or fixture for horizontal measurement using ImageJ. Results: After 10 years, patients treated with Astra Tech implant system demonstrated less inter-implant crestal bone resorption when implants had a distance of 3mm or less between them. In cases of implants that had a greater than 3 mm distance between them, however, there appeared to be no statistically significant difference in crestal bone loss between two systems. Conclusion and clinical implications: In the situation of partially edentulous patients planning to have more than two implants, the inter-implant distance is one of the most important factors to be considered. If it is impossible to make sure of having sufficient inter-implant distance, the implants with less micro gap in the fixture-abutment junction, less traumatic 2nd surgery approach, and the adequate surface topography would be choice of appropriate options to minimize inter-implant crestal bone resorption.

Keywords: implant design, crestal bone loss, inter-implant distance, 10-year retrospective study

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Authors: Chalachew Gashu, Yoseph Kassa, Habtamu Geremew, Mengestie Mulugeta

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Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low‐ and middle‐income countries. The aim of this study was to determine the survival time of under‐five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under‐five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analyzed using Kaplan‒Meier plots and log‐rank tests. The survival time of severe acute malnutrition was further analyzed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.

Keywords: Bayesian analysis, severe acute malnutrition, survival data analysis, survival time

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Authors: Peiming Li

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This paper presents an innovative blockchain-based approach to enhance the reliability and efficiency of federated learning systems. By integrating a decentralized oracle consensus mechanism into the federated learning framework, we address key challenges of data and model integrity. Our approach utilizes a network of redundant oracles, functioning as independent validators within an epoch-based training system in the federated learning model. In federated learning, data is decentralized, residing on various participants' devices. This scenario often leads to concerns about data integrity and model quality. Our solution employs blockchain technology to establish a transparent and tamper-proof environment, ensuring secure data sharing and aggregation. The decentralized oracles, a concept borrowed from blockchain systems, act as unbiased validators. They assess the contributions of each participant using a Hidden Markov Model (HMM), which is crucial for evaluating the consistency of participant inputs and safeguarding against model poisoning and malicious activities. Our methodology's distinct feature is its epoch-based training. An epoch here refers to a specific training phase where data is updated and assessed for quality and relevance. The redundant oracles work in concert to validate data updates during these epochs, enhancing the system's resilience to security threats and data corruption. The effectiveness of this system was tested using the Mnist dataset, a standard in machine learning for benchmarking. Results demonstrate that our blockchain-oriented federated learning approach significantly boosts system resilience, addressing the common challenges of federated environments. This paper aims to make these advanced concepts accessible, even to those with a limited background in blockchain or federated learning. We provide a foundational understanding of how blockchain technology can revolutionize data integrity in decentralized systems and explain the role of oracles in maintaining model accuracy and reliability.

Keywords: federated learning system, block chain, decentralized oracles, hidden markov model

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Authors: Inaam Khalaf, Nadin M. Abdel Razeq, Hamza Alduraidi, Suhaila Halasa, Omayyah S. Nassar, Eman Al-Horani, Jumana Shehadeh, Anna Talal

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Background: Nursing researchers are responsible for generating knowledge that corresponds to national and global research priorities in order to promote, restore, and maintain the health of individuals and societies. The objectives of this scoping review of Jordanian literature are to assess the existing research on pediatric nursing in terms of evolution, authorship and collaborations, funding sources, methodologies, topics of research, and pediatric subjects' age groups so as to identify gaps in research. Methodology: A search was conducted using related keywords obtained from national and international databases. The reviewed literature included pediatric health articles published through December 2019 in English and Arabic, authored by nursing researchers. The investigators assessed the retrieved studies and extracted data using a data-mining checklist. Results: The review included 265 articles authored by Jordanian nursing researchers concerning children's health, published between 1987 and 2019; 95% were published between 2009 and 2019. The most commonly applied research methodology was the descriptive non-experimental method (76%). The main generic topics were health promotion and disease prevention (23%), chronic physical conditions (19%), mental health, behavioral disorders, and forensic issues (16%). Conclusion: The review findings identified a grave shortage of evidence concerning nursing care issues for children below five years of age, especially those between ages two and five years. The research priorities identified in this review resonate with those identified in international reports. Implications: Nursing researchers are encouraged to conduct more research targeting topics of national-level importance in collaboration with clinically involved nurses and international scholars.

Keywords: Jordan, scoping review, children health nursing, pediatric, adolescents

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Authors: Annika Stechemesser, Rachel Pounds, Emma Lucas, Chris Dawson, Julia Lipecki, Pavle Vrljicak, Jan Brosens, Sean Kehoe, Jason Yap, Lawrence Young, Sascha Ott

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Advances in technology make it now possible to retrieve the genetic information of thousands of single cancerous cells. One of the key challenges in single cell analysis of cancerous tissue is to determine the number of different cell types and their characteristic genes within the sample to better understand the tumors and their reaction to different treatments. For this analysis to be possible, it is crucial to filter out background noise as it can severely blur the downstream analysis and give misleading results. In-depth analysis of the state-of-the-art filtering methods for single cell data showed that they do, in some cases, not separate noisy and normal cells sufficiently. We introduced an algorithm that filters and clusters single cell data simultaneously without relying on certain genes or thresholds chosen by eye. It detects communities in a Shared Nearest Neighbor similarity network, which captures the similarities and dissimilarities of the cells by optimizing the modularity and then identifies and removes vertices with a weak clustering belonging. This strategy is based on the fact that noisy data instances are very likely to be similar to true cell types but do not match any of these wells. Once the clustering is complete, we apply a set of evaluation metrics on the cluster level and accept or reject clusters based on the outcome. The performance of our algorithm was tested on three datasets and led to convincing results. We were able to replicate the results on a Peripheral Blood Mononuclear Cells dataset. Furthermore, we applied the algorithm to two samples of ovarian cancer from the same patient before and after chemotherapy. Comparing the standard approach to our algorithm, we found a hidden cell type in the ovarian postchemotherapy data with interesting marker genes that are potentially relevant for medical research.

Keywords: cancer research, graph theory, machine learning, single cell analysis

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Authors: Inayat Shah, Muhammad Omar Malik, Ghareeb Alshuwaier, Ronald H. Baxendale

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Background: The balance between angiogenesis and angiostasis is important in growth and developmental processes in the body. Angiogenic and angiostatic mediators control this balance. Endostatin is one of the prominent angiostatic mediators. The marked angiostatic effect of endostatin includes inhibiting endothelial cell migration, proliferation and apoptosis. Physical activity decreases the risk and development of many angiogenesis related health problems including atherosclerosis and numerous cancers. Physiological influences of different physical activities on plasma endostatin concentration are controversial and not completely clear. Moreover, correlation of physical characteristics and metabolic predictors during physical activity on circulating endostatin is indistinct and poorly speculated. The study aimed to determine the effects of mild, moderate and vigorous exercise on the concentration of endostatin in plasma. Methodology: 22 participants, 16 males (age = 30.6 ± 7.8 years) and 6 females (age = 26.5 ± 5 years) were recruited. Weekly session of different intensities exercise based on the predicted maximum heart of the participants [60%(low), 70% (moderate) and 80% (vigorous)] were carried out. The duration and work rate for each participant was determined through sub-maximal exercise. Standardization of the session was done on total energy expenditure of the participants per session. One pre exercise and two post exercise samples were taken at intervals of 10 and 60 minutes. Results: Pre-exercise mean endostatin was 101 ± 20 ng/dl. Low intensity exercise insignificantly decreased the endostatin concentration in plasma at 10 and 60 minutes 97 ± 20 ng/dl (p= 0.5), 98 ± 23 ng/dl (p= 0.8)). However, moderate (p= 0.022, 0.004) and vigorous intensities (p ≤ 0.001, 0.02) increased the endostatin concentrations significantly at both 10 and 60 minutes intervals respectively. The effects were not significantly influenced by gender, exercise mode (walking vs. running), components of exercise (HR, Speed, Gradients, distance, duration) or metabolism during exercise (VO₂ max, VCO₂, RER, energy expenditure, rate of carbohydrate or fats oxidation). Conclusion: Low intensity exercises did not influence endostatin concentration. However, moderate to high intensity exercises significantly increase endostatin concentration and may have potential benefits.

Keywords: angiogenesis, exercise, endostatin, physical activity

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Authors: F. Saleh, F. Lyall, A. Abdulsid, L. Marks

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Background: Labour in human is a complex biological process that involves interactions of neurological, hormonal and inflammatory pathways, with the placenta being a key regulator of these pathways. It is known that uterine contractions and labour pain cause physiological changes in gene expression in maternal and fetal blood, and in placenta during labour. Oxidative and inflammatory stress pathways are implicated in labour and they may cause alteration of placental gene expression. Additionally, in placental tissues, labour increases the expression of genes involved in placental oxidative stress, inflammatory cytokines, angiogenic regulators and apoptosis. Recently, Hydrogen Sulphide (H2S) has been considered as an endogenous gaseous mediator which promotes vasodilation and exhibits cytoprotective anti-inflammatory properties. The endogenous H2S is synthesised predominantly by two enzymes: cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). As the H2S pathway has anti-oxidative and anti-inflammatory characteristics thus, we hypothesised that the expression of CBS and CSE in placental tissues would alter during labour. Methods: CBS and CSE expressions were examined in placentas using western blotting and RT-PCR in inner, middle and outer placental zones in placentas obtained from healthy non labouring women who delivered by caesarian section. These were compared with the equivalent zone of placentas obtained from women who had uncomplicated labour and delivered vaginally. Results: No differences in CBS and CSE mRNA or protein levels were found between the different sites within placentas in either the labour or non-labour group. There were no significant differences in either CBS or CSE expression between the two groups at the inner site and middle site. However, at the outer site there was a highly significant decrease in CBS protein expression in the labour group when compared to the non-labour group (p = 0.002). Conclusion: To the best of author’s knowledge, this is the first report to suggest that, CBS is expressed in a spatial manner within the human placenta. Further work is needed to clarify the precise function and mechanism of this spatial regulation although it is likely that inflammatory pathways regulation is a complex process in which this plays a role.

Keywords: anti-inflammatory, hydrogen sulphide, labour, oxidative stress

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Authors: Mehena Fedoul

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This paper examines the intersection of race, gender, and disability through a Critical disability race theory and black feminist disability perspective in Keah Brown's memoir, "The Pretty One." The background of the study highlights the significance of intersectionality in understanding the multifaceted experiences of individuals who navigate multiple marginalized identities. The study contributes to the underrepresented field of disability studies from Critical race and black feminist perspectives, shedding light on the unique challenges and resilience of black disabled women. The study employs a qualitative analysis of Keah Brown's memoir as a primary text. Drawing on intersectionality theory and black feminist disability scholarship, the analysis focuses on how Brown's memoir illuminates the ways in which her race, gender, and disability intersect and shape her lived experiences. The analysis reveals how Brown's memoir challenges traditional notions of disability, beauty, and empowerment through the unapologetic celebration of her blackness, femaleness, and disability. The major findings of the study indicate that Brown's memoir provides a powerful narrative of the complexity, uniqueness and richness of the lived experiences of black disabled women. It demonstrates how the intersectionality of race, gender, and disability shapes Brown's identity, body image, relationships, and societal interactions. The paper also highlights how Brown's memoir emphasizes the importance of inclusivity and intersectionality in understanding and addressing the challenges faced by black disabled women. In conclusion, this study offers a critical analysis of the intersection of race, gender, and disability in Keah Brown's memoir, "The Pretty One," from a black feminist disability perspective. It contributes to the growing body of literature that recognizes the significance of intersectionality in understanding the experiences of marginalized individuals in the disability community. The study underscores the need for more inclusive and intersectional perspectives in disability studies and advocates for greater recognition of the voices and experiences of black disabled women in academic and societal discourse.

Keywords: disability studies, intersectionality, black feminism, Keah Brown

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Authors: A. Rohit Kumar, B. R. K. Pathak

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Background: Geroanthropology or the anthropology of ageing is a term which can be understood in terms of the anthropology of old age, old age within anthropology, and the anthropology of age. India is known as the land of spirituality and philosophy and is the birthplace of four major religions of the world namely Hinduasim, Buddhisim, Jainisim, and Sikhism. The most dominant religion in India today is Hinduism. About 80% of Indians are Hindus. Hinduism is a religion with a large number of Gods and Goddesses. Religion in India plays an important role at all life stages i.e. at birth, adulthood and particularly during old age. India is the second largest country in the world with 72 million elder persons above 60 years of age in 2001 as compared to china 127 million. The very concept of old age homes in India is new. The elderly people staying away from their homes, from their children or left to them is not considered to be a very happy situation. This paper deals with anthropology of ageing, religion and spirituality among the elderly residing in old age homes and tries to explain that how religion plays a vital role in the health of the elderly during old age. Methods: The data for the present paper was collected through both Qualitative and Quantitative methods. Old age homes located in Jallandher (Punjab) were selected for the present study. Age sixty was considered as a cut off age. Narratives, case studies were collected from 100 respondents residing in old age homes. The dominant religion in Punjab was found to be Sikhism and Hinduism while Jainism and Buddhism were found to be in minority. It was found that as one grows older the religiosity increases. Religiosity and sprituality was found to be directly proportional to ageing. Therefore religiosity and health were found to be connected. Results and Conclusion: Religion was found out to be a coping mechanism during ill health. The elderly living in old age homes were purposely selected for the study as the elderly in old age homes gets medical attention provided only by the old age home authorities. Moreover, the inmates in old age homes were of low socio-economic status couldn’t afford medical attention on their own. It was found that elderly who firmly believed in religion were found to be more satisfied with their health as compare to elderly who does not believe in religion at all. Belief in particular religion, God and godess had an impact on the health of the elderly.

Keywords: ageing, geroanthropology, religion, spirituality

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Authors: Bharati Mehta, Manish Parakh, Bharti Bhandari, Sneha Ambwani

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Speech and language delay (SLD) is seen commonly as a co-morbidity in children having severe resistant focal and generalized, syndromic and symptomatic epilepsies. It is however not clear whether epilepsy contributes to or is a mere association in the pathogenesis of SLD. Also, it is acknowledged that Auditory Brainstem Evoked Responses (ABER), besides used for evaluating hearing threshold, also aid in prognostication of neurological disorders and abnormalities in the hearing pathway in the brainstem. There is no circumscribed or surrogate neurophysiologic laboratory marker to adjudge the extent of SLD. The current study was designed to evaluate the abnormalities in Electroencephalography (EEG) and ABER in children with SLD who do not have an overt hearing deficit or autism. 94 children of age group 2-8 years with predominant SLD and without any gross motor developmental delay, head injury, gross hearing disorder, cleft lip/palate and autism were selected. Standard video Electroencephalography using the 10:20 international system and ABER after click stimulus with intensities 110 db until 40 db was performed in all children. EEG was abnormal in 47.9% (n= 45; 36 boys and 9 girls) children. In the children with abnormal EEG, 64.5% (n=29) had an abnormal background, 57.8% (n=27) had presence of generalized interictal epileptiform discharges (IEDs), 20% (n=9) had focal epileptiform discharges exclusively from left side and 33.3% (n=15) had multifocal IEDs occurring both in isolation or associated with generalised abnormalities. In ABER, surprisingly, the peak latencies for waves I, III & V, inter-peak latencies I-III & I-V, III-V and wave amplitude ratio V/I, were found within normal limits in both ears of all the children. Thus in the current study it is certain that presence of generalized IEDs in EEG are seen in higher frequency with SLD and focal IEDs are seen exclusively in left hemisphere in these children. It may be possible that even with generalized EEG abnormalities present in these children, left hemispheric abnormalities as a part of this generalized dysfunction may be responsible for the speech and language dysfunction. The current study also emphasizes that ABER may not be routinely recommended as diagnostic or prognostic tool in children with SLD without frank hearing deficit or autism, thus reducing the burden on electro physiologists, laboratories and saving time and financial resources.

Keywords: ABER, EEG, speech, language delay

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Authors: Mona Nada, Fahmy Fahmy

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Background: Pleomorphic dermal sarcoma is a rare form of skin cancer affecting cutaneous layer and, in some cases associated with recurrence and metastasis, very commonly to seen in elderly patient affecting the area of head and neck. Pleomorphic dermal sarcoma rises in ultraviolet light exposed areas. The symptoms and severity of this kind of skin cancer varies according to histological factors. The differentiation of Pleomorphic dermal sarcoma needs extensive immunohistochemistry, as the diagnosis depends mainly on exclusion to rule out other malignancy like poorly differentiated squamous cell carcinoma, melanoma, angiosarcoma and leiomyosarcoma. Objective: assessing the management of Pleomorphic dermal sarcoma in our unit and compared to the updated guidelines. Design: Retrospective study Collection of patient data from medical records at countess of Chester plastic surgery unit of the last 5 years, all histologically confirmed Pleomorphic dermal sarcoma (2017-2023). Data were collected confirmed to be Pleomorphic dermal sarcoma were included in the study. The data collected: clinical description of the lesions at first presentation, operation time, multidisciplinary team discussion, plan, referral as well as second operation and investigation done. With comparison of histological examination, immunohistochemistry staining, the excision and rate of recurrence. Results: data collected N19 from (2017-2023) showed the disease predominantly affecting males and the lesion mainly in head and neck, the diagnosis needed extensive immunohistochemistry to differentiate between other malignancy. recurrence present in numbers of the cases which managed after multidisciplinary team discussion either by excision or radiotherapy. Conclusion: Pleomorphic dermal sarcoma is a rare malignancy which needs more understanding and avoid missing as it is aggressive form of skin cancer, there is a chance of metastasis and recurrence which makes it very important to understand the process of development of the cancer and frequent review of the management guidelines.

Keywords: pleomorphic dermal sarcoma, recurrence, radiotherapy, surgical

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Authors: Nuri Onat, Omer Tatari, Gokhan Egilmez

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The U.S. buildings consume significant amount of energy and natural resources and they are responsible for approximately 40 % of the greenhouse gases emitted in the United States. Awareness of these environmental impacts paved the way for the adoption of green building movement. The green building movement is a rapidly increasing trend. Green Construction market has generated $173 billion dollars in GDP, supported over 2.4 million jobs, and provided $123 billion dollars in labor earnings. The number of LEED certified buildings is projected to be almost half of the all new, nonresidential buildings by 2015. National Science and Technology Council (NSTC) aims to increase number of net-zero energy buildings (NZB). The ultimate goal is to have all commercial NZB by 2050 in the US (NSTC 2008). Green Building Initiative (GBI) became the first green building organization that is accredited by American National Standards Institute (ANSI), which will also boost number of green buildings certified by Green Globes. However, there is much less focus on greening the residential buildings, although the environmental impacts of existing residential buildings are more than that of commercial buildings. In this regard, current research aims to model the residential green building movement with a dynamic model approach and assess the possible strategies to stabilize the carbon footprint of the U.S. residential building stock. Three aspects of sustainable development are considered in policy making, namely: high performance green building (HPGB) construction, NZB construction and building retrofitting. 19 different policy options are proposed and analyzed. Results of this study explored that increasing the construction rate of HPGBs or NZBs is not a sufficient policy to stabilize the carbon footprint of the residential buildings. Energy efficient building retrofitting options are found to be more effective strategies then increasing HPGBs and NZBs construction. Also, significance of shifting to renewable energy sources for electricity generation is stressed.

Keywords: green building movement, residential buildings, carbon footprint, system dynamics

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Authors: Rebecca S. Hock, Cyralene P. Bryce, Kevin Williams, Arielle G. Rabinowitz, Janina R. Galler

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Background: Findings have been mixed regarding whether offspring of parents who were abused or neglected as children have a greater risk of experiencing abuse or neglect themselves. In addition, many studies on this topic are restricted to physical abuse and take place in a limited number of countries, representing a small segment of the world's population. Methods: We examined relationships between childhood maltreatment history assessed in a subset (N=68) of the original longitudinal birth cohort (G1) of the Barbados Nutrition Study and their now-adult offspring (G2) (N=111) using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We used Pearson correlations to assess relationships between parent and offspring CTQ-SF total and subscale scores (physical, emotional, and sexual abuse; physical and emotional neglect). Next, we ran multiple regression analyses, using the parental CTQ-SF total score and the parental Sexual Abuse score as primary predictors separately in our models of G2 CTQ-SF (total and subscale scores). Results: G1 total CTQ-SF scores were correlated with G2 offspring Emotional Neglect and total scores. G1 Sexual Abuse history was significantly correlated with G2 Emotional Abuse, Sexual Abuse, Emotional Neglect, and Total Score. In fully-adjusted regression models, parental (G1) total CTQ-SF scores remained significantly associated with G2 offspring reports of Emotional Neglect, and parental (G1) Sexual Abuse was associated with offspring (G2) reports of Emotional Abuse, Physical Abuse, Emotional Neglect, and overall CTQ-SF scores. Conclusions: Our findings support a link between parental exposure to childhood maltreatment and their offspring's self-reported exposure to childhood maltreatment. Of note, there was not an exact correspondence between the subcategory of maltreatment experienced from one generation to the next. Compared with other subcategories, G1 Sexual Abuse history was the most likely to predict G2 offspring maltreatment. Further studies are needed to delineate underlying mechanisms and to develop intervention strategies aimed at preventing intergenerational transmission.

Keywords: trauma, family, adolescents, intergenerational trauma, child abuse, child neglect, global mental health, North America

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Authors: Kohkan Shamsi

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Background: MRI and PET are now extensively utilized in Alzheimer's disease (AD) trials for patient eligibility, efficacy assessment, and safety evaluations but including imaging in AD trials impacts site selection process, patient recruitment, and patient retention. Methods: PET/MRI are performed at baseline and at multiple follow-up timepoints. This requires prospective site imaging qualification, evaluation of phantom data, training and continuous monitoring of machines for acquisition of standardized and consistent data. This also requires prospective patient/caregiver training as patients must go to multiple facilities for imaging examinations. We will share our experience form one of the largest AD programs. Lesson learned: Many neurological diseases have a similar presentation as AD or could confound the assessment of drug therapy. The inclusion of wrong patients has ethical and legal issues, and data could be excluded from the analysis. Centralized eligibility evaluation read process will be discussed. Amyloid related imaging abnormalities (ARIA) were observed in amyloid-β trials. FDA recommended regular monitoring of ARIA. Our experience in ARIA evaluations in large phase III study at > 350 sites will be presented. Efficacy evaluation: MRI is utilized to evaluate various volumes of the brain. FDG PET or amyloid PET agents has been used in AD trials. We will share our experience about site and central independent reads. Imaging logistic issues that need to be handled in the planning phase will also be discussed as it can impact patient compliance thereby increasing missing data and affecting study results. Conclusion: imaging must be prospectively planned to include standardizing imaging methodologies, site selection process and selecting assessment criteria. Training should be transparently conducted and documented. Prospective patient/caregiver awareness of imaging requirement is essential for patient compliance and reduction in missing imaging data.

Keywords: Alzheimer's disease, ARIA, MRI, PET, patient recruitment, retention

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Authors: Abdul Fatah, Naveenchandra Acharya, Vamshi Krishna, T. Shivaprasad, Ramesh Ramayya

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Background: Significant number of patients with bladder outlet obstruction due to BPH are on anti-platelets and anticoagulants. Prostate surgery in this group of patients either in the form of TURP or Open prostatectomy is associated with increased risk of bleeding complications requiring transfusions, packing of the prostatic fossa or ligation or embolization of internal iliac arteries. Withholding of antiplatelets and anticoagulants may be associated with cardiac and other complications. Efficacy of Thulium Laser in the above group of patients was evaluated in terms of peri-operative, postoperative and delayed bleeding complications as well as cardiac events in peri-operative and immediate postoperative period. Methods: 217 patients with a mean age of 68.8 years were enrolled between March 2009 and March 2013 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), PSA values, urine analysis and urine culture, uroflowmetry. The post operative complications in the form of drop in hemoglobin level, transfusion rates, post –operative cardiac events within a period of 30 days, delayed hematuria and events like deep vein thrombosis and pulmonary embolism were noted. Results: Our data showed a better post-operative outcome in terms of, postoperative bleeding requiring intervention 7 (3.2%), transfusion rate 4 (1.8%) and cardiac events within a period of 30 days 4(1.8%), delayed hematuria within 6 months 2(0.9 %) compared other series of prostatectomies. Conclusion: The thulium LASER prostatectomy is a safe and effective option for patients with cardiac comorbidties and those patients who are on antiplatelet agents and anticoagulants. The complication rate is less as compared to larger series reported with open and transurethral prostatectomies.

Keywords: thulium laser, prostatectomy, antiplatelet agents, bleeding

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Authors: Ana Cristina Lindsay, Mary L. Greaney

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Background: Racial/ethnic minority children of low-income immigrant families remain at increased risk of obesity. Consistent with high rates of childhood obesity among racial/ethnic minority children are high rates of physical inactivity and increased levels of sedentary behaviors (e.g., TV and other screen viewing). Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on the health issues affecting Brazilian immigrant children. The purpose of this qualitative study was to explore how Brazilian-born immigrant mothers living in the United States obtain information about physical activity and screen-time for their young children. Methods: Qualitative research including focus groups with Brazilian immigrant mothers of preschool-age children living in the U.S. Results: Results revealed that Brazilian immigrant mothers obtain information on young children’s physical activity and screen-time from a variety of sources including interpersonal communication, television and magazines, government health care programs (WIC program) and professionals (e.g., nurses and pediatricians). A noteworthy finding is the significant role of foreign information sources (Brazilian TV shows and magazines) on mothers’ access to information about these early behaviors. Future research is needed to quantify and better understanding Brazilian parents’ access to accurate and sound information related to young children’s physical activity and screen-viewing behaviors. Conclusions: To our knowledge, no existing research has examined how Brazilian immigrant mothers living in the United States obtain information about these behaviors. This information is crucial for the design of culturally appropriate early childhood obesity prevention interventions tailored to the specific needs of this ethnic group.

Keywords: physical activity, scree-time, information, immigrant, mothers, Brazilian, United States

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Authors: Yunhe Chen, Xinyun Liu, Qian Wang, Jianan Li

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Background Cochlear implants (CIs) are currently the primary effective treatment for severe or profound sensorineural hearing loss. As China's population ages and the number of young children rises, the demand for MRI for CI patients is expected to increase. Methods Reviewed MRI cases of 25 CI patients between 2015 and 2024, assessed imaging auditory outcomes and adverse reactions. Use the adverse event record sheet and accompanying medication sheet to record follow-up measures. Results Most CI patients undergoing MRI may face risks such as artifacts, pain, redness, swelling, tissue damage, bleeding, and magnet displacement or demagnetization. Twenty-five CI patients in our hospital were reviewed. Seven patient underwent 3.0 T MR, the others underwent 1.5 T MR. The manufacturers are 18 cases in Austria, 5 cases in Australia and 2 cases in Nurotron. Among them, one patient with bilateral CI underwent 1.5 T MR examination after head pressure bandaging, and the left magnet was displaced (CI24RE Series, Australia). This patient underwent surgical replacement of the magnet under general anesthesia. Six days after the operation, the patient's feedback indicated that the performance of the cochlear implant was consistent with the previous results following the reactivation of the external device. Based on the experience of our hospital, we proposed the feasible management scheme of MRI examination procedure for CI patients. This plan should include a module for confirming MRI imaging parameters, informed consent, educational materials for patients, and other safety measures to ensure that patients receive imaging results safely and effectively, implify clinical. Conclusion As indications for both MRI and cochlear implantation expand，the number of MRI studies recommended for patients with cochlear implants will also increase. The process and management scheme proposed in this study can help to obtain imaging results safely and effectively, and reduce clinical stress.

Keywords: cochlear implantation, MRI, magnet, displacement

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Authors: Yuwaratu Syafira, Wahyu K. Y. Putra, Kusharisupeni Djokosujono

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Background/Objective: Body Mass Index (BMI) serves various purposes, including measuring the prevalence of obesity in a population, and also in formulating a patient’s diet at a hospital, and can be calculated with the equation = body weight (kg)/body height (m)². However, the BMI of an individual with difficulties in carrying their weight or standing up straight can not necessarily be measured. The aim of this study was to form a prediction model for the BMI of young adult students of Public Health Faculty of University of Indonesia. Subject/Method: This study used a cross sectional design, with a total sample of 132 respondents, consisted of 58 males and 74 females aged 21- 30. The dependent variable of this study was BMI, and the independent variables consisted of sex and anthropometric measurements, which included ulna length, arm length, tibia length, knee height, mid-upper arm circumference, and calf circumference. Anthropometric information was measured and recorded in a single sitting. Simple and multiple linear regression analysis were used to create the prediction equation for BMI. Results: The male respondents had an average BMI of 24.63 kg/m² and the female respondents had an average of 22.52 kg/m². A total of 17 variables were analysed for its correlation with BMI. Bivariate analysis showed the variable with the strongest correlation with BMI was Mid-Upper Arm Circumference/√Ulna Length (MUAC/√UL) (r = 0.926 for males and r = 0.886 for females). Furthermore, MUAC alone also has a very strong correlation with BMI (r = 0,913 for males and r = 0,877 for females). Prediction models formed from either MUAC/√UL or MUAC alone both produce highly accurate predictions of BMI. However, measuring MUAC/√UL is considered inconvenient, which may cause difficulties when applied on the field. Conclusion: The prediction model considered most ideal to estimate BMI is: Male BMI (kg/m²) = 1.109(MUAC (cm)) – 9.202 and Female BMI (kg/m²) = 0.236 + 0.825(MUAC (cm)), based on its high accuracy levels and the convenience of measuring MUAC on the field.

Keywords: body mass index, mid-upper arm circumference, prediction model, ulna length

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Authors: Arjun Prakash, Samanvitha H.

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BACKGROUND: Breast cancer is the commonest malignancy among women globally, with an estimated incidence of 2.3 million new cases as of 2020, representing 11.7% of all malignancies. As per Globocan data 2020, it accounted for 13.5% of all cancers and 10.6% of all cancer deaths in India. Early diagnosis and treatment can improve the overall morbidity and mortality, which necessitates the importance of differentiating benign from malignant breast masses. OBJECTIVE: The objective of the present study was to evaluate and compare the role of Digital Mammography (DM), B mode Ultrasound (USG), Shear Wave Elastography (SWE) and Strain Elastography (SE) in differentiating benign and malignant breast masses (ACR BI-RADS 3 - 5). Histo-Pathological Examination (HPE) was considered the Gold standard. MATERIALS & METHODS: We conducted a cross-sectional study on 53 patients with 64 breast masses over a period of 10 months. All patients underwent DM, USG, SWE and SE. These modalities were individually assessed to know their accuracy in differentiating benign and malignant masses. All Digital Mammograms were done using the Fujifilm AMULET Innovality Digital Mammography system and all Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound system equipped with 2 to 9 MHz and 3 – 16 MHz linear transducers. All masses were subjected to HPE. Independent t-test and Chi-square or Fisher’s exact test were used to assess continuous and categorical variables, respectively. ROC analysis was done to assess the accuracy of diagnostic tests. RESULTS: Of 64 lesions, 51 (79.68%) were malignant and 13 (20.31%) (p < 0.0001) were benign. SE was the most specific (100%) (p < 0.0001) and USG (98%) (p < 0.0001) was the most sensitive of all the modalities. E max, E mean, E max ratio, E mean ratio and Strain Ratio of the malignant masses significantly differed from those of the benign masses. Maximum SWE value showed the highest sensitivity (88.2%) (p < 0.0001) among the elastography parameters. A combination of USG, SE and SWE had good sensitivity (86%) (p < 0.0001). CONCLUSION: A combination of USG, SE and SWE improves overall diagnostic yield in differentiating benign and malignant breast masses. Early diagnosis and treatment of breast carcinoma will reduce patient mortality and morbidity.

Keywords: digital mammography, breast cancer, ultrasound, elastography

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Authors: Fae Princess Bermudez

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Background: One of the least significant leads on a 12-lead electrocardiogram is the augmented right lead (aVR), as it is not as specific compared to the other leads. In this case series, the value of lead aVR, which is more often than not ignored, is highlighted. Three cases of aVR ST segment elevation on 12-lead electrocardiogram are described, with the end outcome of demise of all three patients. The importance of immediate revascularization is described to improve prognosis in this group of patients. Objectives: This case series aims to primarily present under-reported cases of isolated aVR ST-segrment elevation myocardial infarction (STEMI), their course and outcome. More specific aims are to identify the criteria in determination of isolated aVR STEMI, know its clinical significance, and determine appropriate management for patients with this ECG finding. Method: A short review of previous studies, case reports, articles and guidelines from 2011-2016 was done. The author reviewed available literature, sorted out those that proved to be significant for the presented cases, and described them in conjunction with the aforementioned cases. Findings: Based on the limited information on these rare or under-reported cases, it was found that isolated aVR STEMI had a poorer prognosis that led to significant mortality and morbidity of patients. The significance of aVR ST-elevation was that of an occlusion of the left coronary artery or a severe three-vessel disease in the presence of an Acute Coronary Syndrome. Guidelines from American Heart Association/American College of Cardiology Foundation in 2013 already recognized ST-elevation of lead aVR in isolation as a STEMI; hence, recommended that patients with this particular ECG finding should undergo reperfusion strategies to improve prognosis. Conclusion: The indispensability of isolated aVR ST-segment elevation on ECG should alert physicians, especially Emergency physicians, to the high probability of Acute Coronary Syndrome with a very poor prognosis. If this group of patients is not promptly managed, demise may ensue, with cardiogenic shock as the most probable cause. With this electrocardiogram finding, physicians must be quick to make clinical decisions to increase chances of survival of this group of patients.

Keywords: AVR ST-elevation, diffuse ST-segment depression, left coronary artery infarction, myocardial infarction

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Authors: Ben Khayut, Lina Fabri, Maya Avikhana

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The models of the modern Artificial Narrow Intelligence (ANI) cannot: a) independently and continuously function without of human intelligence, used for retraining and reprogramming the ANI’s models, and b) think, understand, be conscious, cognize, infer, and more in state of Uncertainty, and changes in situations, and environmental objects. To eliminate these shortcomings and build a new generation of Artificial Intelligence systems, the paper proposes a Conception, Model, and Method of Computational Psycholinguistic Cognitive Situational-Fuzzy Self-Controlled Brain and Mind System (CPCSFSCBMSUU) using a neural network as its computational memory, operating under uncertainty, and activating its functions by perception, identification of real objects, fuzzy situational control, forming images of these objects, modeling their psychological, linguistic, cognitive, and neural values of properties and features, the meanings of which are identified, interpreted, generated, and formed taking into account the identified subject area, using the data, information, knowledge, and images, accumulated in the Memory. The functioning of the CPCSFSCBMSUU is carried out by its subsystems of the: fuzzy situational control of all processes, computational perception, identifying of reactions and actions, Psycholinguistic Cognitive Fuzzy Logical Inference, Decision making, Reasoning, Systems Thinking, Planning, Awareness, Consciousness, Cognition, Intuition, Wisdom, analysis and processing of the psycholinguistic, subject, visual, signal, sound and other objects, accumulation and using the data, information and knowledge in the Memory, communication, and interaction with other computing systems, robots and humans in order of solving the joint tasks. To investigate the functional processes of the proposed system, the principles of Situational Control, Fuzzy Logic, Psycholinguistics, Informatics, and modern possibilities of Data Science were applied. The proposed self-controlled System of Brain and Mind is oriented on use as a plug-in in multilingual subject Applications.

Keywords: computational brain, mind, psycholinguistic, system, under uncertainty

Procedia PDF Downloads 177

Authors: Habtamu Wolde Engudai

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Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in pediatric intensive care unit (PICU). Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light, it has its own adverse effects, and hence, it is important to monitor the level of sedation and maintain an optimal level. Objectives: The objective is to assess the level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: A prospective observation study was conducted in the PICU of JUMC in September 2021 in 105 patients who were going to be admitted to the PICU aged less than 14 and with GCS >8. Data was collected by residents and nurses working in PICU. Data entry was done by Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts is going to be performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. The assumption of logistic regression and the result of the assumption will be checked. To find potential predictors, bi-variable logistic regression was used for each predictor and outcome variable. A p value of <0.05 was considered as statistically significant. Finally, findings have been presented using figures, AOR, percentages, and a summary table. Result: in this study, 105 critically ill children had been involved who were started on continuous or intermittent forms of sedative drugs. Sedation level was assessed using a comfort scale three times per day. Based on this observation, we got a 44.8% level of suboptimal sedation at the baseline, a 36.2% level of suboptimal sedation at eight hours, and a 24.8% level of suboptimal sedation at sixteen hours. There is a significant association between suboptimal sedation and duration of stay with mechanical ventilation and the rate of unplanned extubation, which was shown by P < 0.05 using the Hosmer-Lemeshow test of goodness of fit (p> 0.44).

Keywords: level of sedation, critically ill children, Pediatric intensive care unit, Jimma university

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Authors: Kalpana Goel

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Australian social work schools are finding it difficult to find appropriate placements for the increasing number of international students enrolled in their Master of Social Work qualifying (MSWQ) programs. Anecdotally, it has been noticed that fewer social work students are ready to work with older people whose numbers are rising globally. An innovative and unique placement for international students enrolled in the MSWQ at one Australian university was organised in partnership with a community-based service working with older clients to meet two objectives: increasing the number of suitable placements for international students and preparing social work students to work with older people. Creative activities and projects were designed to provide meaningful engagement and experience in working with older people in the community. Students participated in a number of projects that were matched with their interest and capability in a 500-hour placement. The students were asked to complete an online survey after all work for the placement had been completed. The areas of assessment were: self-perceived change in perception towards age and older people, valued field placement experiences including reflective practice, knowledge and skill development, and constraints and challenges experienced in the placement. Findings revealed students’ increased level of confidence in applying social work theory to practice, developing effective communication and interpersonal skills, and use of innovation and creativity in preparing well-being plans with older adults. Challenges and constraints related to their limited English language ability and lack of cultural knowledge of the host society. It was recognised that extra support for these students and more planning in the beginning phase of placement are vital to placement success. Caution in matching students with clients of similar cultural background must be exercised to ensure that there is equity in task allocation and opportunities for wider experiences.

Keywords: field placement, international students, older people, social work

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Authors: N. N. Mosola, S. J. Molete, L. S. Masoebe, M. Letsae

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Hand gesture recognition is a technique used to locate, detect, and recognize a hand gesture. Detection and recognition are concepts of Artificial Intelligence (AI). AI concepts are applicable in Human Computer Interaction (HCI), Expert systems (ES), etc. Hand gesture recognition can be used in sign language interpretation. Sign language is a visual communication tool. This tool is used mostly by deaf societies and those with speech disorder. Communication barriers exist when societies with speech disorder interact with others. This research aims to build a hand recognition system for Lesotho’s Sesotho and English language interpretation. The system will help to bridge the communication problems encountered by the mentioned societies. The system has various processing modules. The modules consist of a hand detection engine, image processing engine, feature extraction, and sign recognition. Detection is a process of identifying an object. The proposed system uses Canny pruning Haar and Haarcascade detection algorithms. Canny pruning implements the Canny edge detection. This is an optimal image processing algorithm. It is used to detect edges of an object. The system employs a skin detection algorithm. The skin detection performs background subtraction, computes the convex hull, and the centroid to assist in the detection process. Recognition is a process of gesture classification. Template matching classifies each hand gesture in real-time. The system was tested using various experiments. The results obtained show that time, distance, and light are factors that affect the rate of detection and ultimately recognition. Detection rate is directly proportional to the distance of the hand from the camera. Different lighting conditions were considered. The more the light intensity, the faster the detection rate. Based on the results obtained from this research, the applied methodologies are efficient and provide a plausible solution towards a light-weight, inexpensive system which can be used for sign language interpretation.

Keywords: canny pruning, hand recognition, machine learning, skin tracking

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Authors: Siswoyo Haryono

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Purpose – The fundamental goal of this research is to see if the integrative organizational behavior model can be used effectively in Islamic boarding schools. This paper also seeks to assess the effect of Islamic organizational culture, leadership, and spiritual intelligence on teachers' organizational commitment to Islamic Boarding schools. The goal of the mediation analysis is to see if the Islamic work ethic has a more significant effect on the instructors' organizational commitment than the direct effects of Islamic organizational culture, leadership, and Islamic spiritual intelligence. Design/methodology/approach – A questionnaire survey was used to obtain data from teachers at Islamic Boarding Schools. This study used the AMOS technique for structural equation modeling to evaluate the expected direct effect. To test the hypothesized indirect effect, employed Sobel test. Findings – Islamic organizational culture, Islamic leadership, and Islamic spiritual intelligence significantly affect Islamic work ethic. When it comes to Islamic corporate culture, Islamic leadership, Islamic spiritual intelligence, and Islamic work ethics have a significant impact. The findings of the mediation study reveal that Islamic organizational culture, leadership, and spiritual intelligence influences organizational commitment through Islamic work ethic. The total effect analysis shows that the most effective path to increasing teachers’ organizational commitment is Islamic leadership - Islamic work ethic – organizational commitment. Originality/value – This study evaluates the Integrative Model of Organizational Behavior by Colquitt (2016) applied in Islamic Boarding School. The model consists of contemporary leadership and individual characteristic as the antecedent. The mediating variables of the model consist of individual mechanisms such as trust, justice, and ethic. Individual performance and organizational commitment are the model's outcomes. These variables, on the other hand, do not represent the Islamic viewpoint as a whole. As a result, this study aims to assess the role of Islamic principles in the model. The study employs reliability and validity tests to get reliable and valid measures. The findings revealed that the evaluation model is proven to improve organizational commitment at Islamic Boarding School.

Keywords: Islamic leadership, Islamic spiritual intelligence, Islamic work ethic, organizational commitment, Islamic boarding school

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Authors: Pierre Mintom, William Djeukeu Asongni, Michelle Moni, William Dakam, Christine Fernande Nyangono Biyegue.

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Background: In order to prevent congestive heart failure, control of hypertension and hypercholesterolemia is necessary because those risk factors frequently occur in combination. Objective: The aim of the study is to determine the prevalence and risk factors of hypertension, hypercholesterolemia and double burden HTA-Hypercholesterolemia in patients with congestive heart failure. Methodology: A database of 98 patients suffering from congestive heart failure was used. The latter were recruited from August 15, 2017, to March 5, 2018, in the Cardiology department of Deido District Hospital of Douala. This database provides information on sociodemographic parameters, biochemical examinations, characteristics of heart failure and food consumption. ESC/ESH and NCEP-ATPIII definitions were used to define Hypercholesterolemia (total cholesterol ≥200mg/dl), Hypertension (SBP≥140mmHg and/or DBP≥90mmHg). Double burden hypertension-hypercholesterolemia was defined as follows: total cholesterol (CT)≥200mg/dl, SBP≥140mmHg and DBP≥90mmHg. Results: The prevalence of hypertension (HTA), hypercholesterolemia (hyperchol) and double burden HTA-Hyperchol were 61.2%, 66.3% and 45.9%, respectively. No sociodemographic factor was associated with hypertension, hypercholesterolemia and double burden, but Male gender was significantly associated (p<0.05) with hypercholesterolemia. HypoHDLemia significantly increased hypercholesterolemia and the double burden by 19.664 times (p=0.001) and 14.968 times (p=0.021), respectively. Regarding dietary habits, the consumption of rice, peanuts and derivatives and cottonseed oil respectively significantly (p<0.05) exposed to the occurrence of hypertension. The consumption of tomatoes, green bananas, corn and derivatives, peanuts and derivatives and cottonseed oil significantly exposed (p<0.05) to the occurrence of hypercholesterolemia. The consumption of palm oil and cottonseed oil exposed the occurrence of the double burden of hypertension-hypercholesterolemia. Consumption of eggs protects against hypercholesterolemia, and consumption of peanuts and tomatoes protects against the double burden. Conclusion: hypercholesterolemia associated with hypertension appears as a complicating factor of congestive heart failure. Key risk factors are mainly diet-based, suggesting the importance of nutritional education for patients. New management protocols emphasizing diet should be considered.

Keywords: risk factors, hypertension, hypercholesterolemia, congestive heart failure

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Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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