Search results for: common rail

Authors: Nicholas Agyepong, Paul Gyan

Abstract:

Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

Procedia PDF Downloads 49

Authors: V. V. Lakshmi, Y. V. S. Annapurna

Abstract:

Urinary tract infection (UTI) is one of the most common infectious diseases seen in the community. Susceptible individuals experience multiple episodes, and progress to acute pyelonephritis or uro-sepsis or develop asymptomatic bacteriuria (ABU). Ability to cause extraintestinal infections depends on several virulence factors required for survival at extraintestinal sites. Presence of virulence phenotypes enhances the pathogenicity of these otherwise commensal organisms and thus augments its ability to cause extraintestinal infections, the most frequent in urinary tract infections(UTI). The present study focuses on detection of the virulence characters exhibited by the uropathogenic organism and most common factors exhibited in the local pathogens. A total of 700 isolates of E.coli and Klebsiella spp were included in the study. These were isolated from patients from local hospitals reported to be suffering with UTI over a period of three years. Isolation and identification was done based on Gram character and IMVIC reactions. Antibiotic sensitivity profile was carried out by disc diffusion method and multi drug resistant strains with MAR index of 0.7 were further selected.. Virulence features examined included their ability to produce exopolysaccharides, protease- gelatinase production, hemolysin production, haemagglutination and hydrophobicity test. Exopolysaccharide production was most predominant virulence feature among the isolates when checked by congo red method. The biofilms production examined by microtitre plates using ELISA reader confirmed that this is the major factor contributing to virulencity of the pathogens followed by hemolysin production

Keywords: Escherichia coli, Klebsiella sp, Uropathogens, Virulence features.

Procedia PDF Downloads 421

Authors: Riikka Elina Kallio

Abstract:

“The walls have ears” phrase is defining the era of dictatorship in Portugal (1926–1974) and political unrest decades in Finland (1917–1948). The phrase is referring to the policing of the political, secret police, PIDE (Policia Internacional e de Defesa do Estado 1933–1969) in Portugal and VALPO (Valtiollinen Poliisi 1939–1948) in Finland. Free speech at any public space and even in private events could be fatal. The members of the PIDE/VALPO or informers/collaborators could be listening. Strict censorship under the Salazar´s regime was controlling media for example newspapers, music, and the film industry. Similarly, the politically affected censorship influenced the media in Finland in those unrest decades. This article examines the similarities and the differences in the images of the political police in Finland and Portugal, by analyzing Finnish and Portuguese films from the nineteen-thirties to nineteensixties. The text addresses two main research questions: what are the common and different features in the representations of the Finnish and Portuguese political police in films between the 1930s and 1960s, and how did the national censorship affect these representations? This study approach is interdisciplinary, and it combines film studies and criminology. Close reading is a practical qualitative method for analyzing films and in this study, close reading emphasizes the features of the police officer. Criminology provides the methodological tools for analysis of the police universal features and European common policies. The characterization of the police in this study is based on Robert Reiner´s 1980s and Timo Korander´s 2010s definitions of the police officer. The research material consisted of the Portuguese films from online film archives and Finnish films from Movie Making Finland -project´s metadata which offered suitable material by data mining the keywords such as poliisi, poliisipäällikkö and konstaapeli (police, police chief, police constable). The findings of this study suggest that even though there are common features of the images of the political police in Finland and Portugal, there are still national and cultural differences in the representations of the political police and policing.

Keywords: censorship, film studies, images, PIDE, political police, VALPO

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Authors: Protyoy Sen

Abstract:

Heritage conservation often holds different meanings and values for different people. To a cultural or architectural body it might be about protecting relics of the past, while for an government body or corporate it might be the value of the real estate which generates profits in terms of hospitality, tourism or some form of trade. But often, a significant proportion of the built fabric in our cities comprises of what usually does not come under the common lenses of collective heritage or conservation i.e. private houses. Standing ode to a bygone era of different communities, trades and practices that once inhabited the city, old private houses of certain architectural or historic character face the gravest challenges of heritage conservation. These – despite being significant to the heritage fabric of a city – neither get the social attention nor the financial aid for repair and periodic maintenance, that many monuments and public buildings do. The situation in India is no different. Private residences belonging to affluent families of an earlier time, today lie in varying degrees of neglect and dilapidation. With the growth of nuclear families, drastic change in people’s and expensive repairs of historic material fabric (amongst other reasons), houses of heritage value often become liabilities, and metaphorical to a white elephant in a poor man’s backyard. In a capitalistic setup that values time and money over everything, it is not reasonable that one justifies the conservation of individual / family assets solely through architectural, historical or cultural values. It is quite logical them, that the houseowner – in most cases, a layperson – must be made to understand of both tangible and intangible values in order to (1) take the trouble of the effort, resources and aid (if possible) to repair and maintain a house of heritage character and, (2) choose to invest into a building that today might’ve lost its practical relevance, over demolishing and building new. The question that still remains is – Why? If heritage conservation is to be seen as an economically viable and realistic building activity, it must shed its image of being an ‘elitist, cultural pursuit’ in the eyes of the common person. Through contextual studies of historic areas in Ahmedabad and Calcutta, reading of theoretical pieces on the subject and conversations with multiple stakeholders, this study intended to justify the act of heritage conservation to the common person – one who is assumed to have no particular sensitivity towards architectural or cultural value, and rather questions what these buildings tangibly bring to the table. The theoretical frameworks (taken from literature) are then tested through actual case studies in Indian cities, followed by an elaborate inference on the subject.

Keywords: heritage values, heritage houses, private ownership, unprotected heritage

Procedia PDF Downloads 57

Authors: Jovana Jankovic Pantic, Dragoslav Rakic, Tina Djuric, Irena Basaric Ikodinovic, Snezana Bogdanovic

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Regardless of the numerous activities undertaken to reduce municipal solid waste, its annual volumes continue to grow. In Serbia, the most common and the only one form of waste disposal is at municipal landfills with daily compaction and soil covering. Municipal waste compacting is one of the basic components of the disposal process. Well compacted waste takes up less volume and allows much safer storage. In order to better predict the behavior of municipal waste at landfills, it is necessary to define compaction parameters: the maximum dry unit weight and optimal moisture content. In current geotechnical practice, the most common method of determination compaction parameters is by the standard method (Proctor compaction test) used in soil mechanics, with an eventual reduction of compaction energy. Although this methodology is accepted in newer geotechnical scientific discipline "waste mechanics", different treatments of municipal waste at the landfill itself (including pretreatment), indicate the need to change this classical approach. The main reason for that is the simulation of the operation of compactors (hedgehogs) at the landfill. Therefore, during the research, various innovative solutions are introduced, such as changing the classic flat Proctor hammer, by adding spikes, whose function is, in addition to compaction, destruction and shredding of municipal waste. The paper presents the behavior of municipal waste for four synthetic waste samples with different waste compositions (Plandište landfill). The samples were tested in standard Proctor apparatus at the same compaction energy, but with two different hammers: standard flat hammer and hammer with spikes.

Keywords: compaction, hammer with spikes, landfill, municipal solid waste, proctor compaction test

Procedia PDF Downloads 225

Authors: V. V. Lakshmi, Y. V. S. Annapurna

Abstract:

Urinary tract infection (UTI) is one of the most common infectious diseases seen in the community. Susceptible individuals experience multiple episodes, and progress to acute pyelonephritis or uro-sepsis or develop asymptomatic bacteriuria (ABU). Ability to cause extraintestinal infections depends on several virulence factors required for survival at extraintestinal sites. Presence of virulence phenotypes enhances the pathogenicity of these otherwise commensal organisms and thus augments its ability to cause extraintestinal infections, the most frequent in urinary tract infections(UTI). The present study focuses on detection of the virulence characters exhibited by the uropathogenic organism and most common factors exhibited in the local pathogens. A total of 700 isolates of E.coli and Klebsiella spp were included in the study.These were isolated from patients from local hospitals reported to be suffering with UTI over a period of three years. Isolation and identification was done based on Gram character and IMVIC reactions. Antibiotic sensitivity profile was carried out by disc diffusion method and multi drug resistant strains with MAR index of 0.7 were further selected. Virulence features examined included their ability to produce exopolysaccharides, protease- gelatinase production, hemolysin production, haemagglutination and hydrophobicity test. Exopolysaccharide production was most predominant virulence feature among the isolates when checked by congo red method. The biofilms production examined by microtitre plates using ELISA reader confirmed that this is the major factor contributing to virulencity of the pathogens followed by hemolysin production.

Keywords: Escherichia coli, Klebsiella spp, Uropathogens, virulence features

Procedia PDF Downloads 320

Authors: Jacob J. Shila, Xiaoyu O. Wu

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As the applications of unmanned aerial vehicles (UAV) continue to increase across the world, it is critical to understand the factors that contribute to incidents and accidents associated with these systems. Given the variety of daily applications that could utilize the operations of the UAV (e.g., medical, security operations, construction activities, landscape activities), the main discussion has been how to safely incorporate the UAV into the national airspace system. The types of UAV incidents being reported range from near sightings by other pilots to actual collisions with aircraft or UAV. These incidents have the potential to impact the rest of aviation operations in a variety of ways, including human lives, liability costs, and delay costs. One of the largest causes of these incidents cited is the human factor; other causes cited include maintenance, aircraft, and others. This work investigates the key human factors associated with UAV incidents. To that end, the data related to UAV incidents that have occurred in the United States is both reviewed and analyzed to identify key human factors related to UAV incidents. The data utilized in this work is gathered from the Federal Aviation Administration (FAA) drone database. This study adopts the human factor analysis and classification system (HFACS) to identify key human factors that have contributed to some of the UAV failures to date. The uniqueness of this work is the incorporation of UAV incident data from a variety of applications and not just military data. In addition, identifying the specific human factors is crucial towards developing safety operational models and human factor guidelines for the UAV. The findings of these common human factors are also compared to similar studies in other countries to determine whether these factors are common internationally.

Keywords: human factors, incidents and accidents, safety, UAS, UAV

Procedia PDF Downloads 244

Authors: L. M. Al-Harbi, A. M. Shokry, J. S. M. Sabir, A. Chaudhary, J. Manikandan, K. S. Saini

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Breast cancer is the second most common cause of cancer death worldwide and is the most common malignancy among Saudi females. During breast carcinogenesis, a wide-array of cytogenetic changes involving deletions, or amplification, or translocations, of part or whole of chromosome regions have been observed. Because of the limitations of various earlier technologies, newer tools are developed to scan for changes at the genomic level. Recently, Array Comparative Genomic Hybridization (aCGH) technique has been applied for detecting segmental genomic alterations at molecular level. In this study, aCGH was performed on twenty breast cancer tumors and their matching non-tumor (normal) counterparts using the Agilent 2x400K. Several regions were identified to be either amplified or deleted in a tumor-specific manner. Most frequent alterations were amplification of chromosome 1q, chromosome 8q, 20q, and deletions at 16q were also detected. The amplification of genetic events at 1q and 8q were further validated using FISH analysis using probes targeting 1q25 and 8q (MYC gene). The copy number changes at these loci can potentially cause a significant change in the tumor behavior, as deletions in the E-Cadherin (CDH1)-tumor suppressor gene as well as amplification of the oncogenes-Aurora Kinase A. (AURKA) and MYC could make these tumors highly metastatic. This study validates the use of aCGH in Saudi breast cancer patients and sets the foundations necessary for performing larger cohort studies searching for ethnicity-specific biomarkers and gene copy number variations.

Keywords: breast cancer, molecular biology, ecology, environment

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Authors: Titap Yazicioglu

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Purpose: To determine the etiological factors responsible for the eye removal surgery and to evaluate our surgical results. Material and Methods: Medical records of 226 patients, who underwent eye removal surgery, were analyzed retrospectively. Demographic information, clinical history, surgical procedure, and histopathological data were all collected. Evisceration surgery was performed under general anesthesia in all patients except tumor cases and one patient with rhino-orbital mucormycosis. The patients were followed for an average of 16.46±10.78 months and checked for the possible complications, cosmesis, and functional results.Results: 144 men, and 82 women,with a mean age of 41.78±22.6 years, were underwent enucleation (n=15) or evisceration (n=211) due to traumatic (n=169) and non-traumatic (n=57) causes. In the traumatic group, 79.8% of 169 patients were injured by penetrating and 14.2% by blunt trauma.3.6% of the patients were injured in a traffic accident, and 2.4% of them were injured by explosives. In the non-traumatic group, 40% of 25 patients had post-traumatic endophthalmitis, 32% had endophthalmitis due to corneal ulceration and melting, and 24% had endophthalmitis after cataract surgery. One patient had panophthalmitis due to rhino-orbital mucormycosis. Another cause in the non-traumatic group was glaucoma, of which 92.3% had neovascular glaucoma, and 8.7% had congenital glaucoma. Of the 14 patients who were enucleated for tumor, 35.7% had retinoblastoma, 14.3% had medulloepithelioma, 42.9% had uveal melanoma, and 7.1% had metastatic tumor from paranasal sinuses.The most common complaint in the follow-up period was discharging, seen in all prosthesis-wearing patients. 13.3% of the patients had itching due to ocular prosthesis. 4.4% of the patients were complaining about deep superior sulcus. 4.4% had pyogenic granuloma, and 17.8% had implant exposure. Conclusion: Etiological factors should be carefully evaluated, and precautions should be taken in order to reduce the devastating effect of the physical loss of the eye.

Keywords: enucleation, evisceration, ocular injury, etiology, frequency

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Authors: Juliani Rianto, Emma Lumby, Tracey Smith

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Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.

Keywords: cancer, exercises, benefit, mental health

Procedia PDF Downloads 60

Authors: Magdy Al Shourbagi

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Diabetes mellitus is the commonest cause of neuropathy. The common pattern is a distal symmetrical sensory polyneuropathy, associated with autonomic disturbances. Less often, Diabetes mellitus is responsible for a focal or multifocal neuropathy. Common causes for non-healing of diabetic foot are the infection and ischemia. Diabetes mellitus is associated with a defective cellular and humoral immunity. Particularly, decreased phagocytosis, decreased chemotaxis, impaired bacterial killing and abnormal lymphocytic function resulting in a reduced inflammatory reaction and defective wound healing. Hyperbaric oxygen therapy is defined by the Undersea and Hyperbaric Medical Society as a treatment in which a patient intermittently breathes 100% oxygen and the treatment chamber is pressurized to a pressure greater than sea level (1 atmosphere absolute). The pressure increase may be applied in mono-place (single person) or multi-place chambers. Multi-place chambers are pressurized with air, with oxygen given via face mask or endotracheal tube; while mono-place chambers are pressurized with oxygen. Oxygen gas plays an important role in the physiology of wound healing. Hyperbaric oxygen therapy can raise tissue oxygen tensions to levels where wound healing can be expected. HBOT increases the killing ability of leucocytes also it is lethal for certain anaerobic bacteria and inhibits toxin formation in many other anaerobes. Multiple anecdotal reports and studies in HBO therapy in diabetic patients report that HBO can be an effective adjunct therapy in the management of diabetic foot wounds and is associated with better functional outcomes.

Keywords: hyperbari oxygen therapy, diabetic foot, neuropathy, multiplace chambers

Procedia PDF Downloads 292

Authors: Deependra Prasad Sarraf, Gajendra Prasad Rauniar, Robin Maskey, Rajiv Maharjan, Ashish Shrestha, Ramayan Prasad Kushwaha

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Objectives: To assess the perception of faculties towards online teaching-learning activities conducted during the COVID-19 pandemic and to identify barriers and facilitators to conducting online teaching-learning activities in our context. Methods: A cross-sectional study was conducted among faculties at B. P. Koirala Institute of Health Sciences using a 26-item semi-structured questionnaire. A Google Form was prepared, and its link was sent to the faculties via email. Descriptive statistics were calculated, and findings were presented as tables and graphs. Results: Out of 158 faculties, the majority were male (66.46%), medical faculties (85.44%), and assistant professors (46.84%). Only 16 (10.13%) faculties had received formal training regarding preparing and/or delivering online teaching learning activities. Out of 158, 133 (84.18%) faculties faced technical and internet issues. The most common advantage and disadvantage of online teaching learning activities perceived by the faculties were ‘not limited to time or place’ (94.30%) and ‘lack of interaction with the students’ (82.28%), respectively. Majority (94.3%) of them had a positive perception towards online teaching-learning activities conducted during COVID-19 pandemic. Slow internet connection (91.77%) and frequent electricity interruption (82.91%) were the most common perceived barriers to online teaching-learning. Conclusions: Most of the faculties had a positive perception towards online teaching-learning activities. Academic leaders and stakeholders should provide uninterrupted internet and electricity connectivity, training on online teaching-learning platform, and timely technical support.

Keywords: COVID-19 pandemic, faculties, medical education, perception

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Authors: B. S. Yadav, A. Mani, S. Srivastava

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Chickpea (Cicer arietinum L.) is an annual, self-pollinating, diploid (2n = 2x = 16) pulse crop that ranks second in world legume production after common bean (Phaseolus vulgaris). ICC 4958 flowers approximately 39 days after sowing under peninsular Indian conditions and the crop matures in less than 90 days in rained environments. The estimated collective yield losses due to abiotic stresses (6.4 million t) have been significantly higher than for biotic stresses (4.8 million t). Most legumes are known to be salt sensitive, and therefore, it is becoming increasingly important to produce cultivars tolerant to high-salinity in addition to other abiotic and biotic stresses for sustainable chickpea production. Our aim was to identify the genes that are involved in the defence mechanism against heavy metal toxicity in chickpea and establish the biological network of heavy metal toxicity in chickpea. ICC4958 variety of chick pea was taken and grown in normal condition and 150µM concentration of different heavy metal salt like CdCl₂, K₂Cr2O₇, NaAsO₂. At 15th day leave samples were collected and stored in RNA Later solution microarray was performed for checking out differential gene expression pattern. Our studies revealed that 111 common genes that involved in defense mechanism were up regulated and 41 genes were commonly down regulated during treatment of 150µM concentration of CdCl₂, K₂Cr₂O₇, and NaAsO₂. Biological network study shows that the genes which are differentially expressed are highly connected and having high betweenness and centrality.

Keywords: abiotic stress, biological network, chickpea, microarray

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Authors: Elad Vashdi

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It is common to find speech deficit among children diagnosed with Autism. It can be found in the clinical field and recently in research. One of the DSM-V criteria suggests a speech delay (Delay in, or total lack of, the development of spoken language), but doesn't explain the cause of it. A common perception among professionals and families is that the inability to talk results from the autism. Autism is a name for a syndrome which just describes a phenomenon and is defined behaviorally. Since it is not based yet on a physiological gold standard, one can not conclude the nature of a deficit based on the name of the syndrome. A wide retrospective research (n=270) which included children with motor speech difficulties was conducted in Israel. The study analyzed entry evaluations in a private clinic during the years 2006-2013. The data was extracted from the reports. High percentage of children diagnosed with Autism (60%) was found. This result demonstrates the high relationship between Autism and motor speech problem. It also supports recent findings in research of Childhood apraxia of speech (CAS) occurrence among children with ASD. Only small percentage of the participants in this research (10%) were diagnosed with CAS even though their verbal deficits well fitted the guidelines for CAS diagnosis set by ASHA in 2007. This fact raises questions regarding the diagnostic procedure in Israel. The understanding that CAS might highly exist within Autism and can have a remarkable influence on the course of early development should be a guiding tool within the diagnosis procedure. CAS can explain the nature of the speech problem among some of the autistic children and guide the treatment in a more accurate way. Calculating the prevalence of CAS which includes the comorbidity with ASD reveals new numbers and suggests treating differently the CAS population.

Keywords: childhood apraxia of speech, Autism, treatment, speech

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Authors: Aikaterini Tsalampouni

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The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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Authors: Lakmali Anthony, Madeline Gillies

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Purpose: Decreasing mortality has led to increased focus on patient-reported outcomes such as quality of life (QoL) in breast cancer. Breast cancer patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment breast cancer patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 3,150 total participants (mean = 197) with a mean age of 51.9 years. There was substantial heterogeneity in measures of QoL. The most common was the European Organisation for Research and Treatment of Cancer QLQ-C30 (n=7, 41.1%). Most studies (n=12, 70.5%) found that emotional distress correlated with poor QoL, while 3 found no significant association. The most common measure of emotional distress was the Hospital Anxiety and Depression Scale (n=12, 70.5%). Other psychosocial factors associated with QoL were unmet needs, problematic social support, and negative affect. Clinicopathologic determinants included mastectomy without reconstruction, stage IV disease, and adjuvant chemotherapy. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment breast cancer patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: breast cancer, quality of life, psychosocial determinants, cancer surgery

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Authors: Ahmed El-Sabbagh, Heba Mansour, Magdy El-Hedeny

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This study provided a taphonomic alteration and paleoecology of Cenomanian oysters from the Musabaa Salama area, south western Sinai, Egypt. Three oyster zones can be recognized in the studied area, a lower one of Amphidonte (Ceratostreon) flabellatum (lower-middle Cenomanian), a middle zone of Ilymatogyra (Afrogyra) africana (upper Cenomanian) and an upper one of Exogyra (Costagyra) olisiponensis (upper Cenomanian). Taphonomic features including disarticulation, fragmentation, encrustation and bioerosion were subjected to multivariate statistical analyses. The analyses showed that the distributions of the identified ichnospecies were greatly similar within the identified oyster zones in the Musabaa Salama section. With rare exceptions, Entobia cretacea, Gastrochaenolites torpedo and Maeandropolydora decipiens are considered as common to abundant ichnospecies within the three recorded oyster zones. In contrast, and with some exceptions, E. ovula, E. retiformis and Rogerella pattei are considered as frequent to common ichnospecies within the identified oyster zones. Other ichnospecies, including Caulostrepsis cretacea, G. orbicularis, Trypanites solitarius, E. geometrica and C. taeniola, are mostly recorded in rare to frequent occurrences. Careful investigation of these host shells and the preserved encrusters and/or bioerosion sculptures provided data concerning: 1) the substrate characteristics, 2) time of encrustation and bioerosion, 3) rate of sedimentation, 4) the planktonic productivity level, and 5) the general bathymetry and the rate of transgression across the substrate.

Keywords: oysters, Cenomanian, taphonomy, palaeoecology, Sinai, Egypt

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Authors: Hassan Samadi, Mustapha El Jarroudi

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In this work, we consider the homogenization of a non-linear problem in periodic medium with two periodic connected media exchanging a heat flux throughout their common interface. The interfacial exchange coefficient λ is assumed to tend to zero or to infinity following a rate λ=λ(ε) when the size ε of the basic cell tends to zero. Three homogenized problems are determined according to some critical value depending of λ and ε. Our method is based on Γ-Convergence techniques.

Keywords: variational methods, epiconvergence, homogenization, convergence technique

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Authors: Nazneen Zehra

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Gir Protected Area (PA) is home to two sympatric large carnivores, the Asiatic lion and the common leopard, which share the same habitat. Understanding their interactions and coexistence is crucial for effective conservation management. From 2009 to 2012, we studied the availability and consumption of prey by these two carnivores to understand the dynamics of their interactions and coexistence. Ungulates provided approximately 3634.45 kg/km² of prey biomass, primarily composed of chital (ca. 2711.25 kg/km²), sambar (ca. 411.78 kg/km²), and nilgai (ca. 511.52 kg/km²). Other prey included peafowl (75.76 kg/km²) and langur (ca. 158.72 kg/km²). Both carnivores prioritized chital as their key prey species. The diet of Asiatic lions was predominantly composed of ungulates, with biomass contributions of chital (301.14 kg), sambar (378.75 kg), and nilgai (291.42 kg). Other prey species, such as peafowl and langur, contributed 1.36 kg and 2.40 kg, respectively, to the lions' diet. For leopards, the diet also heavily relied on chital (311.49 kg), followed by sambar (44.03 kg) and nilgai (172.78 kg). The biomass of other prey species in the leopards' diet included peafowl (2.08 kg) and langur (36.07 kg). Both species were found to primarily utilize teak-mixed forest, followed by riverine forest and teak-acacia-zizyphus habitats. The similarities in diet composition and habitat use indicate competition between these sympatric species. This competition may require one predator species to bear certain costs for the benefit of the other, which can influence conservation and management strategies. Effective conservation strategies are necessary to ensure the long-term survival of both the Asiatic lion and the common leopard equally and to maintain ecological balance in Gir PA.

Keywords: large carnivores, Gir PA, coexistence, resource utilization

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Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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Authors: J. F. Gonzalez-Rojo, Federico Lluesma-Rodriguez, Temoatzin Gonzalez

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Hyperloop, a new mode of transport, is gaining significance. It consists of the use of a ground-based transport system which includes a levitation system, that avoids rolling friction forces, and which has been covered with a tube, controlling the inner atmosphere lowering the aerodynamic drag forces. Thus, hyperloop is proposed as a solution to the current limitation on ground transportation. Rolling and aerodynamic problems, that limit large speeds for traditional high-speed rail or even maglev systems, are overcome using a hyperloop solution. Zeleros is one of the companies developing technology for hyperloop application worldwide. It is working on a concept that reduces the infrastructure cost and minimizes the power consumption as well as the losses associated with magnetic drag forces. For this purpose, Zeleros proposes a Hybrid ElectroMagnetic Suspension (EMS) for its prototype. In the present manuscript an active and optimal electromagnetic suspension levitation method based on nearly zero power consumption individual modules is presented. This system consists of several hybrid permanent magnet-coil levitation units that can be arranged along the vehicle. The proposed unit manages to redirect the magnetic field along a defined direction forming a magnetic circuit and minimizing the loses due to field dispersion. This is achieved using an electrical steel core. Each module can stabilize the gap distance using the coil current and either linear or non-linear control methods. The ratio between weight and levitation force for each unit is 1/10. In addition, the quotient between the lifted weight and power consumption at the target gap distance is 1/3 [kg/W]. One degree of freedom (DoF) (along the gap direction) is controlled by a single unit. However, when several units are present, a 5 DoF control (2 translational and 3 rotational) can be achieved, leading to the full attitude control of the vehicle. The proposed system has been successfully tested reaching TRL-4 in a laboratory test bench and is currently in TRL-5 state development if the module association in order to control 5 DoF is considered.

Keywords: active optimal control, electromagnetic levitation, HEMS, high-speed transport, hyperloop

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Authors: Monika Szymańska-Czerwińska, Agnieszka Jodełko, Krzysztof Niemczuk

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Q fever (coxiellosis) is an infectious disease of animals and humans causes by C. burnetii and widely distributed throughout the world. Cattle and small ruminants are commonly known as shedders of C. burnetii. The aims of this study were the evaluation of seroprevalence and shedding of C. burnetii in cattle. Genotypes of the pathogen present in the tested specimens were also identified using MLVA (Multiple Locus Variable-Number Tandem Repeat Analysis) and MST (multispacer sequence typing) methods. Sampling was conducted in different regions of Poland in 2018-2021. In total, 2180 bovine serum samples from 801 cattle herds were tested by ELISA (enzyme-linked immunosorbent assay). 489 specimens from 157 cattle herds such as: individual milk samples (n=407), bulk tank milk (n=58), vaginal swabs (n=20), placenta (n=3) and feces (n=1) were subjected to C. burnetii specific qPCR. The qPCR (IS1111 transposon-like repetitive region) was performed using Adiavet COX RealTime PCR kit. Genotypic characterization of the strains was conducted utilizing MLVA and MST methods. MLVA was performed using 6 variable loci. The overall herd-level seroprevalence of C. burnetii infection was 36.74% (801/2180). Shedders were detected in 29.3% (46/157) cattle herds in all tested regions. ST 61 sequence type was identified in 10 out of 18 genotyped strains. Interestingly one strain represents sequence type which has never been recorded previously. MLVA method identified three previously known genotypes: most common was J but also I and BE were recognized. Moreover, a one genotype has never been described previously. Seroprevalence and shedding of C. burnetii in cattle is common and strains are genetically diverse.

Keywords: Coxiella burnetii, cattle, MST, MLVA, Q fever

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Authors: Anela Lupuwana

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The main objective of this paper is to develop an ethnobotanical survey that documents medicinal plants used to treat diarrhea among infants in the Eastern Cape province of South Africa. In South Africa’s pluralistic healthcare system, medicinal plants are an integral part of healing and treating an array of diseases. This is also the case in rural areas of South Africa, where healthcare facilities are hard to access. There is a lack of literature on the use of medicinal plants to cure ailments common to children, and this paper fills this gap. A total of 18 participants were interviewed using semi-structured interviews. A purposive approach was used to sample the study cohorts. A total of 28 medicinal plants representing 19 different families were recorded, with the family Asteraceae (11%) having the most medicinal plants. The remaining plants (82%) were distributed equally among the following families: Rubiaceae, Canellaceae, Aloaceae, Rutaceae, Thymeleaceae, Myrinaceae, Olinaceae, Iradeceae, Zingiberaceae, Capparaceae, Aizoaceae, Fabaceae, Geraniaceae, Cornaceae, Monimiaceae, Talinaceae, Chrysobalanaceae, and Icacinaceae. Oral administration was the most common mode of administration, with 82% of plants taken orally. Healing was proven to be holistic; it was more than just treating physical ailments as such; infants were protected from evil spirits that made them vulnerable to illnesses. There was also evidence of the assimilation of Dutch medicine and animal products into traditional healing methods. In order to mitigate the prevalence of disease and illness in South Africa, I recommend that diversity in healing practices should be acknowledged and appreciated.

Keywords: infants, traditional healers, primary care givers, traditional medicine

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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Authors: Marzieh Imani

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Antoni Gaudi and Santiago Calatrava have reputation for designing bio-inspired creative and technical buildings. Even though they have followed different independent approaches towards design, the source of bio-inspiration seems to be common. Taking a closer look at their projects reveals that Calatrava has been influenced by Gaudi in terms of interpreting nature and applying natural principles into the design process. This research firstly discusses the dialogue between Biomimicry and architecture. This review also explores human/nature discourse during the history by focusing on how nature revealed itself to the fine arts. This is explained by introducing naturalism and romantic style in architecture as the outcome of designers’ inclination towards nature. Reviewing the literature, theoretical background and practical illustration of nature have been included. The most dominant practical aspects of imitating nature are form and function. Nature has been reflected in architectural science resulted in shaping different architectural styles such as organic, green, sustainable, bionic, and biomorphic. By defining a set of common aspects of Gaudi and Calatrava‘s design approach and by considering biomimetic design categories (organism, ecosystem, and behaviour as the main division and form, function, process, material, and construction as subdivisions), Gaudi’s and Calatrava’s project have been analysed. This analysis explores if their design approaches are equivalent or different. Based on this analysis, Gaudi’s architecture can be recognised as biomorphic while Calatrava’s projects are literally biomimetic. Referring to these architects, this review suggests a new set of principles by which a bio-inspired project can be determined either biomorphic or biomimetic.

Keywords: biomimicry, Calatrava, Gaudi, nature

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Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain

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Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.

Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India

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Authors: Khalid Al Saleh, Najlaa AlSayed

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Background: Palliative care is changing from just ‘end of life care’ to care delivered earlier in the disease course. Metanalysis showed that Palliative Performance Scale (PPS) is associated with increased length of survival. The Palliative Care Center (PCC) in Kuwait is the only stand-alone center in Eastern Mediterranean Region with a capacity of 92 beds. We compared clinical characteristics between patients referred from the Specialized Cancer Center and general hospitals in Kuwait to PCC. Method: A cross Sectional survey was conducted since the opening of PCC in January 2011 to June 2013. Patients’ data on demographics, type of the cancer, PPS score and referring hospital were collected and analyzed. Results: Total number of the patients was 142. Mean age was 61.05±14.79 years, 66 patients (47.1%) were males and 74 (52.9%) were females. The most common cancers in males were lung (n=18, 27.3%) followed by head and neck cancers (n=8, 12.1%) and brain tumors (n=7, 10.6%) while in females, the most common cancers were breast cancer (n=12, 16.7%) followed by ovarian cancer (n=10, 13.9%) and Cancer Colon (n=8, 11.1%). Patients with PPS score 30% were 27.9% (n=39), 40% in 40.7% (n=57), and 50% in 17.1% (n=24) respectively. Patients referred from the Specialized Cancer Center had significantly higher portion of patients with PPS score > 30% (73.4%, n=94), compared to patients coming from general hospitals (33.3%, n=4), P value= 0.007. Conclusion: There is significant difference in PPS scores between patients referred from the Specialized Cancer Center compared to patients referred from general hospitals. We encourage that all cancer patients should be treated in Specialized Cancer Centers and earlier involvement of Palliative Care Centers to achieve better survival. Training workshops are needed for health care professionals working in general hospitals to raise awareness about earlier referral of patients to palliative care services.

Keywords: palliative care, kuwait, performance scale differences, pps score, specialized hospitals

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Authors: Tapiwa Shumba, Nyaradzo D. T. Karubwa

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Dispute resolution is the plinth of regional integration initiatives anchored on the rule of law and compliance with obligations. Without effective and reliable despite resolution mechanisms, it may be difficult to foster deeper integration. Within the Southern African Development Community (SADC) legal and institutional framework exists an apparent recognition that dispute resolution is an integral part of the regional integration. Almost all legal instruments of SADC include some provision for dispute resolution. Institutionally, the somewhat now defunct SADC Tribunal is meant to be the fulcrum for resolving disputes that arise under SADC instruments. However, after a closer analysis of the substance of these legal provisions and the attendant procedural mechanisms for addressing disputes, an argument can be made that dispute resolution in SADC is somewhat scant, fragmented and neglected. In most instruments, the common provision on dispute resolution appears to be a ‘mid-night clause’. In other instruments which have specialised provisions and procedures, questions of practicality and genius cannot be avoided. Worse still there now appears to be a lack of magnanimity between the substantive provisions in various instruments and the role of the transformed Tribunal. This scant, fragmented and neglected dispute resolution system may have an impact on the observance of the rule of law and compliance with obligations in the rules-based SADC system. This all, in turn, has an effect on the common agenda for deeper regional integration. This article seeks to expose this scant, fragmented and neglected SADC dispute resolution system and to propose a harmonised system that addresses these challenges. A ‘one stop shop’ system under a strengthened SADC tribunal is proposed as a responsive solution.

Keywords: regional integration, harmonisation, SADC tribunal, dispute resolution

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